Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, 106320, Taiwan.
Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701, Taiwan.
BMC Psychol. 2023 Nov 1;11(1):365. doi: 10.1186/s40359-023-01414-w.
Weight stigma is an issue often studied in Western countries; however, such information is scarce in Asian studies.
This study aimed to examine the role of internalized weight stigma as a mediator in the relationship between perceived weight stigma and changes in body mass index (BMI). The data were collected through a longitudinal online survey with two phases (n = 974; Phase 1: August and September 2021; Phase 2: November and December 2021). The Perceived Weight Stigma Scale (PWSS), Weight Self-Stigma Questionnaire (WSSQ), and Depression, Anxiety, Stress Scale - 21 (DASS-21) were administered to assess perceived weight stigma, internalized weight stigma, and psychological distress. Hierarchical regressions were used to examine the proposed model, and Hayes' Process Macro was used to test a mediation model.
The changes in perceived weight stigma and internalized weight stigma were significantly and positively associated with changes in BMI. There were significant and positive associations between perceived weight stigma, internalized weight stigma and psychological distress over time. Change in internalized weight stigma was found to be a significant mediator in the association of change in perceived weight stigma with change in BMI for the entire sample (unstandardized coefficient = 0.04; 95% CI = 0.02, 0.06), female subgroup (unstandardized coefficient = 0.05; 95% CI = 0.02, 0.08), and male subgroup (unstandardized coefficient = 0.03; 95% CI = 0.01, 0.06). Change in perceived weight stigma also had significant effects on change in BMI for the entire sample and the female subgroup, but not for the male subgroup.
Because perceived weight stigma may significantly impact changes in BMI through internalized weight stigma, treatment strategies to ameliorate self-stigma may enhance the results of weight-reduction programs. Such treatment strategies should be considered for inclusion in weight-loss interventions.
体重歧视在西方国家是一个经常被研究的问题；然而，在亚洲的研究中，这种信息很少。
本研究旨在检验内化的体重歧视作为感知体重歧视与体重指数（BMI）变化之间关系的中介作用。数据通过两阶段的纵向在线调查收集（n=974；第 1 阶段：2021 年 8 月和 9 月；第 2 阶段：2021 年 11 月和 12 月）。使用感知体重歧视量表（PWSS）、体重自我歧视问卷（WSSQ）和抑郁、焦虑和压力量表-21（DASS-21）评估感知体重歧视、内化的体重歧视和心理困扰。采用分层回归检验所提出的模型，使用 Hayes 的 Process Macro 检验中介模型。
感知体重歧视和内化的体重歧视的变化与 BMI 的变化呈显著正相关。感知体重歧视、内化的体重歧视与心理困扰随时间呈显著正相关。在整个样本中（未标准化系数=0.04；95%CI=0.02，0.06）、女性亚组（未标准化系数=0.05；95%CI=0.02，0.08）和男性亚组（未标准化系数=0.03；95%CI=0.01，0.06），内化的体重歧视的变化被发现是感知体重歧视变化与 BMI 变化之间关联的一个显著中介。感知体重歧视的变化对整个样本和女性亚组的 BMI 变化有显著影响，但对男性亚组没有影响。
由于感知体重歧视可能通过内化的体重歧视显著影响 BMI 的变化，因此减轻自我歧视的治疗策略可能会增强减肥计划的效果。这些治疗策略应考虑纳入减肥干预措施。
