Volume 17, Issue 1 (2-2025)                   IJDO 2025, 17(1): 28-39 | Back to browse issues page


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Tavakoli N, Manouchehri M, Seyrafi M, Sarami Foroushani G, Norouzy A. Weight Self-Stigma and Disordered Eating Behaviors in Iranian Women: The Mediating Roles of Self-Efficacy and Guilt. IJDO 2025; 17 (1) :28-39
URL: http://ijdo.ssu.ac.ir/article-1-932-en.html
Assistant Professor, Department of Psychology, Faculty of Welfare and Health Social Sciences, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
Abstract:   (84 Views)
Objective: This study aimed to investigate the concurrent relationships between weight self-stigma and disordered eating behaviors, mediated by weight- and body-related shame and guilt, fear of negative appearance evaluation, and eating self-efficacy, among women with overweight and obesity.
Materials and Methods: This study was a cross-sectional study. The sample consisted of 228 Iranian women, aged 18-70 years, with overweight and obesity (BMI≥ 25), who were purposively selected. Participants responded to online demographic questions and research measurement tools (Dutch Eating Behavior Questionnaire, Weight Self-Stigma Questionnaire, Weight- and Body-Related Shame and Guilt Scale, Weight Efficacy Lifestyle-Short Form, Fear of Negative Appearance Evaluation Scale). Statistical methods of descriptive statistics, Pearson correlation matrix, structural equation modeling and bootstrapping mediation analysis were used to analyze the data, through SPSS 23 and AMOS 23.
Results: The results showed that weight self-stigma had significant paths to all research variables in a structural model (P< 0.05). Furthermore, mediation analysis showed that eating self-efficacy mediated the relationships between weight self-stigma and emotional (P< 0.001), external (P< 0.001), and restrained eating behaviors (P< 0.002). Additionally, weight and body-related guilt mediated the relationship between weight self-stigma and restrained eating behavior (P< 0.001). Totally, the research model explained 14.9% of the variance of emotional and external eating behaviors, and 36.2% of the variance of restrained eating behavior.
Conclusion: The findings highlight the importance of considering weight self-stigma in obesity research. Additionally, improving eating self-efficacy and addressing guilt through psychological interventions are crucial for managing eating behaviors in this population.
 
Full-Text [PDF 997 kb]   (33 Downloads)    
Type of Study: Research | Subject: Special
Received: 2024/10/24 | Accepted: 2025/01/17 | Published: 2025/02/27

References
1. Puhl RM, Himmelstein MS, Pearl RL. Weight stigma as a psychosocial contributor to obesity. American Psychologist. 2020;75(2):274.
2. Emmer C, Bosnjak M, Mata J. The association between weight stigma and mental health: A meta‐analysis. Obesity Reviews. 2020;21(1):e12935.
3. Corrigan PW, Larson JE, Ruesch N. Self-stigma and the "why try" effect: impact on life goals and evidence-based practices. World psychiatry. 2009;8(2):75.
4. Ratcliffe D, Ellison N. Obesity and internalized weight stigma: A formulation model for an emerging psychological problem. Behavioural and cognitive psychotherapy. 2015;43(2):239-52.
5. Pearl RL, Puhl RM. Weight bias internalization and health: a systematic review. Obesity reviews. 2018;19(8):1141-63.
6. Lillis J, Luoma JB, Levin ME, Hayes SC. Measuring weight self‐stigma: the weight self‐stigma questionnaire. Obesity. 2010;18(5):971-6.
7. Meadows A, Higgs S. A bifactor analysis of the Weight Bias Internalization Scale: What are we really measuring?. Body Image. 2020;33:137-51.
8. Austen E, Pearl RL, Griffiths S. Inconsistencies in the conceptualisation and operationalisation of internalized weight stigma: A potential way forward. Body Image. 2021;36:iii-v.
9. Levinson JA, Kinkel-Ram S, Myers B, Hunger JM. A systematic review of weight stigma and disordered eating cognitions and behaviors. Body image. 2024;48:101678.
10. Nutter S, Saunders JF, Waugh R. Current trends and future directions in internalized weight stigma research: a scoping review and synthesis of the literature. Journal of Eating Disorders. 2024;12(1):98.
