The role of food reward in the associations between weight-based discrimination and feeding practices among caregivers of young children.

Certain caregiver feeding practices, including restrictive feeding for weight control, restrictive feeding for health, emotion regulation feeding, and reward feeding, are known to negatively influence short- and long-term child eating and health outcomes. Beyond body size, the precise psychosocial characteristics of caregivers more likely to engage in such feeding practices are unknown. In particular, caregivers who have experienced discrimination based on their weight, who have internalized those biased beliefs, or who find food to be very rewarding may be more likely to use restrictive or controlling feeding practices. The present study investigated the associations among experiences of weight-based discrimination, internalized weight bias, and food reward (i.e., reward-based eating drive) with use of restriction for weight control, restriction for health, emotion regulation feeding, and reward feeding in an online US sample of caregivers (M = 35.27 ± 9.08 y/o) of 2-5 year-old children (N = 305). About half (50.8%) of respondents self-identified as women and most as non-Hispanic (88.5%) and White (75.1%). There were significant positive correlations among caregivers' experience of weight-based discrimination, internalized weight bias, and use of all four feeding practices. Regression results showed that caregivers' food reward moderated the main effect of weight-based discrimination on restrictive feeding for weight control and emotion regulation feeding, such that caregivers who were high in food reward and who experienced discrimination were most likely to engage in these feeding practices. These results can inform interventions aimed at improving child food environments and health.

Current trends and future directions in internalized weight stigma research: a scoping review and synthesis of the literature.

BACKGROUND: Since the first papers focused on internalized weight stigma were published in the mid 2000's, the literature has grown into a robust field that complements existing knowledge on weight stigma. Recently, researchers have documented the need for increased conceptual and measurement clarity, to distinguish internalized weight stigma from body dissatisfaction. Although several systematic reviews have been conducted on portions of the internalized weight stigma literature, no review to date has been conducted examining the entirety of the literature. OBJECTIVE: The aim of this research was to conduct a systematic scoping review and synthesis of research on internalized weight stigma. Specifically, we sought to examine the broad scope of the literature, terms used to refer to internalized weight stigma, how internalized weight stigma is defined, sample characteristics, and weight-based framings of internalized weight stigma research. METHODS: We conducted a single-concept search across six databases (EMBASE, Medline, PsychINFO, PubMed, SCOPUS, and Web of Science) of peer-reviewed papers published in English on internalized weight stigma. Data were extracted for article authors, year published, journal name and type, general article topic(s), study design, study location, sample characteristics, variables measured, paper framing, term used to describe internalized weight stigma, and definition of internalized weight stigma. RESULTS: Of the 931 unique records screened, 376 were identified for inclusion in the scoping review. The majority of internalized weight stigma research is characterized by cross-sectional methods, has been conducted in the US, and has utilized samples of higher weight white women. Further, 40 unique terms were used across the literature to refer to internalized weight stigma, and 19 different components of definitions of internalized weight stigma were identified. The literature is also characterized by a focus on understanding the association between internalized weight stigma and health outcomes with an emphasis on obesity. CONCLUSIONS: This scoping review confirms a lack of concept clarity of internalized weight stigma, in part influenced by an inconsistency in definitions of internalized weight stigma across the literature. Considerations are provided for steps to enhance conceptual and measurement clarity. Given the obesity focused framing of much of the research on internalized weight stigma, considerations are also provided for reducing weight-centric approaches to research. In the early 2000's, researchers began to pay more attention to the potential health impacts of believing societal stereotypes, negative attitudes, and beliefs about higher weight people. When these stereotypes, negative attitudes, and beliefs are directed towards the self, it can have significant consequences for an individual's perceptions of self. This research collected and summarized all existing research published in English on internalized weight stigma. Our results highlighted that researchers do not use consistent terminology to refer to internalized weight stigma and that they do not have a consistent definition of internalized weight stigma. Further, a large proportion of the research is focused on obesity or weight loss, which may unintentionally perpetuate weight stigma in scientific research. We provide several recommendations for researchers to address these challenges in future research on internalized weight stigma as well as recommendations to address other identified gaps in the existing literature.

Brief Self-Compassion Intervention for Women of Higher Weight and Internalized Weight Bias: A Randomized Pilot Study.

