Examining the Relationship Between Weight Stigma, Diabetes Stigma, and HbA1c in Adults with Type 2 Diabetes

Abstract

Introduction: This study aims to examine the extent to which experienced and/or internalized weight stigma and diabetes stigma may be associated with HbA1c level in adults with type 2 diabetes mellitus. Methods: A total of 857 participants completed a web-based survey including self-reported demographics, weight, HbA1c, and measures of weight stigma and diabetes stigma, including the Modified Weight Bias Internalization Scale (WBIS-M), Weight Self-Stigma Questionnaire (WSSQ), and the Type 2 Diabetes Stigma Assessment Scale (DSAS-2). Results: Participants with elevated HbA1c reported greater weight stigma and diabetes stigma than those with an HbA1c level within the standard-of-care range. Exploratory subgroup analysis of participants who did not provide an HbA1c level reported experiencing and internalizing weight stigma and diabetes stigma at similarly high levels as those with elevated HbA1c. Compared to Black non-Hispanic participant’s mean WBIS-M and WSSQ-Total scores, Hispanic participants and White non-Hispanic participants reported greater weight stigma. Hispanic participants endorsed higher DSAS-2 Self-Stigma scores than Black non-Hispanic participants. Conclusions: Weight stigma and diabetes stigma may be associated with suboptimal diabetes care outcomes measured as elevated HbA1c or inability to report an HbA1c level.