Explicit, Implicit, and Internalized Weight Bias: Relationships With Self-Perceptions of Weight and Current Dieting

Negative attitudes regarding body size, including explicit, implicit, and internalized weight bias, are associated with deleterious outcomes, particularly for those in larger bodies.

This study evaluated the relation of weight bias (explicit, implicit, and internalized forms) and body mass index (BMI) to self-perceived weight and current dieting.

This was a cross-sectional study. Participants completed the AntiFat Attitudes Questionnaire, which assesses 3 domains of explicit weight bias, a weight-specific version of the Implicit Attitudes Test, and the Weight Bias Internalization-Modified Questionnaires through an online survey.

Participants (N = 392; 62.5% women; 15.8% African American/Black, 24.2% Asian American/Asian/Pacific Islander, 15.1% Latino/Hispanic, 37.0% White, 5.4% Multiracial, 2.3% Other, and 0.2% Did not disclose) were individuals of varying body size (mean BMI = 25.0 ± 5.73 kg/m², range = 14.08 to 50.17 kg/m²). This study took place at a university in the Mid-Atlantic region of the United States from 2020 to 2022. Undergraduates who were aged at least 18 years, fluent in English, and enrolled in a psychology course that required subject pool participation were eligible to take part in the study.

Participants completed the Self-Classified Weight Scale and reported dieting behavior.

Using the PROCESS macro, regression models evaluated main effects and interactions for the different weight bias measures and BMI on self-perceived weight and current dieting, controlling for gender.

The 3 forms of weight bias had inconsistent relationships with self-perceived weight and dieting-some were significant while others were not. There were significant interactions between BMI and fear of fat (explicit weight bias) for both self-perceived weight (P = .003) and dieting (P = .02). A significant interaction was also found between BMI and implicit weight bias (P = .01); those with higher bias had more discrepancies between actual and self-perceived weight. Believing that body size is controlled by willpower (explicit weight bias; P = .005) and weight bias internalization (P = .008) were positively related to dieting. Weight bias internalization was also positively associated with self-perceived weight (P < .001).

Internalized and some domains of explicit weight bias relate to larger self-perceived weight and greater dieting likelihood. Implicit weight bias in conjunction with BMI may also contribute to perceptions about one's own body size. Findings highlight the importance of considering weight bias in disordered eating risk.