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Although a growing body of literature demonstrates negative effects of internalized weight bias (IWB), the relationships between IWB and relevant social, psychological, and behavioral variables have not yet been evaluated systematically. The purpose of the present study was to create and assess a model of hypothesized risks and outcomes of IWB. In an online survey, 650 adult males and females completed self-report measures of IWB, self-esteem, weight-related stigma experiences, body-related shame, body satisfaction, societal influence on body image, appearance comparisons, binge eating, distress, and weight-related quality of life. The originally hypothesized model did not provide an adequate fit to the data. Iterative modifications were undertaken, and the resulting model, in which social factors were associated with IWB and body image-related constructs which were in turn associated with psychological and behavioral outcomes, provided excellent fit to the data (CFI > .99, SRMR = .02, and RMSEA = .03). Most model paths were similar for underweight or normal weight participants versus participants with overweight or obesity. This study represents an initial effort at constructing a comprehensive model of IWB that can be further refined in future research and used to help guide the development of related interventions.

Internalized weight bias and psychological wellbeing: An exploratory investigation of a preliminary model