Background: Physical activity (PA) seems to be important for long-term weight loss following bariatric surgery, however, studies provide evidence for insufficient PA levels in bariatric patients. Research found self-efficacy to be associated with PA and weight bias internalization, whose influence on mental and physical health has been shown in recent studies. Objectives: The purpose of the present study was to investigate the influence of general self-efficacy on PA, mediated by weight bias internalization. Setting: Consecutive multicenter registry study conducted in six German bariatric surgery centers. Methods: In N = 179 bariatric surgery candidates, general self-efficacy, weight bias internalization, and different intensities of PA were assessed by self-report questionnaires. Structural equation modeling was used to analyze the assumed mediational relationship. Results: After controlling for sociodemographic variables, weight bias internalization fully mediated the association between general self-efficacy and moderate-intense as well as vigorous-intense PA. Lower general self-efficacy predicted greater weight bias internalization, which in turn predicted lower levels of moderate-intense and vigorous-intense PA. Conclusions: The results suggest an influence of weight bias internalization on preoperative PA in bariatric surgery candidates. Subsequently, implementation of interventions addressing weight bias internalization in the usual treatment of bariatric surgery candidates might enhance patients’ preoperative PA, while longitudinal analyses are needed in order to further examine its predictive value on PA following bariatric surgery.

Eine Einführung in die Weight Bias Internalization Scale (WBIS) ist ein Selbstbeurteilungsfragebogen zur Erfassung negativer gewichtsbezogener Selbststereotypisierung, inklusive der deutschen Version der Skala.

Past research shows that weight-related teasing is linked to binge eating, but little is known about the individual risk factors that render certain people more vulnerable than others. The current study examined three potential risk factors for binge eating in response to weight-related teasing: weight stigmatization experiences, weight bias internalization, and emotion dysregulation. The current study empirically investigated how these factors interacted to predict concurrent binge eating behavior through a self-report questionnaire and eating behavior in a laboratory following exposure to a weight stigma vignette. First, it was hypothesized that higher levels of weight stigmatization and emotion dysregulation would be associated with higher levels of binge eating, which was consistent with the results of a multiple linear regression analysis. Second, it was predicted that higher levels of weight stigmatization and emotion dysregulation would predict greater quantities of cookie consumption during a bogus taste test following exposure to a weight stigma vignette. The hypothesis was not supported by a multiple linear regression. Third, we posited that weight bias internalization would moderate the relationship between weight stigmatization and emotion dysregulation on disordered eating, such that higher levels of weight bias internalization would be associated with higher levels of binge eating. This was not supported by a hierarchical regression analysis. Overall, the results highlight variables pertinent to the relationship between weight stigma and binge eating. Future research should test the model in clinical samples to see if it is more relevant to people with more severe levels of eating pathology.

Objective: Adolescents with binge-eating disorder (BED) are suffering from weight teasing and, as found in adults with BED, are likely to internalize weight bias. Weight teasing by mothers accounts for psychopathology in overweight, but sources of stigmatization are largely unknown in BED. This study sought to address familial weight bias in adolescents with overweight and BED by examining adolescents’ perceived parental weight teasing and weight bias internalization in relation to their eating disorder psychopathology and maternal stigmatizing attitudes and beliefs. Method: Adolescents with overweight and BED (BED; n = 40) were compared to a socio-demographically matched group with overweight only (OW) and a normal-weight control group (NW; each n = 25). They filled out the Perception of Teasing Scale, with parents as the source of teasing, the Weight Bias Internalization Scale and the Eating Disorder Examination-Questionnaire. Their mothers filled out the Attitudes Toward and Beliefs about Obese Persons Scales. Results: Significantly higher perceived parental weight teasing and weight bias internalization were found in BED compared to OW and NW. Maternal stigmatizing attitudes and beliefs did not differ between groups and were not correlated with adolescents’ perceptions of being stigmatized. Perceived parental weight teasing predicted adolescents’ eating disorder psychopathology, however, this association was fully mediated by weight bias internalization. Discussion: These results indicate that adolescents with overweight and BED perceive weight teasing in their own families. As we found no significant association between adolescents’ perceptions of being stigmatized and maternal stigmatizing attitudes, future research should examine weight-related parent-child interaction or implicit measures of stigmatizing attitudes.

Objective: Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation. Method: Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling. Results: The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms. Discussion: Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients.