BACKGROUND: Internalized weight bias (IWB) negatively impacts mental and physical health, and disproportionately affects women of higher weight. Although self-compassion training may be advantageous for reducing IWB and associated sequalae, further examination of its clinical significance and cultural acceptability is warranted. METHOD: A randomized pilot study was conducted to evaluate the feasibility, including cultural acceptability, and clinical significance of a 3-session self-compassion intervention (SCI) for women with IWB. Women with BMIs of > 25 and IWB (N = 34) were randomly assigned to the SCI or a waitlist control group. Participants completed pre, post, and 1-month follow-up surveys on IWB, self-compassion, body image, eating behaviors, physical activity, and affect. Analyses of covariance were employed and percentages of change were calculated to examine post-intervention between-group differences in outcomes. Cultural acceptability was evaluated through participants' ratings of the perceived inclusivity and relevancy of the SCI. RESULTS: There were 59% (n = 10) and 47% (n = 8) completion rates in the SCI and waitlist control groups, respectively. Compared to the waitlist control group, SCI participants reported greater pre-post improvements in self-compassion, IWB, body shame and surveillance, uncontrolled eating, and physical activity with medium to large effect sizes, and emotional eating with small effects. The SCI was perceived to be beneficial overall, and cultural acceptability ratings were mostly favorable despite individual differences. CONCLUSION: This brief SCI may be beneficial for women impacted by weight stigma and IWB. Attention to increased diversity and cultural acceptability is warranted in future trials.

Weight stigma and mental health outcomes in early-adolescents. The mediating role of internalized weight bias and body esteem.

BACKGROUND: Weight stigma is increasingly common in early adolescence and may lead to weight bias internalization, with negative consequences for mental health outcomes. This study aimed to: examine the relations of perceived weight stigma and internalized weight bias with early adolescents' internalizing symptoms and disordered eating behavior; explore the mediating role of internalized weight bias on the relations of perceived weight stigma with internalizing symptoms and disordered eating behaviors; examine body esteem as a mediator between internalized weight bias and mental health outcomes. METHODS: A sample of 406 early adolescents (59.6% girls) aged between 11 and 13 participated in this cross-sectional study. They completed self-report measures assessing perceived weight stigma, internalized weight bias, body esteem, internalizing symptoms and disordered eating. RESULTS: Path analysis indicated that perceived weight stigma was positively related with internalizing symptoms and internalized weight bias. Further, internalized weight bias was negatively related with body esteem and positively related with internalizing symptoms and disordered eating. Internalized weight bias mediated the relations of perceived weight stigma with internalizing symptoms, disordered eating and body esteem. Further, body esteem mediated the relations of internalized weight bias with internalizing symptoms and disordered eating behavior. CONCLUSIONS: The findings highlight internalized weight bias as a psychological mechanism potentially explaining negative links of weight stigma with internalizing symptoms and disordered eating in early adolescence. The results emphasize the need for early intervention during this developmental stage, in order to prevent psychological and behavioral outcomes of weight stigma and internalized weight bias.

Validation of the Modified Weight Bias Internalization Scale (WBIS-M) among First-Generation Asian Immigrants.

Internalized weight bias (i.e., the application of negative weight-based stereotypes to one's self-evaluation) is associated with adverse physical and mental health outcomes. The 10-item version of the Modified Weight Bias Internalization Scale (WBIS-M) is one of the most commonly used measures to assess internalized weight bias. However, studies examining the psychometric properties of the WBIS-M are limited in racially minoritized U.S.-based populations. The current study sought to examine the factor structure of the 10-item version of the WBIS-M in a sample of first-generation Asian immigrants, as both native and foreign-born Asian populations have consistently demonstrated higher rates of weight-related concerns relative to other racially minoritized groups. Confirmatory factor analysis was used to assess the factor structure, and a multiple indicator multiple cause modeling approach was used to assess associations between internalized weight bias and sociodemographic predictors. Results confirm the unidimensionality of the WBIS-M and provide preliminary support for a nine-item version. Identifying as a woman (p = .027) and perceiving oneself as overweight (p < .001) were significantly associated with greater internalized weight bias. When working with Asian and Asian American clients, mental health service providers should be aware of potential weight-related concerns and may consider using the WBIS-M to assess for internalized weight bias.

