Work

The weight of stigma: pressures for a healthy weight from health professionals can predict binge eating symptoms through the mediation of internalised weight stigma

Year: 2025

Type: article

Abstract: This study explored the mediating role of internalised weight stigma in the relationship between the pressures exerted by health professionals to maintain a healthy weight and the symptoms of binge eating disorder (BED). A sample of 114 participants who screened positive for eating disorder symptoms, with a BMI of 28 kg/m2 or higher, primarily female, were enrolled at the Integrated Service for Eating Disorders at Sapienza University of Rome. BED symptoms, sociocultural influences on weight, internalised weight stigma, and psychological distress were assessed using report measures. Our findings show that pressures from health professionals were significantly associated with binge eating symptoms through an indirect pathway via internalised weight stigma, controlling for patients' BMI. This mediation effect lessens when exposure to general conversations about healthy weight is included as the independent variable. These findings contribute to a deeper understanding of the complex dynamics at play in obesity management and highlight the potential implications of healthcare communication strategies in overweight and obesity care. The study advocates for further research into developing more empathetic and effective approaches to obesity care. Weight stigma is defined as the discrimination against individuals based on their weight or body shape. Internalised weight stigma, or self-stigma, occurs when people who consider themselves overweight or with obesity have weight-based negative attitudes and stereotypes about themselves, with adverse outcomes on health. The weight-centred treatment approaches may underestimate the complexity of body weight and the increasing evidence that recommending weight loss is not always the primary nor the best choice for individuals’ well-being and overall functioning. Moreover, they could increase internalised weight stigma and its related negative outcomes. This study explored the mediating role of internalised weight stigma in the relationship between the pressures by health professionals to maintain a healthy weight and the symptoms of binge eating disorder (BED). A sample of 114 participants who screened positive for eating disorder symptoms, with a BMI of 28 kg/m2 or higher, primarily female, were enrolled at the Integrated Service for Eating Disorders at Sapienza University of Rome. Our findings show that pressures from health professionals were significantly associated with binge eating symptoms via internalised weight stigma. These findings contribute to a deeper understanding of the delicate role played by health professionals’ communication strategies in obesity management.

Source: Journal of Eating Disorders

DOI: 10.1186/s40337-025-01267-1

Authors: Monica D’Amico, Edoardo Mocini, Francesco Frigerio, Caterina Lombardo, Lorenzo Maria Donini, Silvia Cerolini

Institutions: Sapienza University of Rome, Università degli Studi eCampus, San Raffaele University of Rome, Marconi University

Language: English

Topic: Obesity and Health Practices

Subfield: Pharmacy

Field: Health Professions

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,190