Weight Bias and Weight Loss Treatment Outcomes in Treatment-Seeking Adults

Abstract

Background Few studies have explored the relationship between weight bias and weight loss treatment outcomes. Purpose This investigation examined the relationship between implicit and explicit weight bias and (a) program attrition, (b) weight loss, (c) self-monitoring adherence, (d) daily exercise levels and overall caloric expenditure, (e) daily caloric intake, and (f) daily caloric deficit among overweight/obese treatment-seeking adults. Methods Forty-six overweight/obese adults (body mass index≥27 kg/m2) participating in an 18-week, stepped-care, behavioral weight loss program completed implicit and explicit measures of weight bias. Participants were instructed to self-monitor and electronically report daily energy intake, exercise, and energy expenditure. Results Greater weight bias was associated with inconsistent self-monitoring, greater caloric intake, lower energy expenditure and exercise, creation of a smaller caloric deficit, higher program attrition, as well as less weight loss during the self-help phase of the stepped-care treatment. Conclusions Weight bias may interfere with overweight/obese treatment-seeking adults' ability to achieve optimal health.

Obesity Stigma in Online News: A Visual Content Analysis

“…An accumulation of research demonstrates that obesity stigma poses a significant threat to psychological and physical health, including increasing vulnerability for depression, anxiety, low self-esteem, disordered eating, lower levels of physical activity, and weight gain (Ashmore, Friedman, Rechmann, & Musante, 2008;Carels et al, 2009;Puhl & Brownell, 2006;Puhl & Heuer, 2009;Puhl, Moss-Racusin, & Schwartz, 2007;Vartanian, Herman, & Polivy, 2005;Vartanian & Shaprow, 2008). Obese individuals who view these stigmatizing images in the news may be vulnerable to internalizing negative weight-based stereotypes, which can, in turn, lead to emotional and physical health consequences (Puhl et al, 2007).…”

“…However, scientific evidence suggests that weight stigma is not a beneficial tool for motivating weight loss. Weight stigma is counterproductive for public health and increases the likelihood for unhealthy eating behaviors, avoidance of physical activity, impaired weight loss efforts, and decreased use of preventive health services (Amy, Aalborg, Lyons, & Keranen, 2006;Ashmore et al, 2008;Carels et al, 2009;Puhl & Brownell, 2006;Puhl & Heuer, 2010). In contrast, studies suggest that communicating acceptance and providing support, rather than instilling stigma and shame, are more appropriate and effective strategies to promote healthy lifestyle behaviors in obese persons (Lillis, Hayes, Bunting, & Masuda, 2009).…”

The role of weight self-stigma on the quality of life of women with overweight and obesity: A multi-group comparison between binge eaters and non-binge eaters

“…Weight stigma may even hold a negative impact on the efficacy of weight loss treatments (Carels, et al, 2009;Puhl & Heuer, 2009). …”

Stimulating Weight Stigma in Future Experimental Designs on Physical Activity - Development and Pilot Validation of a Video Instrument

“…Another solution would be to test implicit attitudes. For instance, the Implicit Association Test [51] has already been successfully used in the context of weight stigma [52,53] and should be taken into consideration for future validations. Third, the QDAC was a self-developed and non-validated instrument.…”