An examination of the unique contributions of body image and internalized weight bias to psychological well-being outcomes.

High correlations between measures of internalized weight bias (IWB) and body image (BI) have resulted in concerns that IWB is conceptually redundant with BI. This investigation examined the contribution of the unique variance of BI and IWB on three important, weight-related factors: self-esteem, depressive symptoms, and body shame. The study included 403 participants recruited through a Qualtrics research panel. Participants were required to be aged 18 + and have a BMI > 25. The sample contained three equally represented, self-identified racial/ethnic groups: Black non-Hispanic (N = 140), Hispanic (N = 133), and White non-Hispanic (N = 130). When BI was entered in the first step of the regression model, it accounted for 14-40% of the variance in various models; the addition of IWB in step two contributed 11-18% of unique variance. By contrast, when IWB was entered in the first step, it accounted for 25-56% of the variance in various models, with the addition of BI contributing between 0% and 2% unique variance. Therefore, even with a high correlation among the constructs of IWB and BI, IWB was able to contribute unique variance in predicting depressive symptoms, self-esteem, and body shame, and is not redundant with the construct of BI.

Assessment and impact of paediatric internalized weight bias: A systematic review.

BACKGROUND: Internalized weight bias (IWB) refers to an individual's belief in negative weight-related stigma. Children and adolescents are particularly vulnerable to IWB, but little is known about IWB in this population. OBJECTIVE: To conduct a systematic review to (1) identify the instruments that measure IWB among children and adolescents and (2) explore comorbid variables associated with paediatric IWB. METHODS: This systematic review was conducted in accordance with the PRISMA guidelines. Articles were pulled from Ovid and PubMED Medline, Ovid HealthStar and ProQuest PsychInfo. Studies were included if they were observational studies, addressed the topic of IWB, and included children under the age of 18. Major outcomes were collected and analysed using inductive qualitative methods. RESULTS: 24 studies met inclusion/exclusion criteria. Researchers used two main instruments to measure IWB: Weight Bias Internalization Scale and Weight Self Stigma Questionnaire. There was some variation in the response scales and wording of these instruments between studies. Outcomes with significant associations were divided into four categories: physical health (n = 4), mental health (n = 9), social functioning (n = 5), and eating behaviours (n = 8). CONCLUSIONS: IWB is significantly associated with and may contribute to maladaptive eating behaviours and adverse psychopathology in children.

Internalized Weight Bias, Weight-Related Experiences, And Peripartum Weight.

INTRODUCTION: The purpose of this study was to investigate internalized weight bias (IWB) and its relationship with pregnancy-related weight changes and postpartum depression. IWB is defined as the internalization of negative attitudes and beliefs about people due to their weight. Although IWB has been linked with weight change and depression in other samples, it has never been investigated in the postpartum period. METHODS: We used a cross-sectional survey design. Participants were 251 women recruited via social media who were living in the United States and 6 to 12 months postpartum. We calculated percentage of body weight gained during pregnancy and percentage of that weight that was retained postpartum from self-reported weights. Participants completed self-report measures of IWB (modified version of the Weight Bias Internalization Scale) and postpartum depression (Edinburgh Postnatal Depression Scale). RESULTS: Gestational weight gain was not significantly associated with IWB or depression. Postpartum retention of gestational weight was significantly positively associated with both IWB and depressive symptoms. Furthermore, IWB mediated the relationship between postpartum weight retention and depressive symptoms. DISCUSSION: Postpartum retention of weight gained during pregnancy, but not weight gain itself, was related to both IWB and depressive symptoms. The relationship between pregnancy-related weight changes and psychological distress is complex. Sociocultural pressures to return to a prepregnancy physical state swiftly after giving birth may increase risk for IWB during a time in life when stress is already likely to be high, posing additional psychological risk. IWB existing prepregnancy may also worsen postpartum self-concept, contributing to depression. This is the first study, to our knowledge, to directly assess associations among gestational weight change, IWB, and postpartum depression. In addition to discussing weight in pregnancy, perinatal care providers could improve postpartum health by helping women set realistic, body-positive goals postpartum.

