Ard Jamy, Dunn Julia P, Kan Hong, Sims Tracy J, Ahmad Nadia N, Hwang Soohyun, Jauregui Adam, Drakeley Sheila, Kahan Scott, Xavier Neena A
Wake Forest University School of Medicine Winston-Salem North Carolina USA.
Eli Lilly and Company Indianapolis Indiana USA.
Obes Sci Pract. 2025 Jun 30;11(4):e70082. doi: 10.1002/osp4.70082. eCollection 2025 Aug.
Experiencing bias and stigma are social determinants of health (SDoH). Recently, internalized weight bias (IWB) has been included as an SDoH in obesity medicine. This study examined the association of IWB with other pillars of SDoH and how IWB contributes to cumulative social disadvantage for people living with obesity.
A cross-sectional, web-based survey was conducted in the United States (May-December 2022) with a sample of adults with obesity or overweight. Multiple linear regression was performed to evaluate the relationship between WSSQ (higher score indicating experiencing more IWB) and other pillars of SDoH.
Participants who reported race as Black (adjusted mean difference [95% CI] -3.86 [-5.21, -2.52]; < 0.001) or multiracial (-3.26 [-5.37, -1.16]; = 0.002) had significantly lower total WSSQ scores than those who self-identified as White race. Participants who experienced negative social interactions due to weight had significantly higher total WSSQ scores (7.04 [5.81, 8.27]; < 0.001) than those who did not.
The study showed that IWB is associated with certain other pillars of SDoH. Findings highlight the need for a comprehensive and patient-centric approach to managing individuals with greater IWB, which may contribute to a higher cumulative social disadvantage and, consequently, worse health outcomes.
经历偏见和污名是健康的社会决定因素（SDoH）。最近，内化体重偏见（IWB）已被纳入肥胖医学中的一个健康社会决定因素。本研究调查了内化体重偏见与健康社会决定因素其他要素之间的关联，以及内化体重偏见如何导致肥胖者累积的社会劣势。
2022年5月至12月在美国开展了一项基于网络的横断面调查，样本为肥胖或超重的成年人。采用多元线性回归来评估体重羞耻感量表（WSSQ，得分越高表明经历的内化体重偏见越多）与健康社会决定因素其他要素之间的关系。
报告种族为黑人（调整后平均差[95%CI]-3.86[-5.21，-2.52]；<0.001）或多种族（-3.26[-5.37，-1.16]；=0.002）的参与者的体重羞耻感量表总得分显著低于自我认定为白人的参与者。因体重而经历负面社会互动的参与者的体重羞耻感量表总得分（7.04[5.81，8.27]；<0.001）显著高于未经历负面社会互动的参与者。
该研究表明，内化体重偏见与健康社会决定因素的某些其他要素相关。研究结果凸显了需要采取全面且以患者为中心的方法来管理内化体重偏见程度较高的个体，因为这可能导致更高的累积社会劣势，进而导致更差的健康结果。
