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Coping with Weight Stigma Among Adults in a Commercial Weight Management Sample

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Abstract

Background

Coping responses to weight stigma can adversely affect health. Using data from a large commercial weight management sample, this study examined how adults cope with weight stigma, relationships among experienced weight stigma, weight bias internalization, and coping, as well as coping strategies as mediators of the stigma-health relationship.

Method

Participants were adults enrolled in WW (formerly Weight Watchers) who reported at least one lifetime experience of weight stigma (N = 11,924). Participants completed questionnaires about the type and frequency of stigma experiences, weight bias internalization, strategies used to cope with weight stigma, and health-related quality of life.

Results

Active coping, planning, positive reframing, acceptance, emotional support, and exercise avoidance were the most common coping strategies employed in response to acute weight stigma experiences. Weight bias internalization was more strongly associated with coping strategies likely to exacerbate health (e.g., disordered eating, substance use, self-blame) than positive reframing, acceptance, and emotional support. More types of experienced weight stigma (e.g., teasing, unfair treatment) were associated with more frequent use of all coping strategies. Coping strategies did not mediate the stigma-health relationship, and several strategies were associated with poor mental health.

Conclusion

More types of experiences with weight stigma were associated with more attempts to cope generally, while weight bias internalization was associated with coping strategies which were in turn associated with poor mental health. Developing effective approaches for identifying individuals likely to internalize weight stigma and helping individuals adopt effective coping strategies in response to stigma are important avenues of future research.

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Author information

Authors and Affiliations

  1. Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA

    Rebecca M. Puhl

  2. Department of Psychological Sciences, Kent State University, PO Box 5190, Kent, OH, 44242-0001, USA

    Mary S. Himmelstein

  3. Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA

    Rebecca M. Puhl

  4. Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

    Rebecca L. Pearl & Gary D. Foster

  5. WW, New York, NY, USA

    Angela M. Pinto & Gary D. Foster

  6. Psychology Department, Baruch College, City University of New York, New York, NY, USA

    Angela M. Pinto

Authors
  1. Mary S. Himmelstein
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  2. Rebecca M. Puhl
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  3. Rebecca L. Pearl
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  4. Angela M. Pinto
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  5. Gary D. Foster
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Corresponding author

Correspondence to Mary S. Himmelstein.

Ethics declarations

All procedures and measures were approved by the institutional review board at the University of Connecticut.

Competing Interests

This study was funded by a grant from WW to the University of Connecticut on behalf of RMP. RLP is supported in part by a Mentored Patient-Oriented Research Career Development Award from the National Heart, Lung and Blood Institute/NIH (No. K23HL140176). RLP discloses receiving grant support, outside of the current study, from WW. GDF and AMP are employees of WW and GDF is a shareholder of WW.

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Himmelstein, M.S., Puhl, R.M., Pearl, R.L. et al. Coping with Weight Stigma Among Adults in a Commercial Weight Management Sample. Int.J. Behav. Med. 27, 576–590 (2020). https://doi.org/10.1007/s12529-020-09895-4

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