Association of Weight-Related Stigmas With Daily Pain Symptoms Among Individuals With Obesity.

BACKGROUND: Individuals with obesity are disproportionately impacted by pain-related symptoms. PURPOSE: This study evaluated experienced weight stigma and internalized weight bias (IWB) as predictors of pain symptoms in daily life among individuals with obesity. METHODS: Adults with obesity (n = 39; 51% female, 67% White, 43.8 ± 11.6 years old, BMI = 36.8 ± 6.7 kg/m2) completed a baseline assessment (demographics, experienced weight stigma, IWB) and a 14-day Ecological Momentary Assessment (EMA) period involving five daily prompts of pain/aches/joint pain, muscle soreness, experienced weight stigma, and IWB. Generalized linear models were used to assess experienced weight stigma and IWB at baseline as prospective predictors of EMA pain/soreness symptoms. Multi-level models were used to test the association of momentary weight stigma experiences and IWB with pain/soreness at the same and subsequent EMA prompts. RESULTS: IWB at baseline, but not experienced weight stigma, was associated with more frequent pain symptoms (p < .05) and muscle soreness (p < .01) during EMA. Momentary IWB (but not experienced stigma) was associated with more pain/aches/joint pain and muscle soreness at the same and subsequent prompt. CONCLUSIONS: Internalized (but not experienced) weight bias was prospectively associated with pain symptoms in daily life among individuals with obesity. Results are consistent with growing evidence that weight-related stigmas represent psychosocial factors that contribute to weight-related morbidity typically attributed to body size.

Associations of Use of Social Media and Psychopathology and Body Image in Pre- and Post-surgical Bariatric Samples: a Cross-sectional Analysis.

PURPOSE: Interest has grown regarding the impact of social media platforms on mental health including body image and internalized weight bias (IWB) in those who have struggled with weight issues. However, few studies have addressed social media usage in bariatric patient samples. The objective of this study was to understand how the amount of time spent on social media could serve as a predictor for IWB in both pre- and post-operative bariatric patients. MATERIALS AND METHODS: Pre- and post-operative patients at one academic medical center completed self-report measures assessing patients' IWB, depression, anxiety, body dissatisfaction, sociodemographic variables, and social media usage. Data were collected from March 2019 to April 2020. Statistical methods that included correlations, logistical regression models, and ANOVA analysis were used to determine the relationship between time spent on social media and other covariates. RESULTS: A total of 148 responses were collected from the pre-surgical population, with 81 responses from the post-surgical sample. At baseline, the majority of respondents used social media for approximately 1 h per day (n = 37; 27.82%). Time spent on social media was negatively associated with age (r = - 0.24 [- 0.40, - 0.08]), and positively associated with IWB (r = 0.20 [0.02, 0.36]) and anxiety (r = 0.21 [0.01, 0.39]). In the post-operative group, only the 6-month BMI (r = 0.29 [0.05, 0.49]) was positively associated with time spent on social media. CONCLUSION: Given this study's findings, providers are encouraged to become aware of patients' use of social media, and to understand the impact social media usage can have on the mental well-being of patients.

Associations between Internalized Weight Stigma and Visceral Adipose Tissue Status are Observed in Women but not Men.

Purpose: This study investigated the relationship between internalized weight stigma (IWS) and visceral adipose tissue (VAT), an independent predictor of cardiometabolic disease risk, and how this relationship is moderated by gender. Methods: Participants (N=70, 81% white, 51% women, M age=30.4±7.8 years, M BMI=28.7±5.5 kg/m2, M BF%=32.4±8.9%) completed in-lab measures of demographic factors (age, gender, race/ethnicity), IWS (Weight Bias Internalization Scale-Modified; WBIS-M) and visceral adiposity. VAT mass was measured via DXA. Primary moderation analysis investigated the effect of gender on associations between IWS and VAT mass. Covariates were age, race/ethnicity, and total body fat percent. Results: After adjusting for covariates in the primary moderation analysis, WBIS-M scores displayed a positive association with VAT mass (b=32.58, p=0.033). The relationship between WBIS-M scores and VAT mass was moderated by gender (b=68.63, p=0.020); no relationship between WBIS-M scores and VAT mass was observed in men (b=-2.71, p=0.894), whereas a positive association between WBIS-M scores and VAT mass was observed in women (b=65.92, p=0.003). Conclusions: Internalization of weight stigma was associated with greater visceral adiposity in women across the BMI spectrum, suggesting it as a chronic stressor. Future studies should investigate directionality and causality of this relationship to elucidate mechanisms of stigma-associated CVD risk.

