Interrelation between weight and weight stigma in youth: is there evidence for an obesogenic vicious cycle?

Many children and adolescents are confronted with weight stigma, which can cause psychological and physical burden. While theoretical frameworks postulate a vicious cycle linking stigma and weight status, there is a lack of empirical evidence. The aim was to analyze the longitudinal bidirectional relationship between body weight and weight stigma among children and adolescents. The sample consisted of 1381 children and adolescents, aged 9-19 years at baseline (49.2% female; 78% normal weight), from a prospective study encompassing three measurement points over 6 years. Participants provided self-reported data on experienced weight-related teasing and weight/height (as indicators for weight status). Latent structural equation modelling was used to examine the relationship between weight-related teasing experiences and weight. Additionally, gender-related differences were analyzed. Between the first two waves, there was evidence for a bidirectional relationship between weight and weight-related teasing. Between the last two waves, teasing predicted weight, but there was no reverse association. No gender-related differences were found. The data indicate a reciprocal association between weight stigma and body weight across weight groups and independent of gender. To prevent vicious cycles, approaches that simultaneously promote healthy weight and reduce weight stigma are required.

Simply too much: the extent to which weight bias internalization results in a higher risk of eating disorders and psychosocial problems.

PURPOSE: Weight bias internalization (WBI) is associated with negative health consequences such as eating disorders and psychosocial problems in children. To date, it is unknown to what extent WBI considerably raises the risk of negative outcomes. METHODS: Analyses are based on cross-sectional data of 1,061 children (9-13 years, M = 11, SD = 0.9; 52.1% female) who filled in the WBI scale (WBIS-C). First, ROC analyses were run to identify critical cut-off values of WBI (WBIS-C score) that identify those who are at higher risk for psychosocial problems or eating disorder symptoms (as reported by parents). Second, it was examined whether WBI is more sensitive than the relative weight status in that respect. Third, to confirm that the cut-off value is also accompanied by higher psychological strain, high- and low-risk groups were compared in terms of their self-reported depressive symptoms, anxious symptoms, body dissatisfaction, and self-esteem. RESULTS: WBIS-C scores ≥ 1.55 were associated with a higher risk of disturbed eating behavior; for psychosocial problems, no cut-off score reached adequate sensitivity and specificity. Compared to relative weight status, WBI was better suited to detect disturbed eating behavior. Children with a WBIS-C score ≥ 1.55 also reported higher scores for both depressive and anxious symptoms, higher body dissatisfaction, and lower self-esteem. CONCLUSION: The WBIS-C is suitable for identifying risk groups, and even low levels of WBI are accompanied by adverse mental health. Therefore, WBI is, beyond weight status, an important risk factor that should be considered in prevention and intervention. LEVEL OF EVIDENCE: Level III, cross-sectional analyses based on data taken from a well-designed, prospective cohort study.

Intrapersonal predictors of weight bias internalization among elementary school children: a prospective analysis.

BACKGROUND: Weight-related stigmatization is a widespread problem. Particularly the internalization of weight-related stereotypes and prejudices (weight bias internalization, WBI) is related to mental and physical health impairments. To date, little is known about the risk factors of WBI. Previous studies are mainly cross-sectional and based on adult samples. As childhood is a sensitive period for the development of a healthy self-concept, we examined predictors of WBI in children. METHODS: The final sample included 1,463 schoolchildren (6-11 years, 51.7% female) who took part in a prospective study consisting of three measurement waves. The first two waves delivered data on objective weight status and self-reported weight-related teasing, body dissatisfaction, relevance of one's own figure, self-esteem and depressive symptoms; WBI was measured during the third wave. To examine predictors of WBI, we ran hierarchical regression analyses and exploratory mediation analyses. RESULTS: Lower parental education level, higher child weight status, female gender, experience of teasing, higher body dissatisfaction, higher figure-relevance, and higher depression scores were found to be predictive for higher WBI scores. Body dissatisfaction (only for girls) and the relevance of one's own figure (both genders) mediated the association between self-esteem and WBI; no weight-related differences were observed. CONCLUSIONS: Our study offers longitudinal evidence for variables that enable the identification of children who are at risk for WBI. Thus, the findings deliver starting points for interventions aimed at the prevention of adverse health developments that come along with WBI.