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Cited by 96Obesity and Health PracticesEating Disorders and BehaviorsObesity, Physical Activity, Diet

Weight stigma as a predictor of distress and maladaptive eating behaviors during COVID-19: longitudinal findings from the EAT study

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Puhl, Rebecca M, Lessard, Leah M, Larson, Nicole, Eisenberg, Marla E, Neumark-Stzainer, Dianne·2020·Annals of Behavioral Medicine
DOI 10.1093/abm/kaaa077PMC PMC7499477
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Abstract

BACKGROUND: Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. PURPOSE: We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults. METHODS: Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020. RESULTS: Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (β = 0.15, p < .001), stress (β = 0.15, p = .001), eating as a coping strategy (β = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables. CONCLUSIONS: Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.

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  • In Puhl et al. (2020), no significant interactions based on gender were found.

    “Furthermore, no significant interactions based on gender were found.”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Puhl et al. (2020)

  • In Puhl et al. (2020), pre-pandemic experiences of weight stigma predicted higher levels of stress, depressive symptoms, eating to cope with stress, and increased likelihood of binge eating during the COVID-19 pandemic.

    “The comparison between the two samples (stigma perceived before COVID vs. stigma perceived during COVID) revealed that pre-pandemic experiences of weight stigma predicted higher levels of stress, depressive symptoms, eating to cope with stress, and an increased likelihood of binge eating, during the COVID-19 pandemic.”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Puhl et al. (2020)

  • In Puhl et al. (2020) C-EAT survey, the majority of the overall sample reported that COVID-19 negatively affected mood and anxiety levels, raised stress, and exacerbated problems with food intake.

    “In agreement with the original assumption, majority of the overall sample reported that COVID-19 negatively affected mood and anxiety levels, raising stress, and exacerbating problems with food intake.”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Puhl et al. (2020)

  • Uncertainty and anxiety due to the pandemic contributed to an increase in subjective discomfort and raised the risk of compulsory eating as a strategy to cope with stress.

    “We found that uncertainty and anxiety due to pandemic contributed to an increase in subjective discomfort and raised the risk of compulsory eating as a strategy to cope with stress (Flaudias et al., 2020; Puhl et al., 2020).”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Puhl et al., 2020

  • The Puhl et al. (2020) study was on secondary school students enrolled in a 10-year longitudinal cohort study, with a mean age of 24 years in pandemic.

    “The study by Puhl et al. (2020) was on secondary school students, enrolled in a 10-year longitudinal cohort study, with a mean age of 24 years in pandemic (Puhl et al., 2020).”

    From Eating Disorders Spectrum During the COVID Pandemic: A Systematic Review (2021) · cites this paper as Puhl et al., 2020

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Research works printed but not linked: 2

  1. [31]Yanovski SZ Questionnaire on eating and weight patterns–revised (QEWP-R). Obes Res. 1993; 1: 319– 324.
  2. [53]Watanabe PI, Fontana FE, Silva MPD, Mazzardo O, Bacil EDA, Campos W Association between weight-teasing and physical activity in adolescents. Rev Paul Pediatr. 2017; 35: 309– 315. 28977290 PMC5606173

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Authors
Puhl, R. M., Lessard, L. M., Larson, N., Eisenberg, M. E., & Neumark-Stzainer, D.
Affiliations
  • University of Connecticut (US)
  • University of Minnesota (US)
Corresponding author
Puhl, Rebecca M
ORCID
Venue
Annals of Behavioral Medicine
Publisher
Oxford University Press (OUP)
Published
2020-09-10
Volume
54
Issue
10
Pages
738-746
ISSN
  • 0742-5554 (ISSN-L)
  • 0883-6612
  • 1532-4796
DOI
10.1093/abm/kaaa077
PMC
PMC7499477
OpenAlex
W3085050840
Cited by
96
References
53
Citations by year
2026: 8 · 2025: 8 · 2024: 6 · 2023: 20 · 2022: 27 · 2021: 23 · 2020: 3 · 2014: 1
FWCI
28.20
Type
journal article
Language
en
Open access
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • Annals of Behavioral Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Heart, Lung, and Blood Institute (R35HL139853)
  • National Institutes of Health
Topics
  • Health Sciences › Health Professions › Pharmacy › 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 stigma, COVID-19 pandemic, binge eating, depressive symptoms, stress, physical activity, young adults, obesity, maladaptive eating behaviors, body size diversity
MeSH terms
Betacoronavirus, Psychological Distress, COVID-19, SARS-CoV-2, Feeding and Eating Disorders, Body Weight, Female, Humans, Longitudinal Studies, Male, Obesity, Pneumonia, Viral, Exercise, Coronavirus Infections, Young Adult, Social Stigma, Pandemics

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