Fat is feminine: A qualitative study of how weight stigma is constructed among sexual minority men who use Grindr.

Why is weight stigma so potent among sexual minority men? We propose that sexual minority men may be more vulnerable to weight stigma because of factors not captured by existing measures - for instance, men's perception of fatness as less masculine and/or more feminine. To investigate, we qualitatively examined how 17 sexual minority men (Mage = 28.52, SDage = 1.63, range: 18-49) described fatness in their discussions of body ideals and appearance pressures. We generated two themes: (i) Masculinity is a currency that fat men have less of and (ii) Fatness is stigmatized or fetishized. Participants described appearing masculine (i.e., lean, muscular) as particularly valuable within the gay community - opposingly, fatness was framed as unmasculine and undesirable. Fat men's treatment was understood as rarely divorced from their body size, either being stigmatized or fetishized because of their weight. Finally, being unattracted to fat men was constructed as a personal preference that ought not be criticised. These findings suggest the value of masculinity within the gay community may exacerbate weight stigma experiences and internalization among sexual minority men. Future research should account for the anticipated effects of fatness on men's masculinity and clarify whether sexual preferences and fetishization should be subsumed in weight stigma definitions.

Corrigendum: Examining the Conceptual and Measurement Overlap of Body Dissatisfaction and Internalized Weight Stigma in Predominantly Female Samples: A Meta-Analysis and Measurement Refinement Study.

[This corrects the article DOI: 10.3389/fgwh.2022.877554.].

Examining the Conceptual and Measurement Overlap of Body Dissatisfaction and Internalized Weight Stigma in Predominantly Female Samples: A Meta-Analysis and Measurement Refinement Study.

Both body dissatisfaction and internalized weight stigma have been identified as risk factors for many negative health outcomes for women, including depression and eating disorders. In addition to these contributions, these concepts have been found to overlap to various degrees in existing literature. We conducted a systematic review and meta-analysis on articles published prior to February 2022 to demonstrate the conceptual and measurement overlap between body dissatisfaction and internalized weight stigma as currently quantified. We identified 48 studies examining the interrelation between body dissatisfaction and internalized weight stigma in predominantly female samples. Stronger correlations between these two constructs, some bordering on multicollinearity, were prevalent in community samples compared to clinical samples and with some but not all the commonly used measures in the body image and weight stigma fields. Body mass index (BMI) moderated these relations such that individuals with higher self-reported BMI were more likely to report lower correlations between the constructs. This concept proliferation, stronger for individuals with lower BMIs and community samples, necessitates the need change how we conceptualize and measure body dissatisfaction and internalized weight stigma. To this end, we conducted study two to refine existing measures and lessen the degree of measurement overlap between internalized weight stigma and body dissatisfaction, particularly in community samples of women. We aimed to clarify the boundaries between these two concepts, ensuring measurement error is better accounted for. Female university students completed existing measures of body satisfaction and internalized weight stigma, which were analyzed using an exploratory followed by a confirmatory factor analysis. In our attempts to modify two existing measures of internalized weight stigma and body dissatisfaction, the majority of the internalized weight stigma items were retained. In contrast, most of the body dissatisfaction items either cross-loaded onto both factors or loaded on to the internalized weight stigma factor despite being intended for the body dissatisfaction factor, suggesting that the measurement issues identified in recent prior research may be due not only to the way we conceptualize and quantify weight stigma, but also the ways in which we quantify body dissatisfaction, across the existing corpus of body dissatisfaction scales.

Intuitive eating buffers the link between internalized weight stigma and body mass index in stressed adults.

