The impact of internalized weight stigma on mental health and perceived stress in a sample of Italian women

Introduction: Overweight and obesity are pervasive clinical conditions resulting from several factors (i.e. biological, psychological, and socio-economic) that interact with behavior and lifestyle. Nevertheless, the false idea that individuals can totally control their bodies through dietary choices and physical activity is widespread. Unfortunately, those beliefs are also reinforced by health professionals and social media. This oversimplification increases self-related overweight stigma, defined as the internalization of negative stereotypes about overweight, with a noticeable impact on general quality of life. Aim: The purpose of the present study was to examine the negative impact of the internalized overweight stigma on mental health and perceived stress, controlling for body mass index (BMI) and other variables potentially related. Methods: Participants filled out three self-reported questionnaires including: the Weight Bias Internalization Scale (WBIS) assessing internalized weight stigma and negative stereotypes about overweight; the Perceived Stress Scale (PSS) measuring the degree to which situations in one’s life are appraised as stressful; the Mental Component Summary index (MCS) of the 36-Item Short Form Health Survey (SF-36). Data about self-reported height and weight, hypertension and type 2 diabetes therapies were also collected. Results: A convenience sample of 3672 Italian women (Mage = 34.11, SD = 9.67) with a mean BMI of 28.89 (SD = 5.99) was recruited via social network. Two hierarchical linear regressions were conducted separately for MCS and PSS. The accounted variance is approximately 26% and 25%, respectively. BMI, hypertension and type 2 diabetes therapies were entered at the first step as control variables. Internalized weight stigma entered at the second step significantly impacted on MCS scores (β = -0.509, p < 0.001) and PSS scores (β = 0.515, p < 0.001). Discussion and conclusions: Results show that internalized weight stigma may predict lower mental health and higher level of perceived stress, even after controlling for BMI and other confounders. This may have several implications for clinical practice (i.e., promoting specific strategies to reduce patients’ negative attitudes and beliefs about their own weight) and for the development of prevention programs to reduce weight stigma among the general public.