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Behavior, Psychology and Sociology

Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review

International Journal of Obesity volumeĀ 46,Ā pages 1ā€“9 (2022)Cite this article

Subjects

Abstract

Objective

To systematically review studies that have assessed the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and any biopsychosocial outcomes.

Methods

PsycINFO, PsycExtra, Web of Science, CINAHL, Medline and Embase were systematically searched. Identified studies were double screened (HB and XPG).

Results

Seventeen studies (across 16 articles) met our inclusion criteria (Nā€‰=ā€‰21,172), and almost all studies measured only psychological outcomes (nā€‰=ā€‰15). Eight studies found consistent evidence for internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and disordered eating outcomes. Preliminary evidence was found for the mediating role of internalised weight stigma on the relationship between experienced/perceived weight stigma and body shame, body dissatisfaction, exercise behaviour, healthcare experiences and behaviours, bodily pain and parental weight talk. However, the findings were inconsistent for depression and anxiety, although only two studies reported these.

Conclusion

This review provides preliminary evidence for internalised weight stigma as an intervening variable in the relationship between experienced/perceived weight stigma and adverse health outcomes. Results suggest that there are potential benefits of interventions addressing internalised weight stigma to improve health outcomes. However, these findings must be considered in the context of the psychometric limitations of the Weight Bias Internalisation Scale, which was used in all but one study.

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Fig. 1: Internalised weight stigma mediates weight stigma effects.
Fig. 2: PRISMA flowchart showing the study selection process.

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Funding

HB is supported by an Australian Government Research Training Program (RTP) scholarship through ACU.

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Authors and Affiliations

  1. School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, 3065, Australia

    Hugh Bidstrup, Leah Kaufmann & Xochitl de la Piedad Garcia

  2. School of Psychology and Public Health, La Trobe University, Albury-Wodonga, 3690, Australia

    Leah Brennan

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  1. Hugh Bidstrup
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  2. Leah Brennan
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  3. Leah Kaufmann
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  4. Xochitl de la Piedad Garcia
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Contributions

Conceptualisation, systematic search, and double screening: XPG and HB. Data extraction: HB. XPG and HB wrote the manuscript; LB and LK edited the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xochitl de la Piedad Garcia.

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Bidstrup, H., Brennan, L., Kaufmann, L. et al. Internalised weight stigma as a mediator of the relationship between experienced/perceived weight stigma and biopsychosocial outcomes: a systematic review. Int J Obes 46, 1ā€“9 (2022). https://doi.org/10.1038/s41366-021-00982-4

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