Internalized weight stigma (IWS) is independently associated with less intuitive eating (i.e., eating based on endogenous hunger/satiety cues) and higher Body Mass Index (BMI), and intuitive eating training is commonly conceptualized as protective against the effects of IWS on poor behavioral health. The 3-way relationship between IWS, intuitive eating, and BMI has yet to be examined, and it is unclear whether the link between IWS and BMI is buffered by high intuitive eating. This secondary preliminary analysis examined baseline data of stressed adults with poor diet (N = 75, 70% female, 64.1% White, 42.7% with overweight/obesity) in a parent clinical trial that tested the effects of yoga on diet and stress. Validated self-report surveys of IWS and intuitive eating were analyzed with objectively-assessed BMI. Moderated regression analyses using the SPSS PROCESS macro tested whether intuitive eating moderated the IWS-BMI link. The analysis revealed IWS was positively associated with BMI except among people with high intuitive eating. Results extend observational findings linking intuitive eating to lower BMI, and offer preliminary support for the hypothesis that this link may hold even among those with greater IWS. It's possible that individuals with lower BMI and greater IWS may gravitate more towards intuitive eating than those with greater BMI, and/or intuitive eating may be an important target for ameliorating the adverse association of IWS with behavioral and physical health indicators linked to BMI. Continued work is warranted in larger, more generalizable samples using causal and prospective designs.

"I am very critical of my body, but I am not a worthless person": A qualitative investigation of internalized weight stigma in Denmark.

Aim: The aim of this study was to explore how two of the main dimensions of internalized weight stigma (IWS), namely weight-related self-devaluation and distress, play out in the lives of people with excess weight (EW), and to study whether there are further dimensions of IWS. Method: Ten informants with EW were included in this study. The sample size was determined prior to data collection based on available resources at the time of data collection. All informants both participated in in-depth interviews and responded to the questionnaire WBIS-2F consisting of the two subscales: weight-related self-devaluation and distress. The interview accounts were thematically coded and compared with the informants' scoring on WBIS-2F. Findings: Seven themes were identified from the in-depth interviews: (1) devaluation of competencies, (2) self-blame, (3) bodily devaluation, (4) ambivalence, (5) anticipated stigma, (6) coping strategies, and (7) mental well-being. Overall, the informants scored low on the WBIS-2F subscale weight-related self-devaluation and high on the subscale weight-related distress. The qualitative findings echo the informants' scoring on WBIS-2F. However, novel aspects of IWS not covered by WBIS-2F were also identified. In particular, bodily devaluation presented itself as an integral part of IWS. Conclusion: The two current dimensions of WBIS-2F were retrieved, but important additional aspects of IWS were also identified. Future research is needed to evaluate and test both qualitatively and quantitatively whether the additional aspects of IWS identified in this exploratory examination are separate constructs of IWS.

Weight stigma predicts reduced psychological wellbeing and weight gain among sexual minority men: A 12-month longitudinal cohort study using random intercept cross-lagged panel models.

Weight stigma among sexual minority men predicts negative health outcomes; however, existing research is cross-sectional. Therefore, we longitudinally examined the presence, strength, and direction of relationships between weight stigma and health outcomes in a multi-national cohort of 2953 sexual minority men (Mage = 37.70, SDage = 13.70). Participants reported their Body Mass Index (BMI), experiences of weight discrimination, internalized weight bias, and psychological quality of life at three time-points over 12 months (~August 2019-20). Analyses revealed feedback loops of internalized weight bias with BMI and psychological quality of life: over time, increases in internalized weight bias were associated with small BMI increases (ß = 0.07) and small decreases in psychological quality of life (ß = 0.12). Reciprocally, increases in BMI and decreases in psychological quality of life were associated with increases in internalized weight bias (ßs = 0.18). Experiences of weight discrimination were not longitudinally predictive and were associated with higher BMI (ß = 0.29), greater internalized weight bias (ß = 0.29), and lower psychological quality of life (ß = 0.26) between-persons/cross-sectionally only. Weight stigma is longitudinally and reciprocally associated with reduced psychological wellbeing and weight gain among sexual minority men. Internalized weight bias is a particularly promising intervention target.

Internalized weight stigma and intuitive eating among stressed adults during a mindful yoga intervention: associations with changes in mindfulness and self-compassion.

