Internalized Weight Stigma Mediates Psychosocial Impact in Bariatric Surgery Candidates

Overview

This cross-sectional study of 217 bariatric surgery candidates found that perceived weight stigma is positively correlated with internalized weight stigma and adverse psychosocial outcomes. Internalized weight stigma significantly mediates the relationship between perceived weight stigma and negative psychosocial factors such as depression, anxiety, and quality of life.

Background

Weight stigma involves social devaluation based on weight and manifests as experiences, perceptions, internalization, and anticipation of stigma. Individuals seeking bariatric surgery often experience higher rates of depression and disordered eating, which have been linked to weight stigma. Prior research suggests internalized weight stigma may mediate the impact of perceived stigma on psychological health, but this mechanism remains understudied in bariatric populations. Understanding these pathways could inform targeted interventions in pre- and post-surgical care.

Data Highlights

Key Findings

• Perceived weight stigma positively correlates with internalized weight stigma among bariatric surgery candidates.
• Both perceived and internalized weight stigma are associated with negative psychosocial outcomes including higher depression and anxiety, poorer quality of life, and disordered eating behaviors.
• Internalized weight stigma significantly mediates the relationship between perceived weight stigma and psychosocial correlates.
• The mediation effect was observed even when controlling for other psychosocial factors such as body shame and self-compassion.
• Physical health correlates showed exploratory findings with no clear predictive pattern related to weight stigma.

Clinical Implications

Clinicians should assess both perceived and internalized weight stigma in bariatric surgery candidates as part of comprehensive psychosocial evaluation. Interventions targeting internalized weight stigma may reduce depression, anxiety, and improve quality of life in this population. Incorporating stigma reduction strategies into pre- and post-operative care could enhance psychological outcomes and support long-term surgical success.

Conclusion

Internalized weight stigma plays a key mediating role in the relationship between perceived weight stigma and adverse psychosocial outcomes among individuals seeking bariatric surgery. Addressing internalized stigma may be critical for improving mental health in this vulnerable population.

References

1. Pearl et al. 2021 -- The Role of Internalized Weight Stigma in Bariatric Surgery Candidates