Objective: Internalizing the pervasive weight bias commonly directed towards individuals with overweight and obesity, cooccurs with increased psychopathology and impaired quality of life. This study sought to establish population norms and psychometric properties of the most widely used self-report questionnaire, the Weight Bias Internalization Scale (WBIS), in a representative community sample. Design and Methods: In a survey of the German population, N = 1158 individuals with overweight and obesity were assessed with the WBIS and self-report measures for convergent validation. Results: Item analysis revealed favorable item-total correlation of all but one WBIS item. With this item removed, item homogeneity and internal consistency were excellent. The one-factor structure of the WBIS was confirmed using confirmatory factor analysis. Convergent validity was shown through significant associations with measures of depressive and somatoform symptoms. The WBIS contributed to the explanation of variance in depressive and somatoform symptoms over and above body mass index. Higher WBIS scores were found in women than in men, in individuals with obesity than in individuals with overweight, and in those with lower education or income than those with higher education or income. Sex specific norms were provided. Conclusions: The results showed good psychometric properties of the WBIS after removal of one item. Future research is warranted on further indicators of reliability and validity, for example, retest reliability, sensitivity to change, and prognostic validity.

Objective: Internalizing the pervasive weight bias commonly directed towards individuals with overweight and obesity, cooccurs with increased psychopathology and impaired quality of life. This study sought to establish population norms and psychometric properties of the most widely used self-report questionnaire, the Weight Bias Internalization Scale (WBIS), in a representative community sample. Design and Methods: In a survey of the German population, N = 1158 individuals with overweight and obesity were assessed with the WBIS and self-report measures for convergent validation. Results: Item analysis revealed favorable item-total correlation of all but one WBIS item. With this item removed, item homogeneity and internal consistency were excellent. The one-factor structure of the WBIS was confirmed using confirmatory factor analysis. Convergent validity was shown through significant associations with measures of depressive and somatoform symptoms. The WBIS contributed to the explanation of variance in depressive and somatoform symptoms over and above body mass index. Higher WBIS scores were found in women than in men, in individuals with obesity than in individuals with overweight, and in those with lower education or income than those with higher education or income. Sex specific norms were provided. Conclusions: The results showed good psychometric properties of the WBIS after removal of one item. Future research is warranted on further indicators of reliability and validity, for example, retest reliability, sensitivity to change, and prognostic validity.

Background: Physical activity (PA) seems to be important for long-term weight loss following bariatric surgery, however, studies provide evidence for insufficient PA levels in bariatric patients. Research found self-efficacy to be associated with PA and weight bias internalization, whose influence on mental and physical health has been shown in recent studies. Objectives: The purpose of the present study was to investigate the influence of general self-efficacy on PA, mediated by weight bias internalization. Setting: Consecutive multicenter registry study conducted in six German bariatric surgery centers. Methods: In N = 179 bariatric surgery candidates, general self-efficacy, weight bias internalization, and different intensities of PA were assessed by self-report questionnaires. Structural equation modeling was used to analyze the assumed mediational relationship. Results: After controlling for sociodemographic variables, weight bias internalization fully mediated the association between general self-efficacy and moderate-intense as well as vigorous-intense PA. Lower general self-efficacy predicted greater weight bias internalization, which in turn predicted lower levels of moderate-intense and vigorous-intense PA. Conclusions: The results suggest an influence of weight bias internalization on preoperative PA in bariatric surgery candidates. Subsequently, implementation of interventions addressing weight bias internalization in the usual treatment of bariatric surgery candidates might enhance patients’ preoperative PA, while longitudinal analyses are needed in order to further examine its predictive value on PA following bariatric surgery.

Objective: Weight bias internalization (WBI) is associated with eating disorder psychopathology and non-normative eating behaviors among individuals with overweight and obesity, but has rarely been investigated in prebariatric patients. Based on findings demonstrating a relationship between emotion dysregulation and eating behavior, this study sought to investigate the association between WBI and eating disorder psychopathology as well as non-normative eating behaviors (i.e., food addiction, emotional eating, and eating in the absence of hunger), mediated by emotion dysregulation. Method: Within a consecutive multicenter study, 240 prebariatric patients were assessed using self-report questionnaires. The mediating role of emotion dysregulation was examined using structural equation modeling. Results: The analyses yielded no mediational effect of emotion dysregulation on the association between WBI and eating disorder psychopathology. However, emotion dysregulation fully mediated the associations between WBI and emotional eating as well as eating in the absence of hunger. Further, emotion dysregulation partially mediated the relationship between WBI and food addiction symptoms. Discussion: Prebariatric patients with high levels of WBI are at risk for non-normative eating behaviors, especially if they experience emotion regulation difficulties. These findings highlight the importance of interventions targeting WBI and improving emotion regulation skills for the normalization of eating behavior in prebariatric patients.