Background: The purpose of this study was to examine the relationships among weight stigma, eating behaviors, and stress, as well as to analyze the effect of stress in mediating the association between weight stigma and eating behaviors.
Methods: The study involved 1818 adolescents between 14 to 19 years of age and was conducted in Wuhan, China in 2019. Weight stigma, eating behaviors (cognitive restraint, uncontrolled eating, and emotional eating), and stress were assessed by self-report questionnaires. Hierarchical linear regression analyses were used to examine the predictors of cognitive restraint, uncontrolled eating, and emotional eating; the serial mediation models analyses were conducted to analyze the effect of stress in mediating the association between weight stigma and eating behaviors for the whole non-overweight (normal and underweight) and overweight or obese participants, respectively.
Results: Hierarchical linear regression analyses showed that experiences of weight stigma significantly predicted uncontrolled eating and emotional eating regardless of body mass index (BMI) (non-overweight adolescents: uncontrolled eating: β [SE] = 0.161 [0.017]; emotional eating: β [SE] = 0.199 [0.008], p < 0.05; overweight or obese adolescents: uncontrolled eating: β [SE] = 0.286 [0.030]; emotional eating: β [SE] = 0.267 [0.014], p < 0.05); experiences of weight stigma significantly predicted cognitive restraint among non-overweight adolescents (β [SE] = 0.204 [0.013], p < 0.05). Mediation analyses showed that stress mediated the associations between weight stigma and uncontrolled eating and emotional eating among non-overweight adolescents (uncontrolled eating: indirect effect coefficient = 0.0352, 95% CI = 0.0241, 0.0478; emotional eating: indirect effect coefficient = 0.0133, 95% CI = 0.0085, 0.0186).
Conclusions: These findings suggest that non-overweight individuals can still experience weight stigma and its associated negative consequences; the relationship between weight stigma and eating behaviors is modulated by weight status; stress mediated the associations between weight stigma and uncontrolled and emotional eating among non-overweight adolescents.
Keywords: Adolescents; Eating behaviors; Stress; Weight stigma.
© The Author(s) 2020.
Conflict of interest statement
Competing interestsThe authors declare that they have no competing interests.
The relationship between weight stigma and eating behavior is explained by weight bias internalization and psychological distress.Appetite. 2016 Jul 1;102:70-6. doi: 10.1016/j.appet.2016.02.032. Epub 2016 Feb 18. Appetite. 2016. PMID: 26898319
Association between Cognitive Restraint, Uncontrolled Eating, Emotional Eating and BMI and the Amount of Food Wasted in Early Adolescent Girls.Nutrients. 2018 Sep 10;10(9):1279. doi: 10.3390/nu10091279. Nutrients. 2018. PMID: 30201904 Free PMC article.
Weight-related teasing and non-normative eating behaviors as predictors of weight loss maintenance. A longitudinal mediation analysis.Appetite. 2016 Jul 1;102:25-31. doi: 10.1016/j.appet.2016.02.017. Epub 2016 Feb 11. Appetite. 2016. PMID: 26877218
Weight stigma and eating behavior: A review of the literature.Appetite. 2016 Jul 1;102:3-14. doi: 10.1016/j.appet.2016.01.034. Epub 2016 Jan 29. Appetite. 2016. PMID: 26829371 Review.
Screening and Interventions for Childhood Overweight [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2005 Jul. Agency for Healthcare Research and Quality (US). 2005. PMID: 20722132 Free Books & Documents. Review.