PURPOSE: Internalized weight stigma (IWS) is common in the United States of America across body weight categories, and is implicated in the development of distress and unhealthy eating behaviors (e.g. overeating, disordered eating) that can foster poor cardiometabolic health. While emerging intervention research shows early promise in reducing IWS, long-term efficacy is unclear and novel strategies remain needed. This analysis examined whether participation in a mindful yoga intervention was associated with reduced IWS and increased intuitive eating, an adaptive eating behavior, and whether these changes correlated with each other or with changes in mindfulness and self-compassion. METHODS: Participants were stressed adults with low fruit and vegetable intake (N = 78, 64.1% White, M. Body Mass Index 25.59 ± 4.45) enrolled in a parent clinical trial of a 12-week mindful yoga intervention. Validated self-report measures of IWS, intuitive eating, mindfulness, and self-compassion were administered at pre-treatment, mid-treatment (8 weeks), post-treatment (12 weeks), and 4-month follow-up (24 weeks). RESULTS: Linear mixed modeling revealed significant improvements in IWS and intuitive eating across the four timepoints (p < .001). Reduced IWS correlated with increased intuitive eating pre- to post-treatment (p = .01). Improved self-compassion and mindfulness correlated with intuitive eating (both p = . 04), but not IWS (p = .74 and p = .56, respectively). CONCLUSION: This study offers preliminary support for the hypothesis that mindful yoga may promote intuitive eating and reduce IWS among stressed adults with poor diet, and suggests that changes in these factors may co-occur over time. Further investigation with controlled designs is necessary to better understand the temporality and causality of these relationships.Trial registration: ClinicalTrials.gov identifier: NCT02098018.

Internalized weight bias is associated with perceived exertion and affect during exercise in a sample with higher body weight.

OBJECTIVE: For individuals with overweight/obesity, internalized weight bias (IWB) is linked to low physical activity (PA). This study used a laboratory-based paradigm to test the hypothesis that IWB moderates the association between heart rate (HR) and perceived exertion and affect during PA. METHODS: Participants with overweight/obesity completed 30-min of supervised moderate-intensity treadmill walking (65%-75% of age-predicted maximal HR). Body Mass Index (BMI) and Weight Bias Internalization Scale were assessed at baseline. HR was monitored every minute; perceived exertion and affect were assessed every 5 min. Linear mixed models were employed with random effects of time and participant. RESULTS: The sample (n = 59; 79.7% female, 91.5% white) had an average BMI = 32.1 kg/m2 (SD: 3.3), and age = 47.1 (SD: 10.3) years. There was a main effect of IWB on perceived exertion (greater IWB was associated with greater perceived exertion during exercise; p < 0.001). There was an interaction of IWB and HR on affect (B = -0.01, p < 0.01). For individuals with high IWB, HR elevations were associated with a negative affective response during exercise. For individuals with low IWB, HR elevations were associated with increased positive affect during PA. CONCLUSIONS: Findings indicate that among individuals of higher body weight, IWB is associated with reporting higher perceived exertion during 30 min of moderate intensity PA. IWB moderated the relationship between increasing HR during exercise and affect. Among individuals with overweight/obesity who report IWB, the initial experience of PA may be harder and more unpleasant, with lasting implications for the adoption of PA.

Validation of the modified weight bias internalization scale in a Spanish adult population.

Weight bias internalization has received considerable attention in recent years and has been associated with serious psychological and physical consequences in Westernized societies. The modified weight bias internalization scale (WBIS-M) is one of the most frequently used instruments for assessing internalized weight stigma across different body weight categories. The aim of this study was to adapt the WBIS-M for use in Spanish adult populations. The sample consisted of 678 participants from the Spanish general population recruited through the internet, 79.6% of whom were women. The scale was translated into Spanish and then backtranslated. To study the internal structure, a cross-validation analysis was carried out including both exploratory and confirmatory factor analyses to assess the scale's psychometric properties. Internal consistency was evaluated using Cronbach's alpha and McDonald's omega and a test-retest was conducted to assess one-month stability. Results confirmed that the Spanish adaptation of the WBIS-M is an 11-item unidimensional scale, like the original version and shows excellent psychometric properties. In conclusion, the Spanish WBIS-M version seems to be a robust psychometric tool for use in clinical and research settings.