11. Pearl RL, Wadden TA, Hopkins CM, Shaw JA, Hayes MR, Bakizada ZM, et al. Association between weight bias internalization and metabolic syndrome among treatment‐seeking individuals with obesity. Obesity. 2017;25(2):317-22.
12. Olson KL, Mensinger JL. Weight-related stigma mediates the relationship between weight status and bodily pain: A conceptual model and call for further research. Body image. 2019;30:159-64.
13. Gan WY, Tung SE, Ruckwongpatr K, Ghavifekr S, Paratthakonkun C, Nurmala I, et al. Evaluation of two weight stigma scales in Malaysian university students: weight self-stigma questionnaire and perceived weight stigma scale. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2022;27(7):2595-604.
14. Almenara CA, Aimé A, Maïano C, Ejova A, Guèvremont G, Bournival C, et al. Weight stigmatization and disordered eating in obese women: The mediating effects of self-esteem and fear of negative appearance evaluation. European Review of Applied Psychology. 2017;67(3):155-62.
15. Forbes Y, Donovan C. The role of internalised weight stigma and self‐compassion in the psychological well‐being of overweight and obese women. Australian Psychologist. 2019;54(6):471-82.
16. Hübner C, Baldofski S, Zenger M, Tigges W, Herbig B, Jurowich C, et al. Influences of general self-efficacy and weight bias internalization on physical activity in bariatric surgery candidates. Surgery for Obesity and Related Diseases. 2015;11(6):1371-6.
17. Farhangi MA, Emam-Alizadeh M, Hamedi F, Jahangiry L. Weight self-stigma and its association with quality of life and psychological distress among overweight and obese women. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity. 2017;22(3):451-6.
18. Soulliard ZA, Brode C, Tabone LE, Szoka N, Abunnaja S, Cox S. Disinhibition and subjective hunger as mediators between weight bias internalization and binge eating among pre-surgical bariatric patients. Obesity surgery. 2021;31:797-804.
19. Palmeira L, Pinto-Gouveia J, Cunha M, Carvalho S. Finding the link between internalized weight-stigma and binge eating behaviors in Portuguese adult women with overweight and obesity: The mediator role of self-criticism and self-reassurance. Eating behaviors. 2017;26:50-4.
20. Baldofski S, Rudolph A, Tigges W, Herbig B, Jurowich C, Kaiser S, et al. Weight bias internalization, emotion dysregulation, and non‐normative eating behaviors in prebariatric patients. International Journal of Eating Disorders. 2016;49(2):180-5.
21. Ahorsu DK, Lin CY, Imani V, Griffiths MD, Su JA, Latner JD, et al. A prospective study on the link between weight‐related self‐stigma and binge eating: Role of food addiction and psychological distress. International Journal of Eating Disorders. 2020;53(3):442-50.
22. Donahue ML, Levin ME, Olson K, Panza E, Lillis J. Examining the role of experiential avoidance and valued action in the negative effects of weight self-stigma. Journal of behavioral medicine. 2023;46(3):517-24.
23. Romano KA, Heron KE, Henson JM. Examining associations among weight stigma, weight bias internalization, body dissatisfaction, and eating disorder symptoms: Does weight status matter?. Body Image. 2021;37:38-49.
24. Mehak A, Friedman A, Cassin SE. Self-objectification, weight bias internalization, and binge eating in young women: Testing a mediational model. Body image. 2018;24:111-5.
25. Braun TD, Gorin AA, Puhl RM, Stone A, Quinn DM, Ferrand J, et al. Shame and self-compassion as risk and protective mechanisms of the internalized weight bias and emotional eating link in individuals seeking bariatric surgery. Obesity surgery. 2021;31(7):3177-87.
26. Tylka TL, Annunziato RA, Burgard D, Daníelsdóttir S, Shuman E, Davis C, et al. The weight‐inclusive versus weight‐normative approach to health: evaluating the evidence for prioritizing well‐being over weight loss. Journal of obesity. 2014;2014(1):983495.
27. Mensinger JL, Tylka TL, Calamari ME. Mechanisms underlying weight status and healthcare avoidance in women: A study of weight stigma, body-related shame and guilt, and healthcare stress. Body image. 2018;25:139-47.
