Nagy Veronika, Poole Lydia, Banting Esme, Satherley Rose-Marie
School of Psychology, Department of Psychological Interventions, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
Specialist Weight Management Service, Ashford and St. Peter's Hospital NHS Foundation Trust, Chertsey, UK.
Br J Health Psychol. 2025 May;30(2):e12804. doi: 10.1111/bjhp.12804.
Internalized weight stigma (IWS) refers to the internalization of societal weight-based prejudices. While research on external weight stigma is well-established, the psychological mechanisms underlying IWS remain underexplored. This study aims to provide a deeper understanding of IWS by examining the lived experiences of individuals with obesity and identifying key psychological processes contributing to IWS.
A qualitative design was employed, using both in-depth interviews and photo-elicitation to explore the lived experiences of nine participants.
Participants were invited to take pictures of situations which made them feel stigmatized about their body size during a 2-week-long photography task. Subsequently, participants reflected on the implications of their photographs during a 60-minute research interview. IPA was used to guide the analysis of the interview data.
Four key psychological processes contributing to IWS were identified: (1) Self-application of negative stereotypes, where participants internalized societal stigma, sometimes resisting it but still experiencing self-critical thoughts; (2) Imposition of an undesired identity, where societal labels restricted self-expression, leading participants to adopt socially acceptable personas; (3) Heightened anxiety and social vigilance, where participants experienced anxiety, hyper-awareness, and discomfort in public settings; and (4) Distress and coping, where emotional distress and coping strategies like social withdrawal appeared to reinforce IWS.
These findings extended existing literature by providing a data-driven conceptualization of IWS. The findings underscore the importance of developing psychological interventions that address both IWS and external societal weight stigma, focusing on strategies that challenge self-critical narratives and promote more adaptive self-concepts.
内化的体重污名（IWS）指的是基于体重的社会偏见的内化。虽然关于外在体重污名的研究已经很成熟，但IWS背后的心理机制仍未得到充分探索。本研究旨在通过考察肥胖个体的生活经历并确定导致IWS的关键心理过程，来更深入地理解IWS。
采用定性设计，通过深度访谈和照片引出法来探索9名参与者的生活经历。
邀请参与者在为期两周的摄影任务中拍摄那些让他们因自己的体型而感到受污名化的情境。随后，参与者在60分钟的研究访谈中反思他们照片的含义。诠释现象学分析法（IPA）被用来指导访谈数据的分析。
确定了导致IWS的四个关键心理过程：（1）负面刻板印象的自我应用，即参与者内化了社会污名，有时会抵制它，但仍会产生自我批评的想法；（2）强加不想要的身份，即社会标签限制了自我表达，导致参与者采用社会可接受的角色；（3）焦虑和社会警惕性增强，即参与者在公共场合会感到焦虑、过度警觉和不适；（4）痛苦与应对，即情绪困扰和诸如社交退缩等应对策略似乎强化了IWS。
这些发现通过提供一个数据驱动的IWS概念化扩展了现有文献。这些发现强调了开发心理干预措施的重要性，这些措施既要解决IWS问题，也要解决外在社会体重污名问题，重点是挑战自我批评性叙述并促进更具适应性的自我概念的策略。
