Internalization of Weight Stigma: Psychological Mechanisms, Health Consequences and Intervention Measures: A Narrative Review

Abstract

This narrative review systematically examines the psychological mechanisms, health consequences, and intervention measures of internalized weight stigma. By searching the literature in PubMed, PsycINFO, and Web of Science, English empirical studies that included core measurements of internalized weight stigma (WBI, such as WBIS) were included. The review clearly states that weight stigma is the prejudice and discrimination an individual faces due to their weight not conforming to societal ideals, and it can be divided into perceived and internalized types. It exists in various fields such as the workplace, healthcare (with an incidence rate of nearly 69%), and education. It can be measured using tools like AFAT, WBIS, and IAT. Its negative impact on individuals is significant: it lowers self-esteem and causes depression and anxiety in terms of mental health; it increases binge eating and reduces physical activity in terms of health behaviours; and it raises BMI and inflammation risks in terms of physical health, forming a vicious cycle of “stigma - stress - weight gain” through the COBWEBS model. There are mainly three types of intervention strategies: reducing public stigma (educational interventions are difficult to change implicit attitudes in the short term), weight loss interventions (such as the NEW-R project, where more than half of the participants regained weight within 12 months), and positive psychological interventions (such as mindfulness therapy, which can alleviate symptoms). Current research has shortcomings such as shallow mechanisms and few interventions. Future research needs to deepen the empirical studies on mechanisms and interventions.