Clinical correlates of the Weight Bias Internalization Scale in overweight adults with binge and purge behaviours

Abstract

Objective: The present study explored the clinical correlates of the Weight Bias Internalization Scale (WBIS). Method: Participants were 656 overweight and obese (mean body mass index (BMI): 34.3 ± 7.7) adults who completed the WBIS and measures of disordered eating behaviors and attitudes via an online survey. Results: Based on both the Eating Disorder Examination Questionnaire (EDE-Q) and Questionnaire on Eating and Weight Patterns – Revised (n = 442), 9.7% and 22.2% of participants were classified into a binge/purge (B/P) and binge eating (BE) group, respectively. WBIS scores were significantly higher among those with binge and/or purge behaviors compared to those without eating pathology, and higher degree of internalized weight bias was predictive of the presence of B/P behaviors (OR = 2.408, 95% CI: 1.727–3.359, p < .001) and BE (OR = 1.459, 95% CI: 1.224–1.739, p < .001). Partial correlations, controlling for BMI, revealed positive correlations between WBIS score and number of weight fluctuations, depression, and all EDE-Q subscales (Restraint, Eating Concern, Shape Concern, and Weight Concern) and a negative correlation with age at overweight onset. Discussion: These novel findings suggest an association between weight bias internalization and clinical eating pathology among overweight adults. The associations between internalization of weight bias and depression, weight instability, and eating pathology have important implications for healthcare providers working with overweight patients.

Keywords:

• weight bias
• overweight
• binge eating disorder
• bulimia nervosa

Notes on contributors

Natasha A. Schvey, MS, MPhil, is a clinical psychology doctoral candidate at Yale University.  Her research focuses on the intersection of obesity and eating pathology and the impact of weight stigmatization on the emotional and physical health of those who are targeted.

Christina A. Roberto, PhD is a psychologist and epidemiologist whose research examines public health policies aimed at improving diet and reducing obesity and eating disorders. Dr Roberto is currently a Robert Wood Johnson Foundation Health and Society Scholar at the Harvard School of Public Health.

Marney A. White, PhD, MS, is a clinical psychologist and an assistant professor of Psychiatry and of Epidemiology and Public Health (Chronic Diseases) at the Yale University School of Medicine. Her research focuses on binge-eating disorder and the interaction of cigarette smoking with eating disorder symptomatology and weight problems.

Notes

*Correlation is significant at the .05 level (two-tailed).

**Correlation is significant at the .001 level (two-tailed).