28. Webb JB, Hardin AS. An integrative affect regulation process model of internalized weight bias and intuitive eating in college women. Appetite. 2016;102:60-9.
29. Hilbert A, Braehler E, Haeuser W, Zenger M. Weight bias internalization, core self‐evaluation, and health in overweight and obese persons. Obesity. 2014;22(1):79-85.
30. Althumiri NA, Basyouni MH, AlMousa N, AlJuwaysim MF, Alhamdan AA, Al-Qahtani FS, et al. Exploring weight stigma in Saudi Arabia: A nationwide cross-sectional study. International journal of environmental research and public health. 2021;18(17):9141.
31. Kargari Padar L, Asgharnejad Farid AA, Fathali Lavasani F, Farahani H, Gharaei B. Coping with weight stigma: Validation of the Persian brief coping responses inventory with Iranian adolescents sample. Frontiers in Psychology. 2022;13:996052.
32. Abiri B, Ahmadi AR, Amini S, Akbari M, Hosseinpanah F, Madinehzad SA, et al. Prevalence of overweight and obesity among Iranian population: a systematic review and meta-analysis. Journal of Health, Population and Nutrition. 2023;42(1):70.
33. Conradt M, Dierk JM, Schlumberger P, Rauh E, Hebebrand J, Rief W. Development of the weight-and body-related shame and guilt scale (WEB-SG) in a nonclinical sample of obese individuals. Journal of personality assessment. 2007;88(3):317-27.
34. Ames GE, Heckman MG, Grothe KB, Clark MM. Eating self-efficacy: development of a short-form WEL. Eating behaviors. 2012;13(4):375-8.
35. Ames GE, Heckman MG, Diehl NN, Grothe KB, Clark MM. Further statistical and clinical validity for the weight efficacy lifestyle questionnaire-short form. Eating behaviors. 2015;18:115-9.
36. Lundgren JD, Anderson DA, Thompson JK. Fear of negative appearance evaluation: Development and evaluation of a new construct for risk factor work in the field of eating disorders. Eating behaviors. 2004;5(1):75-84.
37. Van Strien T, Frijters JE, Bergers GP, Defares PB. The Dutch Eating Behavior Questionnaire (DEBQ) for assessment of restrained, emotional, and external eating behavior. International journal of eating disorders. 1986;5(2):295-315.https://doi.org/10.1002/1098-108X(198602)5:2<295::AID-EAT2260050209>3.0.CO;2-T [DOI:10.1002/1098-108X(198602)5:23.0.CO;2-T]
38. Matsunaga M. Item parceling in structural equation modeling: A primer. Communication methods and measures. 2008;2(4):260-93.
39. Kline RB. Principles and practice of structural equation modeling. Guilford publications; 2023.
40. Hu LT, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural equation modeling: a multidisciplinary journal. 1999;6(1):1-55.
41. Goffman E. Stigma: Notes on the management of spoiled identity. Simon and schuster; 2009.
42. Major B, O'brien LT. The social psychology of stigma. Annual review of psychology. 2005;56:393-421.
43. Bandura A. Health promotion by social cognitive means. Health education & behavior. 2004;31(2):143-64.
44. Tomiyama AJ. Weight stigma is stressful. A review of evidence for the Cyclic Obesity/Weight-Based Stigma model. Appetite. 2014;82:8-15.
45. Sikorski C, Luppa M, Luck T, Riedel‐Heller SG. Weight stigma "gets under the skin"-evidence for an adapted psychological mediation framework-a systematic review. Obesity. 2015;23(2):266-76.
46. Heatherton TF, Baumeister RF. Binge eating as escape from self-awareness. Psychological bulletin. 1991;110(1):86.
47. Herman CP, Mack D. Restrained and unrestrained eating. Journal of personality. 1975;43(4):647-60.
48. Groshon LC, Pearl RL. Longitudinal associations of binge eating with internalized weight stigma and eating self-efficacy. Eating Behaviors. 2023;50:101785.
49. Lewis HB. Shame and guilt in neurosis. International University. 1971.
50. Tracy JL, Robins RW. " Putting the Self Into Self-Conscious Emotions: A Theoretical Model". Psychological inquiry. 2004;15(2):103-25

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