A systematic review of weight stigma and disordered eating cognitions and behaviors

Levinson, Jordan A.; Kinkel-Ram, Shruti; Myers, Bethany; Hunger, Jeffrey M.

doi:10.1016/j.bodyim.2023.101678

Cited by 12 publications

(2 citation statements)

References 222 publications

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“…It is also estimated that up to 50% of bariatric treatment seeking populations may have binge eating disorder, compared with 1%-2% in nonsurgical populations [49]. The present findings contextualise general practice within the current literature outlining the association of WS experienced in healthcare settings with disordered eating behaviours [12,50]. This phenomenon is magnified where there are adverse early childhood experiences of WS in healthcare settings that persist into adulthood, as were reported by the participants in this study [15,26].…”

Section: Comparison With Existing Literaturesupporting

confidence: 67%

“…WS is described as the devaluation and denigration of an individual or a group because of their body size [ 11 ]. There are three conceptualisations of WS: experienced , anticipated and internalised [ 12 ]. WS can be experienced when people with obesity (PwO) face prejudice and/or discriminatory actions toward them, this can be communicated overtly or more subtly through microaggressions [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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‘Beyond the Scale’: A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice

Ryan,

Quigley,

Birney

et al. 2024

Health Expectations

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ObjectiveObesity is a complex, chronic, relapsing disease that requires an individualised approach to treatment. However, weight stigma (WS) experienced in healthcare settings poses a significant barrier to achieving person‐centred care for obesity. Understanding the experiences of people living with obesity (PwO) can inform interventions to reduce WS and optimise patient outcomes. This study explores how patients with obesity perceive WS in general practice settings; its impact on their psychological well‐being and health behaviours, and the patients suggestions for mitigating it.MethodsIn‐depth semistructured interviews were conducted with 11 PwO who had experienced WS in general practice settings in Ireland. The interviews were conducted online via Zoom between May and August 2023; interviews lasted between 31 and 63 min (M = 34.36 min). Interviews were audio‐recorded, transcribed verbatim and analysed using inductive reflexive thematic analysis.ResultsThree overarching themes specific to participants' experience of WS in general practice were generated: (1) shame, blame and ‘failure’; (2) eat less, move more—the go‐to treatment; (3) worthiness tied to compliance. A fourth theme: (4) the desire for a considered approach, outlines the participants' suggestions for reducing WS by improving the quality of patient–provider interactions in general practice.ConclusionThe findings call for a paradigm shift in the management of obesity in general practice: emphasising training for GPs in weight‐sensitive communication and promoting respectful, collaborative, and individualised care to reduce WS and improve outcomes for people with obesity.Patient or Public ContributionPPI collaborators played an active and equal role in shaping the research, contributing to the development of the research questions, refining the interview schedule, identifying key themes in the data, and granting final approval to the submitted and published version of the study.

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Section: Comparison With Existing Literaturesupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

‘Beyond the Scale’: A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice

Ryan,

Quigley,

Birney

et al. 2024

Health Expectations

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Beyond Age, BMI, Gender Identity, and Gender Minority Stress, Weight Bias Internalization Is Uniquely Associated With More Eating and Body Image Disturbances and Poor Physical and Mental Health in Chinese Gender‐Diverse Adults

Barnhart,

Xiao,

et al. 2024

Intl J Eating Disorders

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ObjectiveWeight bias internalization (WBI) is a robust, positive correlate of negative health outcomes; however, this evidence base primarily reflects cisgender individuals from Western cultural contexts. Gender‐diverse individuals from non‐Western cultural contexts (e.g., China) are at potentially high risk for WBI. Yet, no research has examined WBI and associated negative health consequences in this historically underrepresented population.MethodA cross‐sectional, online survey sampled Chinese gender‐diverse individuals (N = 410, Mage = 22.33 years). Variables were self‐reported, including demographics, WBI, body shame, body dissatisfaction, disordered eating, physical and mental health status, and gender minority stress (e.g., internalized cisgenderism). Analyses included correlations and multiple hierarchical regressions.ResultsPearson bivariate correlations demonstrated associations between higher WBI and more eating and body image disturbances and poor physical and mental health. After adjusting for age, BMI, gender identity, and gender minority stress, higher WBI was uniquely and positively associated with higher body shame, higher body dissatisfaction, higher disordered eating, and poor physical and mental health. Notably, WBI accounted for more unique variance in eating and body image disturbances (13%–25% explained by WBI) than physical and mental health (1%–4% explained by WBI).DiscussionWhile replication with longitudinal and experimental designs is needed to speak to the temporal dynamics and causality, our findings identify WBI as a unique, meaningful correlate of eating and body image disturbances in Chinese gender‐diverse adults.

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The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research

Barnhart,

Kalantzis,

Gaggiano

et al. 2024

Appetite

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A systematic review of weight stigma and disordered eating cognitions and behaviors

Cited by 12 publications

References 222 publications

‘Beyond the Scale’: A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice

‘Beyond the Scale’: A Qualitative Exploration of the Impact of Weight Stigma Experienced by Patients With Obesity in General Practice

Beyond Age, BMI, Gender Identity, and Gender Minority Stress, Weight Bias Internalization Is Uniquely Associated With More Eating and Body Image Disturbances and Poor Physical and Mental Health in Chinese Gender‐Diverse Adults

The relation between questionnaire-measured self-reported emotional eating and disordered eating behaviors: A meta-analysis of nearly three decades of research

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