The interaction between BMI, weight criticism, weight bias, and psychological and relational outcomes within marriage.

PURPOSE: To examine (1) whether a wife's BMI interacts with either her husband's weight stigma or (2) her perceived weight criticisms from her husband predict husbands' and wives' psychological and relational outcomes. METHODS: The study sample consisted of 209 currently married men and women in a heterosexual relationship. Participants were drawn from an online survey platform (Qualtrics, Inc. Provo, UT) designed to approximate the US population on age, race, and region of the country. Online measures assessed husbands' weight stigma, wives' perceived weight criticisms from husband, and husbands' and wives': (1) relationship satisfaction, (2) sexual intimacy, (3) self-esteem, (4) depressive symptoms, and (5) perceptions of a desirable or ideal mate. RESULTS: Wives' BMI interacted with husbands' weight stigma to predict (1) mate value for husbands and wives and (2) marital satisfaction for husbands. The same pattern was noted with interaction of wives' BMI and perceptions of husbands' weight related criticisms. The interaction reflected that higher wife BMI and higher husband weight stigma or wife perceived weight-related criticism predicted lower marital satisfaction, greater depression, and lower perceptions of a desirable or an ideal mate. Lower BMI was not associated with outcomes regardless of the husbands' weight stigma or wives' perceived weight-related criticisms. CONCLUSION: To understand the impact of weight stigma and weight related criticisms on perceptions of a desirable or ideal mate and marital outcomes, it is important to examine the interaction with partner's BMI. LEVEL OF EVIDENCE: III: Evidence obtained from cohort or case-control analytic studies.

Comparing stigmatizing attitudes toward anorexia nervosa, binge-eating disorder, avoidant-restrictive food intake disorder, and subthreshold eating behaviors in college students.

OBJECTIVE: The relative stigmatization of various eating disorders (ED) remains understudied, and there is no research examining stigma toward avoidant-restrictive food intake disorder (ARFID) or adult picky eating. The present study examined the relative stigmatization of various EDs and the subthreshold eating behaviors that are risk factors for their development, and the relation of gender differences to stigma. METHOD: A sample of 1147 college students was recruited and completed the study online. Participants were randomized and presented with a vignette representing a clinical ED [anorexia nervosa (AN), binge-eating disorder (BED), ARFID] or a subthreshold eating presentation (restrained eating, emotional eating, picky eating). Participants completed measures of stigma and perceived psychopathology. A 6 (target eating behavior) × 2 (target gender) × 2 (participant gender) MANOVA and subsequent ANOVAs were employed. RESULTS: Measures of stigma revealed significant main effects for eating presentation and participant gender. There were also significant interactions between eating presentation and participant gender. Men reported more stigmatizing views toward BED and AN compared to women. Overall, restraint was stigmatized less than the other targets, and AN received the greatest amount of stigma. Participants rated BED and AN as more pathological than all other targets, emotional eating and ARFID as more pathological than picky eating and restrained eating, and restrained eating as less pathological than all other targets. CONCLUSIONS: Future research should explore how the severity of eating behavior influences perceptions and at what level behaviors such as restriction are recognized as disordered.

Associations between husbands' weight bias and related concerns and husbands' and wives' psychological and relationship outcomes.

The study examines married men's weight stigma, internalized weight bias (IWB) and other weight-related concerns/criticisms directed toward their wife, their perceptions of their wife as an ideal mate, and husbands' and wives' psychological distress and relationship satisfaction. The sample consisted of 209 married men and women in a heterosexual relationship. Participants were drawn from an online survey platform (Qualtrics, Provo, UT) that approximated the US population on age, race, and region of the country. Measures assessed husbands': (1) IWB, (2) weight stigma, (3) weight-related concerns/criticisms directed toward his wife, (4) relationship satisfaction, (5) sexual intimacy, (6) self-esteem, (7) depressive symptoms, and (8) perceived mate value. Husbands' weight stigma, IWB, weight-related concerns/criticisms, and perceived mate value were significantly associated with husbands' and wives' depressive symptoms, self-esteem, relationship satisfaction, and sexual intimacy. Structural equation modeling analyses revealed that husbands' weight stigma and IWB were indirectly linked to husbands' and wives' relationship satisfaction and sexual intimacy through weight-related concerns/criticisms and, to a lesser extent, perceived mate value. This investigation suggests that husbands' weight stigma, IWB, and other weight-related concerns/criticisms, suggestions, and mate perceptions are strongly associated with both husbands' and wives' psychological and relationship outcomes.

A daily diary study of internalised weight bias and its psychological, eating and exercise correlates.

OBJECTIVE: The current investigation extends ecological momentary assessment (EMA) and daily diary weight stigma research in internalised weight bias (IWB). This investigation used daily diaries to examine the relationship between IWB, mood, coping, body appreciation, exercise behaviours and eating behaviours. DESIGN: The study sample consisted of individuals who were overweight or obese (85% female) with MBMI = 36.0, SDBMI = 6.2. Participants completed a daily diary each evening and wore a Fitbit for 30 days. MAIN OUTCOME MEASURES: Participants reported on IWB, mood, coping, body appreciation, exercise behaviours and eating behaviours. RESULTS: Both within- and between-subjects IWB were significantly related to positive affect, negative affect, several coping responses, body appreciation, eating behaviours and the urge to avoid exercise. Exploratory analyses indicated that positive and negative affect mediated many of the associations between IWB and coping responses, body appreciation, and eating and exercise behaviours. CONCLUSION: This investigation provides evidence that IWB experiences have daily impacts on psychological well-being, body appreciation, coping, eating and exercise behaviours. Also, this study raises awareness about IWB and its potential impact on psychological well-being and health behaviours.

A novel stepped-care approach to weight loss: The role of self-monitoring and health literacy in treatment outcomes.

OBJECTIVES: The aims of the current study were twofold: 1) examine the effectiveness of an innovative three-step, stepped-care behavioral weight loss treatment, and 2) examine factors that contribute to poor weight loss outcomes and the need for more intensive treatment. METHODS: The total sample for the study consisted of 53 individuals (87% female) with MBMI=35.6, SDBMI=6.4. A three-step, stepped-care treatment approach was implemented over six months. Step 1 included the Diabetes Prevention Program manual adapted for self-administration augmented with monitoring technology shown to facilitate weight loss and participant accountability and engagement. Participants who were unsuccessful at achieving established weight loss goals received stepped-up treatments in 2-month increments beginning at month 2. The stepped progression included the addition of meal replacement at Step 2 and individual counseling concurrent with meal replacement at Step 3. RESULTS: Un-stepped and once stepped participants lost a clinically significant amount of weight (i.e., >5%), while twice stepped participants lost an insignificant amount of weight. Twice stepped participants were significantly lower in health literacy and self-monitoring frequency. CONCLUSIONS: In this investigation, approximately 60% of the participants were able to lose a clinically significant amount of weight utilizing a minimally intensive intervention with little additional support. Regular self-monitoring and high health literacy proved to be significant correlates of success.