Weight-stigma study identifies self-image paradox

A new University of Florida College of Public Health and Health Professions study finds that a large proportion of participants in a study on weight stigma reported their disagreement with negative stereotypes about people with higher weight, such as being lazy, lacking willpower or having poor eating habits.

However, most of the participants said they nonetheless struggled with positive self-image because of their weight.

The findings, which appear online ahead of the print version of the journal Body Image, suggest the mechanisms of internalized weight stigma are more complicated than previously thought, said lead investigator Rebecca Pearl, Ph.D., an assistant professor in the PHHP department of clinical and health psychology.

“Internalization of negative stereotypes may be so deeply ingrained that individuals may not even be aware that they hold these beliefs. It can be difficult to step back and recognize our own biases, even when they apply to ourselves,” Pearl said.

Internalized stigma has been defined as awareness of negative societal attitudes and stereotypes about one’s group, agreeing with them and applying the beliefs to yourself.

“Most participants in our study did not agree with negative stereotypes about weight. They reported that they did not think the stereotypes were true of themselves or others, yet they were still scoring high on a scale of internalized stigma and reporting that they were experiencing negative thoughts and feelings about their weight,” Pearl said. “These findings challenge our existing theoretical understanding of internalized weight stigma, which assumes that individuals must agree with negative stereotypes and apply them to themselves before experiencing low self-esteem and self-worth due to weight.”

Internalized weight stigma is associated with a host of negative mental and physical health outcomes, including depression, anxiety, body dissatisfaction and disordered eating behaviors, Pearl said.

For the study, Pearl and colleagues interviewed more than 200 adults with a higher body weight — predominantly Black or white women — who were participating in a study of a group-based psychological intervention designed to reduce internalized weight stigma, delivered in combination with a behavioral weight loss treatment. Participants were asked about their awareness of negative stereotypes of people with higher weight. The most frequently identified stereotypes were laziness, lack of willpower and poor eating habits. Up to 66% of participants reported they did not agree with negative weight stereotypes or apply them to themselves.

Asked about the impacts of weight on self-image and emotions, about 60% of participants said their thoughts and feelings about weight had a significant impact on how they felt about themselves, with feelings of sadness, depression, low self-esteem and anxiety among the most commonly reported.

Many factors could be at play, Pearl said, including the pervasiveness of negative messages starting at an early age, making it hard to recognize deeply held beliefs about weight. Some participants admitted their self-image was in conflict with their own values about body positivity.

“We heard a lot of comments along the lines of ‘I reject the idea that women should look a certain way, and yet I can’t shake the fact that I feel better about myself when I’m at a lower weight,’” Pearl said.

Pearl’s co-authors included Laurie Groshon, a PHHP doctoral student in clinical psychology; Thomas Wadden, Ph.D., of the University of Pennsylvania; Caroline Bach of Georgia Southern University; Erica LaFata, Ph.D., of Drexel University; and Hannah Fitterman-Harris, Ph.D., of the University of Louisville. Study funding was provided by WW International Inc., and the National Heart, Lung, and Blood Institute of the National Institutes of Health.

Media contact: Jill Pease, jpease@phhp.ufl.edu, 352-273-5816