Elsevier

Body Image

Volume 11, Issue 1, January 2014, Pages 89-92
Body Image

Brief research report
Measuring internalized weight attitudes across body weight categories: Validation of the Modified Weight Bias Internalization Scale

https://doi.org/10.1016/j.bodyim.2013.09.005Get rights and content

Highlights

  • We modify the Weight Bias Internalization Scale for samples of diverse body weights.

  • The modified scale is psychometrically sound.

  • The scale predicts psychopathology across body weight categories.

  • Body dissatisfaction and eating pathology correlate with the modified measure.

  • The scale can be used as an assessment tool in both research and clinical practice.

Abstract

The purpose of this research was to validate a modified version of the Weight Bias Internalization Scale (WBIS-M) that is applicable to individuals across different body weight statuses. One hundred forty-eight men and women completed an online survey that included the WBIS-M and relevant measures of psychopathology. Results indicated that the WBIS-M had high internal consistency and strong construct validity. The WBIS-M also demonstrated significant correlations with body image, eating pathology, self-esteem, and symptoms of anxiety and depression, and was associated with these outcomes distinctly from antifat attitudes and body mass index. Implications for the use of this scale in diverse samples are discussed.

Introduction

As obesity has gained more attention as a global health concern, researchers, clinicians, and public health officials have also begun considering the consequences of weight-based bias, discrimination, and stigmatization. Weight bias refers to negative attitudes toward individuals because of overweight or obesity, and individuals with obesity commonly experience weight stigmatization in education, employment, and health-care settings, among other life domains (Puhl & Heuer, 2009). Empirical evidence consistently supports links between experiences of weight-based stigmatization and negative physical and mental health outcomes, including depression, anxiety, disordered eating, and poorer overall health-related quality of life (Gearhardt et al., 2012, Puhl and Heuer, 2009). Experiencing weight stigma has also been linked to body image disturbances such as increased body dissatisfaction, body image distress, and preoccupation with weight (Annis et al., 2004, Myers and Rosen, 1999).

In addition to exposure to weight stigma, internalization of weight-biased attitudes, or self-directed stigma, may play a role in facilitating these negative health outcomes among individuals with obesity. Durso and Latner (2008) developed the Weight Bias Internalization Scale (WBIS) to measure the degree to which people apply weight-based stereotypes to themselves and base their self-evaluations on weight. Weight bias internalization, as measured by the WBIS, has consistently correlated with clinically-significant body image disturbance, shape and weight concerns, eating pathology, and other forms of psychopathology among overweight and obese adolescents and adults (Carels et al., 2010, Durso and Latner, 2008, Durso et al., 2012, Puhl et al., 2007, Roberto et al., 2012). Recent studies have also linked weight bias internalization to poorer global health functioning among individuals with overweight and obesity when controlling for body mass index (BMI; Latner et al., 2013, Pearl et al., 2013), highlighting the significant role that this construct may play in determining health over and above the effects of body weight.

In a recent review of existing measures to assess weight stigmatization, DePierre and Puhl (2012) issued a call for more self-report measures that allow for assessment of weight stigmatization across different body weight categories. While the WBIS serves as a useful measure of internalized stigma for individuals who consider themselves to be overweight, the current wording of its items limits its generalizeability to other populations. It is possible that internalized weight stigma affects individuals across weight statuses—such as individuals who were formerly obese, those with distorted body image, or who struggle with eating disorders—but no research to date has applied this construct to these other populations whose health may be similarly affected and thus could benefit from interventions aimed at reducing weight bias. Additionally, there is a need for a measure of weight bias internalization that can be completed by all participants in research studies to allow for comparisons between populations with obesity to non-overweight control groups. Finally, Durso and Latner (2008) cited the lack of men in their sample as a limitation to generalizing the use of this scale. Given the strong links between weight bias internalization, eating and body image disturbances, and psychopathology (Carels et al., 2010, Durso and Latner, 2008, Durso et al., 2012, Roberto et al., 2012), it is important to develop a measure of weight bias internalization that can be applied broadly to diverse populations in order to assess the full impact of this problem. Therefore, the purpose of this study was to validate a modified version of the WBIS that measures internalized weight attitudes among men and women across body weight statuses. It was hypothesized that the modified WBIS would demonstrate similar psychometric properties and correlates as the original scale in this sample of individuals of varying weight statuses and that, while gender differences could emerge, the scale would generalize to men as well as women.

Section snippets

Participants

Data were collected from 150 participants living in the U.S., comparable to the sample size in the original WBIS validation study (Durso & Latner, 2008). Two participants were excluded due to missing self-reported height and weight data, resulting in a total of 148 participants (50% men; 79.1% White, Non-Hispanic; ages 19–70, M = 35.57, SD = 11.95). Participants were recruited via Amazon.com's Mechanical Turk (MTurk) online data collection service and compensated $1.25. MTurk has been established

Correlations

Table 1 presents the means and standard deviations for all outcome measures. The mean score of the WBIS-M was 3.27 (SD = 1.50) with a Cronbach's alpha of 0.94, Eigenvalue of 7.19, and all factor loadings at or above 0.50. These statistics are comparable to those reported for the original WBIS (M = 3.95, SD = 1.28, α = .90, Eigenvalue = 5.42; Durso & Latner, 2008). The correlation results for the WBIS-M alongside the correlations reported by Durso and Latner (2008) for the WBIS are displayed in Table 1.

Discussion

The findings from this study demonstrate the sound psychometric properties of the modified WBIS. Both the internal consistency of the scale and its predictive value for relevant psychological outcomes such as body dissatisfaction, drive for thinness, and binge eating match or exceed the strength of the original scale. This study also validated the scale in a sample that included both men and women. Women scored significantly higher on the WBIS-M than men, which is consistent with research

Acknowledgement

This research was funded by the Yale Rudd Center for Food Policy and Obesity.

References (22)

  • L.E. Durso et al.

    Internalized weight bias in obese patients with binge eating disorder: Associations with eating disturbances and psychological functioning

    International Journal of Eating Disorders

    (2012)
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