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The Implications of Weight Bias Internalisation

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Front. Psychol. | doi: 10.3389/fpsyg.2018.02271

Weight Bias Internalization among Adolescents Seeking Weight Loss: Implications for Eating Behaviors and Parental Communication

  • 1Human Development & Family Studies, University of Connecticut, United States

Background: Emerging evidence has demonstrated a high prevalence of weight bias internalization (WBI) among adults, as well as consistent links between internalization and adverse psychological and physical health. However, research examining WBI in youth and its impact on their health is scarce, especially among youth seeking weight loss treatment who may be particularly vulnerable to weight stigma from peers and parents. To address this research gap, the present study assessed WBI in a weight loss treatment-seeking sample of adolescents, examining associations between internalization and adolescents’ eating behaviors and parental weight-related communication.

Methods: Adolescents (N=148, Mage= 15.97 years), completed online self-report measures to assess WBI (using the modified version of the Weight Bias Internalization Scale), body weight, binge eating, eating as a coping strategy, and weight teasing from peers and family members. Adolescents also reported on the frequency of parental comments about body weight, parental dieting, and parental encouragement of adolescent dieting.

Results: Adolescents expressed a high mean level of internalized weight bias (M=5.45, SD=0.88). Higher levels of internalization were observed across increasing body weight categories; no differences were observed for gender or history of weight teasing. Weight bias internalization was significantly higher among adolescents who reported binge eating and eating to cope with distress. Regression analyses showed that weight-related comments from mothers (but not fathers) significantly predicted adolescents’ WBI (including frequency of mothers’ comments about adolescents’ body weight, comments about their own body weight, and encouragement of their adolescent to diet), as did increased dieting frequency among mothers.

Conclusions: The present study provides novel insights to the scant literature on WBI in youth. Findings indicate that WBI is high in both girls and boys engaged in weight loss, and is associated with maladaptive eating behaviors, higher frequency of maternal dieting, and mothers’ comments about body weight. These findings have important clinical implications for youth and families engaged in weight loss treatment, and underscore the need for research to clarify adverse effects of internalization on weight-related health in youth and to better understand the role that parental weight communication may have on adolescents’ internalization.

Keywords: Internalisation, weight, Youth, eating behavior, Parent-Child Relations

Received: 27 Aug 2018; Accepted: 01 Nov 2018.

Edited by:

Stuart W. Flint, Leeds Beckett University, United Kingdom

Reviewed by:

Shelly Russell-Mayhew, University of Calgary, Canada
Cristiana Duarte, University of Leeds, United Kingdom  

Copyright: © 2018 Puhl and Himmelstein. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Rebecca Puhl, University of Connecticut, Human Development & Family Studies, Mansfield, 06269, Connecticut, United States,