A Bifactor Measure of Societal Stigma Toward Eating Disorders and Obesity: Scale Development and Validation

Area of Science:

• Psychology
• Public Health
• Psychometrics

Background:

• Societal stigma towards eating disorders and obesity is widespread, causing distress and hindering help-seeking.
• Existing stigma assessment tools are scarce, especially for Spanish-speaking populations.
• This study addresses the need for a robust measure of societal stigma in Spain.

Purpose of the Study:

• To develop and validate a multidimensional instrument for assessing societal stigma towards eating disorders and obesity.
• To ensure the instrument is psychometrically sound and grounded in contemporary stigma frameworks.
• To provide a tool for research and public health initiatives in Spain.

Main Methods:

• A cross-sectional observational study with a large online community sample (N=2121).
• Item development based on literature, refined by expert validation.
• Psychometric evaluation included EFA, CFA, bifactor modeling, and reliability testing.

Main Results:

• A 36-item instrument demonstrated excellent psychometric properties.
• Bifactor analysis supported a predominantly unidimensional structure with specific stigma dimensions.
• High reliability (ωh = 0.87) and excellent model fit were achieved.

Conclusions:

• A reliable and theoretically grounded instrument for assessing societal stigma towards eating disorders and obesity in Spain was developed.
• The scale facilitates systematic stigma research and public health surveillance.
• This tool supports intervention development and evaluation for promoting equitable care.