External and Internalized Weight Stigma: An Ecological Momentary Assessment

Abstract

Weight stigma has received attention as a harmful and prevalent form of discrimination against people based on their body size. Internalized weight stigma (IWS) consists of self-imposed beliefs about stereotypes and stigma. Weight stigma events and IWS have been shown to be linked to psychological health problems related to depression, mood, anxiety, body image, and self-esteem, potentially more than external weight stigma. Affect, or an observable expression of mood, has been linked to IWS and weight stigma as an outcome and mediator between health behaviors. The present study aimed to utilize a new hybrid ecological momentary assessment protocol to track real-world accounts of weight stigma, IWS, and affect reactivity. Twenty-four participants completed the entire protocol, where 29 total stigma events were reported from 13 participants. Repeated effects models indicated that positive affect was significantly higher in the morning compared to the evening, but was not related to the occurrence of stigma events. Negative affect was not significantly different between the morning and evening, but was significantly higher during a stigma event. Linear mixed models found that internalized weight stigma was not significantly different in the evening on a stigma event day, but was significantly higher in the morning following a stigma event day. This is the first study to utilize a hybrid EMA approach on weight stigma and IWS, and the first to showcase a potential lagged effect of stigma events on IWS scores.