A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity

doi:10.1016/j.cpr.2022.102127

Review

. 2022 Mar:92:102127.

doi: 10.1016/j.cpr.2022.102127. Epub 2022 Jan 12.

A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity

Kelly A Romano¹, Kristin E Heron², Cassidy M Sandoval³, Lindsay M Howard⁴, Rachel I MacIntyre⁵, Tyler B Mason⁶

Affiliations

¹ The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA. Electronic address: [email protected].
² The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA; Department of Psychology, Old Dominion University, Norfolk, VA, USA.
³ The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA.
⁴ Department of Psychology, Augustana University, Sioux Falls, SD, USA.
⁵ Department of Psychology, Millersville University, Millersville, PA, USA.
⁶ Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 35074712
PMCID: PMC8858873
DOI: 10.1016/j.cpr.2022.102127

Review

A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity

Kelly A Romano et al. Clin Psychol Rev. 2022 Mar.

. 2022 Mar:92:102127.

doi: 10.1016/j.cpr.2022.102127. Epub 2022 Jan 12.

Authors

Kelly A Romano¹, Kristin E Heron², Cassidy M Sandoval³, Lindsay M Howard⁴, Rachel I MacIntyre⁵, Tyler B Mason⁶

Affiliations

¹ The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA. Electronic address: [email protected].
² The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA; Department of Psychology, Old Dominion University, Norfolk, VA, USA.
³ The Virginia Consortium Program in Clinical Psychology, Norfolk, VA, USA.
⁴ Department of Psychology, Augustana University, Sioux Falls, SD, USA.
⁵ Department of Psychology, Millersville University, Millersville, PA, USA.
⁶ Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.

PMID: 35074712
PMCID: PMC8858873
DOI: 10.1016/j.cpr.2022.102127

Abstract

Weight bias internalization (WBI), a process of weight-based self-devaluation, has been associated with adverse mental and physical health. However, there are limitations with the existing conceptualization and operationalization of WBI that raise questions about the implications of this evidence-base. To address these limitations, the present study investigated the construct validity of WBI by conducting a meta-analysis of associations between WBI (as currently operationalized) and conceptually-related correlates. Studies identified through October 2021 that provided zero-order correlations for associations between WBI and conceptually-related constructs were examined. Meta-regression determined whether these associations differed across WBI measures and demographic (age, sex/gender, race, BMI) and study-level (publication status, sample type, study quality) moderators. Data for 128 (sub)samples were identified (Msample size = 477.83, SD = 1679.90; Mage = 34.46, SD = 12.17; range = 10.21-56.60). Greater WBI exhibited large to very large associations with factors suggested to have considerable overlap with this construct (negative and positive body image, self-devaluation), general and weight-specific experiential avoidance, and individuals' anticipation of future weight stigma. Associations varied for other constructs that have been differentially included in conceptualizations of WBI (endorsing weight bias, weight stigma stereotype awareness, weight stigma experiences), and via measurement-related, demographic, and study-level factors. These findings provide important information that can advance WBI conceptualization and measure-refinement.

Keywords: Obesity; Psychological methods; Weight bias internalization; Weight stigma.

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Conflict of interest statement

Declarations of interest: None.

Figures

**Figure 1.**
Preferred reporting items for systematic reviews and meta-analyses (PRISMA) flow diagram for study selection.

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References

1. Alimoradi Z, Golboni F, Griffiths MD, Broström A, Lin CY, & Pakpour AH (2019). Weight-related stigma and psychological distress: A systematic review and meta-analysis. Clinical Nutrition, 39, 2001–2013. 10.1016/j.clnu.2019.10.016 - DOI - PubMed
1. Austen E, Pearl RL, & Griffiths S (2020). Inconsistencies in the conceptualisation and operationalisation of internalized weight stigma: A potential way forward. Body Image, 36. 10.1016/j.bodyim.2020.12.002 - DOI - PMC - PubMed
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1. Braun TD, Quinn DM, Stone A, Gorin AA, Ferrand J, Puhl RM, … & Papasavas P (2020). Weight bias, shame, and self-compassion: Risk/protective mechanisms of depression and anxiety in prebariatic surgery patients. Obesity, 28(10), 1974–1983. 10.1002/oby.22920 - DOI - PMC - PubMed

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[1] Alimoradi Z, Golboni F, Griffiths MD, Broström A, Lin CY, & Pakpour AH (2019). Weight-related stigma and psychological distress: A systematic review and meta-analysis. Clinical Nutrition, 39, 2001–2013. 10.1016/j.clnu.2019.10.016 - DOI - PubMed

[2] Alimoradi Z, Golboni F, Griffiths MD, Broström A, Lin CY, & Pakpour AH (2019). Weight-related stigma and psychological distress: A systematic review and meta-analysis. Clinical Nutrition, 39, 2001–2013. 10.1016/j.clnu.2019.10.016 - DOI - PubMed

[3] Austen E, Pearl RL, & Griffiths S (2020). Inconsistencies in the conceptualisation and operationalisation of internalized weight stigma: A potential way forward. Body Image, 36. 10.1016/j.bodyim.2020.12.002 - DOI - PMC - PubMed

[4] Austen E, Pearl RL, & Griffiths S (2020). Inconsistencies in the conceptualisation and operationalisation of internalized weight stigma: A potential way forward. Body Image, 36. 10.1016/j.bodyim.2020.12.002 - DOI - PMC - PubMed

[5] Borenstein M, Hedges LV, Higgins J, & Rothstein HR (2009). Introduction to meta-analysis. Hoboken, NJ: John Wiley & Sons.

[6] Borenstein M, Hedges LV, Higgins J, & Rothstein HR (2009). Introduction to meta-analysis. Hoboken, NJ: John Wiley & Sons.

[7] Borenstein M, Hedges L, Higgins J, & Rothstein H (2014). Comprehensive meta-analysis: Version 3.0

[8] Borenstein M, Hedges L, Higgins J, & Rothstein H (2014). Comprehensive meta-analysis: Version 3.0

[9] Braun TD, Quinn DM, Stone A, Gorin AA, Ferrand J, Puhl RM, … & Papasavas P (2020). Weight bias, shame, and self-compassion: Risk/protective mechanisms of depression and anxiety in prebariatic surgery patients. Obesity, 28(10), 1974–1983. 10.1002/oby.22920 - DOI - PMC - PubMed

[10] Braun TD, Quinn DM, Stone A, Gorin AA, Ferrand J, Puhl RM, … & Papasavas P (2020). Weight bias, shame, and self-compassion: Risk/protective mechanisms of depression and anxiety in prebariatic surgery patients. Obesity, 28(10), 1974–1983. 10.1002/oby.22920 - DOI - PMC - PubMed

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A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity

Affiliations

A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity

Authors

Affiliations

Abstract

Conflict of interest statement

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