Weight Bias Internalization and Psychosocial,Physical, and Behavioral Health: A Meta-Analysis of Cross-Sectional and Prospective Associations |
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| Institution: | The Virginia Consortium Program in Clinical Psychology;The Virginia Consortium Program in Clinical Psychology;Old Dominion University;The Virginia Consortium Program in Clinical Psychology;Millersville University;Augustana University;Old Dominion University;University of Southern California;Center for Anxiety and Related Disorders, Boston University;Harvard Medical School;Center for Anxiety and Related Disorders, Boston University;University of Washington, Seattle;Harvard Medical School;University of Florence;University of Perugia;Louisiana State University;U.S. Department of Veteran Affairs, VA Boston Healthcare System;Boston University School of Medicine;Florida State University;Florida International University–Center for Children and Families;Texas Tech University;Florida International University–Center for Children and Families;University of Groningen;Sabanci University;University of Groningen;University of Groningen;Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe Mental Health Institute;University of Groningen;University of Maryland, College Park;Center for Health Policy & Health Services Research, Henry Ford Health;Loma Linda University;Center for Health Policy & Health Services Research, Henry Ford Health;Spectrum Health, Helen DeVos Children’s Hospital;College of Medicine, Michigan State University;University of Maryland, College Park;Center for Health Policy & Health Services Research, Henry Ford Health, Detroit |
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| Abstract: | Coinciding with widespread efforts to address obesity, weight bias internalization (a process of self-devaluation wherein individuals apply weight-biased stereotypes to themselves) has gained increased attention as a robust correlate of poor health outcomes. The present meta-analysis aimed to provide the largest quantitative synthesis of associations between weight bias internalization and health-related correlates. Studies that provided zero-order correlations for cross-sectional or prospective associations between weight bias internalization and physical, psychosocial, and behavioral health correlates were included in the meta-analysis. Meta-regression determined whether these associations differed based on demographic (sex/gender, race, age), anthropometric (body mass index), and study-level (publication status, sample type, study quality) moderators. Data for 149 (sub)samples were identified that included between 14 and 18,766 participants (M sample size = 534.96, SD = 1,914.43; M age = 34.73, SD = 12.61, range = 9.95–65.70). Results indicated that greater weight bias internalization was concurrently associated with worse psychosocial (e.g., negative and positive mental health, social functioning), physical (e.g., BMI, weight maintenance, health-related quality of life HRQoL]), and behavioral health (e.g., disordered eating behaviors, healthy eating, physical activity) across most constructs, with effects ranging from small to very large in magnitude. Preliminary evidence also suggested that greater weight bias internalization was subsequently associated with less weight loss and increased negative mental health. Notable variations in the nature and magnitude of these associations were identified based on the health-related correlate and moderator under consideration. These findings indicate that weight bias internalization is linked to multiple adverse health-related outcomes and provide insight into priorities for future research, theory building, and interventions in this area. |
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| Keywords: | weight bias internalization weight stigma health mental health behavioral health |
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