Some overweight and obese individuals are more likely to engage in “self-stigmatization,” in which they internalize their weight stigma experiences and begin to blame and devalue themselves.
In a new study of more than 18,000 adults, researchers from Penn Medicine and the University of Connecticut Rudd Center for Food Policy and Obesity wanted to better understand who is at greater risk for this type of behavior, which has been associated with poor mental and physical health.
Their findings show that participants who reported experiencing weight stigma from others — particularly from people they know such as family, friends and coworkers — had higher levels of internalized weight bias than those who reported no experiences of weight stigma.
The study is published in the journal Obesity Science and Practice.
In addition, those who internalized weight bias the most tended to be younger, female, have a higher body mass index (BMI), and have an earlier onset of their weight struggle. Participants who were black or had a romantic partner had lower levels of internalization.
“We don’t yet know why some people who struggle with their weight internalize society’s stigma and others do not,” said the study’s lead author, Rebecca Pearl, Ph.D., an assistant professor of psychology in psychiatry in the Perelman School of Medicine at the University of Pennsylvania.
“These findings represent a first step toward helping us identify, among people trying to manage their weight, who may be most likely to self-stigmatize. People who are trying to lose weight may be among the most vulnerable to weight self-stigma, but this issue is rarely discussed in treatment settings.”
In this study, the researchers surveyed surveyed more than 18,000 adults enrolled in the commercial weight management program WW International (formerly Weight Watchers Inc.) in order to identify the key characteristics and experiences of people who internalize weight bias. The study is the largest investigation of weight self-stigma to date.
The participants recalled when they had experienced weight stigma from other people during their lifetime, how frequent and how upsetting the experiences were, and who it was that called them names, rejected them, or denied them an opportunity simply because of their weight.
The results show that nearly two-thirds of the participants reported experiencing weight stigma at least once in their life, and almost half reported experiencing these events when they were children or teens. The researchers looked at the relationships between these experiences and levels of self-directed stigma.
Participants who reported experiencing weight stigma from others had higher levels of internalized weight bias than those who reported no experiences of weight stigma.
This link was even stronger among participants who had weight-stigmatizing experiences early in life and who continued to have these upsetting experiences as adults. Those who experienced weight stigma from family members or friends, or from those in their workplace, community, or health care setting, also had greater evidence of weight self-stigma compared to participants who did not encounter weight stigma from those sources.
“Our findings can inform ways to support people who are experiencing or internalizing weight stigma, including opportunities to address weight stigma as part of weight management and healthy lifestyle programs,” said principal investigator Rebecca Puhl, Ph.D., a professor of Human Development and Family Sciences at the University of Connecticut.
The study sample represented only a small percentage of WW members, so the findings may not generalize to all members or to adults trying to lose weight in other ways. Some previous research has suggested that people who internalize weight bias may have worse long-term weight loss outcomes, but more research on this topic is needed.
The research team is developing a psychological intervention for weight self-stigma that can be incorporated into weight management.