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Internalizing Weight Stigma: Prevalence and Sociodemographic Considerations in US Adults
Open accessAbstract
Objective: This study aimed to conduct a comprehensive assessment of the presence, severity, and sociodemographic correlates of weight bias internalization (WBI) across three distinct samples of US adults. Methods: Levels of WBI were compared in (1) a sample of adults with obesity and heightened risk of weight stigma ( N = 456), (2) an online community sample ( N = 519), and (3) a national online panel ( N = 2,529). Samples 2 and 3 comprised adults with and without obesity. Participants completed identical self‐report measures, including demographic variables and weight‐related factors, to determine their relationship with low, mean, and high levels of WBI. Results: At least 44% of adults across samples endorsed mean levels of WBI (as determined by sample 3). The highest levels of WBI were endorsed by approximately one in five adults in the general population samples and by 52% in the sample of adults with obesity. Individuals with the highest WBI were white, had less education and income, were currently trying to lose weight, and had higher BMIs, higher self‐perceived weight, and previous experiences of weight stigma (especially teasing). Conclusions: Internalized weight bias is prevalent among women and men and across body weight categories. Findings provide a foundation to better understand characteristics of individuals who are at risk for internalizing weight bias.
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Approximately 40-50% of US adults with overweight and obesity experience internalized weight bias, and about 20% experience it at high levels.
“Estimates from a 2018 study suggest that approximately 40–50% of US adults with overweight and obesity experience internalized weight bias, and about 20% of US adults experience this at high levels14.”
From Joint international consensus statement for ending stigma of obesity (2020) · cites this paper as [14]
The Discussion (page unavailable) reports that at least 44% of adults across the three samples endorsed mean levels of weight bias internalization, and approximately one in five adults in the general-population samples endorsed high levels. The 44% figure is not an estimate specifically for adults with overweight and obesity; the paper also reports high levels in 52% of its selected sample of adults with obesity. (LLM, conf=0.87)
Experimental — accuracy not yet measuredInternalized weight bias is present across diverse body-weight categories, especially among individuals with higher BMI who are trying to lose weight.
“Internalized weight bias is present in individuals across diverse body-weight categories, but especially among individuals with higher BMI who are trying to lose weight14.”
From Joint international consensus statement for ending stigma of obesity (2020) · cites this paper as [14]
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Internalized Societal Attitudes Moderate the Impact of Weight Stigma on Avoidance of Exercise
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“Some studies have pointed to WBI as a mechanism through which experienced weight stigma exacerbates adverse health behaviors (23), potentially through low self-esteem and basing one’s self-evaluation on body weight (24,25).”
BackgroundDurso, L. E., Latner, J. D., & Ciao, A. C. (2016) · Eating Behaviors · doi:10.1016/j.eatbeh.2016.01.011 · Cited by 106
The Role of Stigma in Weight Loss Maintenance Among U.S. Adults
Puhl, R. M., Quinn, D. M., Weisz, B. M., & Suh, Y. J. (2017) · Annals of Behavioral Medicine · doi:10.1007/s12160-017-9898-9 · Cited by 92
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Sorted by citations
Joint international consensus statement for ending stigma of obesity
Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., Nadglowski, J., Ramos Salas, X., Schauer, P. R., Twenefour, D., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0803-x · Cited by 1,152
“Estimates from a 2018 study suggest that approximately 40-50% of US adults with overweight and obesity experience internalized weight bias, and about 20% of US adults experience this at high levels 14 .”
BackgroundWeight bias internalization and health: a systematic review
Pearl, R. L., & Puhl, R. M. (2018) · Obesity Reviews · doi:10.1111/obr.12701 · Cited by 642
Self-citationApproach to Obesity Treatment in Primary Care: A Review
Yanovski, S. Z., & Yanovski, J. A. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2023.8526 · Cited by 103
Nadolsky, K., Addison, B., Agarwal, M., Almandoz, J. P., Bird, M. D., DeGeeter Chaplin, M., Garvey, W. T., & Kyle, T. K. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.03.272 · Cited by 86
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Pudney, E. V., Himmelstein, M. S., Puhl, R. M., & Foster, G. D. (2020) · Social Science & Medicine · doi:10.1016/j.socscimed.2020.112854 · Cited by 37
Feig, E. H., Amonoo, H. L., Onyeaka, H. K., Romero, P. M., Kim, S., & Huffman, J. C. (2020) · Clinical Obesity · doi:10.1111/cob.12361 · Cited by 28
Ending Weight Stigma to Advance Health Equity
Pearl, R. L., Donze, L. F., Rosas, L. G., Agurs-Collins, T., Baskin, M. L., Breland, J. Y., Byker Shanks, C., Cooksey Stowers, K., Johnson, S., Lee, B. Y., et al. (2024) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2024.06.021 · Cited by 29
Exploring Weight Stigma in Saudi Arabia: A Nationwide Cross-Sectional Study
Althumiri, N. A., Basyouni, M. H., AlMousa, N., AlJuwaysim, M. F., Alhamdan, A. A., Al-Qahtani, F. S., BinDhim, N. F., & Alqahtani, S. A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179141 · Cited by 19
Metadata
- Authors
- Puhl, R. M., Himmelstein, M. S., & Quinn, D. M.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Puhl, Rebecca M.
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2017-10-30
- Volume
- 26
- Issue
- 1
- Pages
- 167-175
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- OpenAlex
- W2765859988
- Cited by
- 294
- References
- 5
- Citations by year
- 2026: 23 · 2025: 45 · 2024: 42 · 2023: 35 · 2022: 35 · 2021: 36 · 2020: 38 · 2019: 22 · 2018: 18
- FWCI
- 19.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Rudd Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- weight bias internalization, weight stigma, sociodemographic correlates, prevalence, weight-related teasing, body mass index, weight loss attempts, weight perception, online communities, gender differences
- MeSH terms
- Adult, Body Weight, Demography, Female, Humans, Male, Middle Aged, United States, Prevalence, Overweight, Sociological Factors
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