Comparing Self-Report Measures of Internalized Weight Stigma: The Weight Self-Stigma Questionnaire versus the Weight Bias Internalization Scale

Abstract

BackgroundInternalized weight stigma has gained growing interest due to its association with multiple health impairments in individuals with obesity. Especially high internalized weight stigma is reported by individuals undergoing bariatric surgery. For assessing this concept, two different self-report questionnaires are available, but have never been compared: the Weight Self-Stigma Questionnaire (WSSQ) and the Weight Bias Internalization Scale (WBIS). The purpose of the present study was to provide and to compare reliability, convergent validity with and predictive values for psychosocial health outcomes for the WSSQ and WBIS.MethodsThe WSSQ and the WBIS were used to assess internalized weight stigma in N = 78 prebariatric surgery patients. Further, body mass index (BMI) was assessed and body image, quality of life, self-esteem, depression, and anxiety were measured by well-established self-report questionnaires. Reliability, correlation, and regression analyses were conducted.ResultsInternal consistency of the WSSQ was acceptable, while good internal consistency was found for the WBIS. Both measures were significantly correlated with each other and body image. While only the WSSQ was correlated with overweight preoccupation, only the WBIS was correlated with appearance evaluation. Both measures were not associated with BMI. However, correlation coefficients did not differ between the WSSQ and the WBIS for all associations with validity measures. Further, both measures significantly predicted quality of life, self-esteem, depression, and anxiety, while the WBIS explained significantly more variance than the WSSQ total score for self-esteem.ConclusionsFindings indicate the WSSQ and the WBIS to be reliable and valid assessments of internalized weight stigma in prebariatric surgery patients, although the WBIS showed marginally more favorable results than the WSSQ. For both measures, longitudinal studies on stability and predictive validity are warranted, for example, for weight-related and psychosocial outcomes.

Eating Behaviors, Weight Bias, and Psychological Functioning in Multi-ethnic Low-income Adolescents

“…ideation (Russell-Mayhew, McVey, Bardick, & Ireland, 2012;Taylor, 2011). This finding is supportive of the data that shows that eating can be used as a coping mechanism to counter the effects of distress experienced from WB (Hübner et al, 2016;Puhl et al, 2017;Puhl & Brownell, 2006). WB is not the only pathway to disordered eating and obesity, but it is a risk factor that has been identified in previous studies (Kirsch, Shapiro, Conley, & Heinrichs, 2016;Neumark-Sztainer et al, 2007;Puhl et al, 2017).…”

“…Sutin and Terracciano (2013) found a correlation between WB, weight gain, and obesity with non-obese participants who reported WB at baseline being 2.5 times more likely to be obese at follow up 4 years later. This research and other studies reveal the difficulty with weight loss (Wott & Carels, 2010) and weight loss maintenance (Hübner et al, 2016) secondary to WB, adding the negative consequences of stigma and highlighting the importance of prevention of WB in adolescents.…”

“…WB is not the only pathway to disordered eating and obesity, but it is a risk factor that has been identified in previous studies (Kirsch, Shapiro, Conley, & Heinrichs, 2016;Neumark-Sztainer et al, 2007;Puhl et al, 2017). A recent longitudinal study found WB during childhood may lead to emotional eating negatively affecting long-term weight loss maintenance in adulthood (Hübner et al, 2016). Therefore, WB interventions should be considered in the prevention of both eating disorders and obesity.…”

Weight bias internalization and health: a systematic review

“…Links between depressive symptoms and WBI have been examined in 30 studies . WBI was significantly and positively associated with depressive symptoms in 28 of the 30 studies; only two did not find a significant association .…”

Sociocultural and Familial Factors Associated with Weight Bias Internalization

“…Two dichotomous variables (yes/no) were created to designate i) siblings and ii) grandparents with overweight/obesity. WBI was measured with the well-validated Weight Bias Internalization Scale (WBIS; 1-7 scale) [3,22]. Due to previous research showing that WBI is related to yet distinct from depression [3], depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9; 0-27 scale) [23].…”