Cross-cultural validation of the Weight Stigma Exposure Inventory (WeSEI): secondary data analysis from Taiwan, China, Hong Kong, Indonesia, Türkiye, and Malaysia
Year: 2025
Type: article
Abstract: BACKGROUND: The Weight Stigma Exposure Inventory (WeSEI) is a newly developed instrument designed to assess weight stigma exposure across both interpersonal and non-interpersonal contexts. While prior studies have supported its use in individual regions, its cross-cultural applicability has not been comprehensively evaluated. OBJECTIVE: The present study examined the psychometric properties and cross-cultural measurement equivalence of the WeSEI across six culturally diverse jurisdictional regions in Asia (i.e., Taiwan, China, Hong Kong, Indonesia, Türkiye, and Malaysia). METHODS: A total of 7,787 participants completed the 35-item WeSEI via various online platforms. The WeSEI assesses weight stigma exposure across seven domains: social media, traditional media, television/movies, parents/siblings, friends/peers, significant others, and strangers. Rasch analysis was conducted to evaluate item fit, rating scale functioning, person separation reliability, and unidimensionality for each domain. Differential item functioning (DIF) was assessed across sex, weight status, and jurisdictional region. RESULTS: The WeSEI demonstrated strong internal consistency, acceptable item fit, and unidimensionality across all domains, with only two items showing misfit (i.e., Friends/Peers_2 and Significant Other_2). Person separation indices exceeded 2.0 for each domain, confirming the scale's ability to distinguish individuals with varying levels of stigma exposure. Minimal DIF was observed by sex and weight status, supporting measurement equivalence across these groups. However, 19 out of 35 items showed significant jurisdictional region-level DIF, particularly those related to slim-normative attractiveness and family-based stigma. Malaysian participants consistently endorsed these items more than Chinese participants, suggesting cultural variation in the exposure of weight stigma. CONCLUSION: The WeSEI is a psychometrically sound and culturally responsive tool for assessing weight stigma exposure across diverse populations in Asia. Cultural adaptation is recommended for cross-national comparisons.
Source: Journal of Eating Disorders
Authors: Chia-Wei Fan, Kamolthip Ruckwongpatr, I-Ching Lin, I-Hua Chen, Ji-Kang Chen, Ira Nurmala, Muthmainnah Muthmainnah, Wan Ying Gan, Servet Üztemur, Yen-Ling Chang, Chien-Chin Lin, Chien-Chin Lin, Jeanette Reffstrup Christensen, Nadia Bevan, Mark D. Griffiths, Amir H. Pakpour, Chung-Ying Lin, Chung-Ying Lin
Institutions: AdventHealth, Christian University of Thailand, Asia University, Asia University Hospital, Chienkuo Technology University, Qufu Normal University, Chinese University of Hong Kong, Universitas Airlangga, Universiti Putra Malaysia, Anadolu University, Cardinal Tien Hospital, Kaohsiung Medical University, National Taiwan University, National Taiwan University Hospital, National Cheng Kung University Hospital, National Cheng Kung University, University of Southern Denmark, Aarhus University, Monash University, Nottingham Trent University, Jönköping University
Language: English
Topic: Obesity and Health Practices
Subfield: Pharmacy
Field: Health Professions
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,190
Awards: G5481764179, G7369236631
OpenAlex ID: W4417321593