Obesity and internalized weight stigma: a formulation model for an emerging psychological problem

Area of Science:

• Psychology
• Public Health
• Clinical Psychology

Background:

• Obesity is frequently associated with weight stigma, leading to psychological distress.
• External devaluation contributes to negative self-perception, fostering internalized weight stigma.
• While weight stigma prevalence is known, the interplay between external and internal stigma requires further understanding.

Purpose of the Study:

• To synthesize existing literature on the psychological effects of weight stigma.
• To develop a formulation model explaining the maintenance of internalized weight stigma.
• To provide a framework for clinical intervention.

Main Methods:

• Systematic review of current research on the psychological impact of weight stigma.
• Identification of cognitive, behavioral, and attentional processes maintaining self-evaluation difficulties.
• Development of a clinical utility-based model.

Main Results:

• The model highlights how negative societal and interpersonal weight stigma experiences shape self-perception in obese individuals.
• Core to the model is the processing of the self as a stigmatized individual.
• Maintenance factors include negative self-judgments, attentional/mood shifts, avoidance behaviors, and deregulated eating/weight management behaviors.

Conclusions:

• Increasing obesity rates suggest a rise in weight stigma and its psychological consequences.
• A framework is provided for understanding and intervening in internalized weight stigma.
• Therapists can adapt existing strategies for other issues to address internalized weight stigma.