Clinical correlates of the Weight Bias Internalization Scale in overweight adults with binge and purge behaviours

Abstract

Objective: The present study explored the clinical correlates of the Weight Bias Internalization Scale (WBIS). Method: Participants were 656 overweight and obese (mean body mass index (BMI): 34.3 ± 7.7) adults who completed the WBIS and measures of disordered eating behaviors and attitudes via an online survey. Results: Based on both the Eating Disorder Examination Questionnaire (EDE-Q) and Questionnaire on Eating and Weight Patterns – Revised (n = 442), 9.7% and 22.2% of participants were classified into a binge/purge (B/P) and binge eating (BE) group, respectively. WBIS scores were significantly higher among those with binge and/or purge behaviors compared to those without eating pathology, and higher degree of internalized weight bias was predictive of the presence of B/P behaviors (OR = 2.408, 95% CI: 1.727–3.359, p < .001) and BE (OR = 1.459, 95% CI: 1.224–1.739, p < .001). Partial correlations, controlling for BMI, revealed positive correlations between WBIS score and number of weight fluctuations, depression, and all EDE-Q subscales (Restraint, Eating Concern, Shape Concern, and Weight Concern) and a negative correlation with age at overweight onset. Discussion: These novel findings suggest an association between weight bias internalization and clinical eating pathology among overweight adults. The associations between internalization of weight bias and depression, weight instability, and eating pathology have important implications for healthcare providers working with overweight patients.