Skip to main content
SpringerLink
Log in

Internalized Weight Bias in Weight-Loss Surgery Patients: Psychosocial Correlates and Weight Loss Outcomes

  • Brief Communication
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Purpose

In this study, we examined the relationship between pre-operative internalized weight bias and 12-month post-operative weight loss in adult bariatric surgery patients.

Methods

Bariatric surgery patients (n = 170) from one urban and one rural medical center completed an internalized weight bias measure (the weight bias internalization scale, WBIS) and a depression survey (Beck depression inventory-II, BDI-II) before surgery, and provided consent to access their medical records.

Results

Participants (BMI = 47.8 kg/m2, age = 45.7 years) were mostly female (82.0 %), White (89.5 %), and underwent gastric bypass (83.6 %). The average WBIS score by item was 4.54 ± 1.3. Higher pre-operative WBIS scores were associated with diminished weight loss at 12 months after surgery (p = 0.035). Pre-operative WBIS scores were positively associated with depressive symptoms (p < 0.001).

Conclusion

Greater internalized weight bias was associated with more depressive symptoms before surgery and less weight loss 1 year after surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Washington RL. Childhood obesity: issues of weight bias. Prev Chronic Dis. 2011;8(5):A94.

    PubMed Central  PubMed  Google Scholar 

  2. Puhl RM, Latner JD. Stigma, obesity, and the health of the nation’s children. Psychol Bull. 2007;133(4):557–80.

    Article  PubMed  Google Scholar 

  3. Puhl RM, Moss-Racusin CA, Schwartz MB, et al. Weight stigmatization and bias reduction: perspectives of overweight and obese adults. Health Educ Res. 2008;23(2):347–58.

    Article  PubMed  Google Scholar 

  4. Roehling MV. Weight discrimination in the American workplace: ethical issues and analysis. J Bus Ethics. 2002;40(2):177–89.

    Article  Google Scholar 

  5. Schwartz MB, Chambliss HO, Brownell KD, et al. Weight bias among health professionals specializing in obesity. Obes Res. 2003;11(9):1033–9.

    Article  PubMed  Google Scholar 

  6. Roehling MV. Weight-based discrimination in employment: psychological and legal aspects. Pers Psychol. 1999;52(4):969–1016.

    Article  Google Scholar 

  7. Friedman KE, Ashmore JA, Applegate KL. Recent experiences of weight-based stigmatization in a weight loss surgery population: psychological and behavioral correlates. Obesity (Silver Spring). 2008;16 Suppl 2:S69–74.

    Article  Google Scholar 

  8. Roberto CA, Sysko R, Bush J, et al. Clinical correlates of the weight bias internalization scale in a sample of obese adolescents seeking bariatric surgery. Obesity. 2012;20(3):533–9.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Vartanian LR, Novak SA. Internalized societal attitudes moderate the impact of weight stigma on avoidance of exercise. Obesity (Silver Spring). 2011;19(4):757–62.

    Article  Google Scholar 

  10. Schwartz MB, Vartanian LR, Nosek BA, et al. The influence of one’s own body weight on implicit and explicit anti-fat bias. Obesity. 2006;14(3):440–7.

    Article  PubMed  Google Scholar 

  11. Myers A, Rosen JC. Obesity stigmatization and coping: relation to mental health symptoms, body image, and self-esteem. Int J Obes. 1999;23(3):221–30.

    Article  CAS  Google Scholar 

  12. Puhl RM, Moss-Racusin CA, Schwartz MB. Internalization of weight bias: implications for binge eating and emotional well-being. Obesity. 2007;15(1):19–23.

    Article  PubMed  Google Scholar 

  13. Neumark-Sztainer D, Falkner N, Story M, et al. Weight-teasing among adolescents: correlations with weight status and disordered eating behaviors. IntJ Obes Relat Metab Disord : J Int Assoc Study Obes. 2002;26(1):123–31.

    Article  CAS  Google Scholar 

  14. Puhl RM, Andreyeva T, Brownell KD. Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes (Lond). 2008;32(6):992–1000.

    Article  CAS  Google Scholar 

  15. Durso LE, Latner JD. Understanding self-directed stigma: development of the weight bias internalization scale. Obesity. 2008;16 Suppl 2:S80–6.

    Article  PubMed  Google Scholar 

  16. Beck AT. Psychiatry: cognitive therapy for depression and panic disorder. West J Med. 1989;151(3):311.

    CAS  PubMed Central  PubMed  Google Scholar 

  17. Carels RA, Young KM, Wott CB, et al. Weight bias and weight loss treatment outcomes in treatment-seeking adults. Ann Behav Med : Publ Soc Behav Med. 2009;37(3):350–5.

    Article  Google Scholar 

  18. Beck AT, Steer RA. Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol. 1984;40(6):1365–7.

    Article  CAS  PubMed  Google Scholar 

  19. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington DC: Text Revision; 2000.

    Google Scholar 

  20. Carels RA, Wott CB, Young KM, et al. Implicit, explicit, and internalized weight bias and psychosocial maladjustment among treatment-seeking adults. Eat Behav. 2010;11(3):180–5.

    Article  CAS  PubMed  Google Scholar 

  21. Hebl MR, Heatherton TF. The stigma of obesity in women: the difference is black and white. Pers Soc Psychol B. 1998;24(4):417–26.

    Article  Google Scholar 

Download references

Acknowledgments

We would like to thank the thousands of participating bariatric surgery patients at Geisinger Health System and Temple University Health System.

Conflicts of Interest

Dr. Foster consulted with ConAgra Foods and Tate & Lyle during this study. He is currently employed at Weight Watchers. Dr. Napolitano received funding from the Living Heart Foundation. All other authors report no conflict of interest.

Statement of Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Author information

Authors and Affiliations

  1. Center for Obesity Research and Education, Temple University, 3223 N. Broad Street, Suite 175, Philadelphia, PA, 19140, USA

    Michelle R. Lent & Gary D. Foster

  2. Departments of Prevention and Community Health and Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave., Third Fl, Washington, DC, 20052, USA

    Melissa A. Napolitano

  3. Geisinger Obesity Research Institute, 100 North Academy Avenue, Danville, PA, 17822, USA

    G. Craig Wood, George Argyropoulos & Christopher D. Still

  4. Penn State Hershey Institute for Personalized Medicine, 500 University Drive, Hershey, PA, 17033, USA

    Glenn S. Gerhard

  5. Department of Psychology, Keiser University, 10330 South Federal Highway, Port Saint Lucie, FL, 34952, USA

    Sharon Hayes

  6. Department of Psychiatry, Geisinger Medical Center, 100 North Academy Avenue, Danville, PA, 17822, USA

    Charlotte A. Collins

Authors
  1. Michelle R. Lent
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Melissa A. Napolitano
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. G. Craig Wood
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. George Argyropoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Glenn S. Gerhard
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sharon Hayes
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gary D. Foster
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Charlotte A. Collins
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Christopher D. Still
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michelle R. Lent.

Additional information

Dr. Lent is currently an employee of Geisinger Health System.

This project was funded by NIH grants F32DK096756 (MRL), DK072488 (GSG, CDS, GA), DK088231 (GSG), and DK091601 (GSG). This research was also supported by research funds from the Geisinger Health System.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lent, M.R., Napolitano, M.A., Wood, G.C. et al. Internalized Weight Bias in Weight-Loss Surgery Patients: Psychosocial Correlates and Weight Loss Outcomes. OBES SURG 24, 2195–2199 (2014). https://doi.org/10.1007/s11695-014-1455-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-014-1455-z

Keywords

Search

Navigation