Background

Previous research in behavioral and surgical weight loss suggests patients with higher internalized weight bias (IWB) and experienced weight stigma (EWS) are at-risk for negative outcomes, including unhealthy eating behaviors, depression, and weight loss difficulties. However, no studies have examined IWB or EWS in medical weight loss (MWL) programs, which combine behavioral and pharmacological interventions.

Methods

New patients (n = 71) in a MWL program were assessed with the Weight Bias Internalization Scale Modified (WBIS-M), Weight Self-Stigma Questionnaire (WSSQ), and a survey of EWS history. Sociodemographic, medical, and psychological correlates of IWB and EWS were assessed.

Results

Participants (age = 48.1 years; 50.7% Caucasian; BMI = 41.7 kg/m2) were predominantly female (78.9%) with no bariatric surgery history (69%). Two-thirds (66%) reported experiencing at least one type of weight stigma (teasing = 63.4%; unfair treatment = 42.3%; discrimination = 32.4%), with the highest rates occurring during adolescence/young adulthood. Greater IWB was associated with younger age (r(68)=-.38, p < .01), male sex (t(37.1)=2.41, p < .05), higher BMI (r(69)=.32, p < .01), and higher PHQ-9 score (r(68)=.31, p < .05). Higher incidence of EWS was associated with higher PHQ-9 score (r(69)=.28, p < .05) and bariatric surgery history (t(67)=-2.12, p < .05).

Conclusions

Participants who were younger, male, with higher BMI, and more depressive symptomatology reported higher internalized weight bias, while those with bariatric surgery history and higher depressive symptomatology endorsed greater experienced weight stigma. Future analyses will assess the relationship between these constructs and weight loss outcomes over time.