Work

Internalized weight stigma and associated clinical features in treatment-seeking adults with obesity: a multicenter Italian study

Year: 2026

Type: article

Abstract: Background This study aimed to evaluate the prevalence and clinical correlates of internalized weight stigma in patients with obesity seeking treatment in various clinical centers across Italy. Methods A total of 438 patients with obesity were included. Patients completed a baseline clinical interview and the Weight Bias Internalization Scale (WBIS) to evaluate the internalized weight stigma. Moreover, they completed the following self-report instruments: Eating Disorder Examination Questionnaire (EDE-Q), Brief Symptom Inventory (BSI), and 36-Item Short Form Health Survey (SF-36) to assess eating disorder psychopathology, general psychopathology, and quality of life, respectively. Results High internalized weight stigma, defined as a WBIS score ≥4, was observed in 211 participants (48.2%). WBIS scores were significantly higher in female patients and were negatively associated with age and the SF-36 mental component score. WBIS scores were positively associated with eating disorder psychopathology, general psychopathology, and 12-month weight-loss expectations, but were not associated with BMI and showed no consistent association with cardiometabolic parameters. In multivariable linear regression, age, EDE-Q global score, and SF-36 mental component score were independently associated with WBIS scores. Conclusions Internalized weight stigma emerged as a common and clinically relevant feature among patients seeking treatment for obesity, showing strong associations with psychological distress and impaired mental well-being independent of body mass index. The findings underscore the importance of systematically assessing internalized weight stigma and addressing it through tailored psychological strategies within multidisciplinary obesity care.

Source: Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity

DOI: 10.1007/s40519-026-01910-z