Weight Bias Internalisation May Increase Risk of Metabolic Syndrome

Association between weight bias internalization and metabolic syndrome among treatment‐seeking individuals with obesity

Pearl et al, 2017 – full study

What’s it about?

This study investigates whether Weight Bias Internalisation is associated with metabolic syndrome – a cluster of conditions that can increase the risk of heart disease, stroke and type 2 diabetes.

Who took part?

159 adults, aged 21 to 65, completed the study. All participants had a BMI of 33 or over. The majority of participants were black (67.3%) and female (88.1%).

Participants had initially been recruited to take part in a weight loss study where they used a weight loss medication. The participants for this study had lost over 5% of their body weight, and were then assigned to take part in a one-year weight loss maintenance program.

How was this studied?

Participants underwent a medical exam at the start of the study to record their physical stats:

  • Systolic Blood Pressure
  • Diastolic Blood Pressure
  • Triglycerides
  • Waist Circumference
  • Fasting Blood Glucose

They also completed questionnaires to measure their levels of Weight Bias Internalisation and depression.

What was found?

32% of participants met the criteria for metabolic syndrome.

When controlling for the influence of BMI and depressive symptoms, participants with higher Weight Bias Internalisation scores had greater odds of meeting criteria for metabolic syndrome.

When also controlling for the influence of demographics (age, sex and race), the risk of metabolic syndrome was no longer significant.

Having high triglycerides was the only individual component of metabolic syndrome that was significantly associated with WBI.

Black participants scored significantly lower on the Weight Bias Internalisation Scale than white participants.

Weight Bias Internalisation was correlated with depressive symptoms.

The bottom line:

The odds of having metabolic syndrome were significantly heightened among participants with high levels of Weight Bias Internalisation.

Other than high triglycerides, other components of metabolic syndrome were not directly associated with Weight Bias Internalisation. However, there may be a linking factor which associates WBI with adverse health outcomes.

Researchers believe that this association could be due to the chronic stress that is caused by self stigmatising. The biological symptoms of stress can increase the likelihood of metabolic abnormalities.

They state that this stress may also cause people to eat unhealthy food or binge eat. They may also be reluctant to take part in physical activity (low self esteem has been linked to reduced participation in physical activity).

This study contradicts the belief that weight stigma may be beneficial for behaviour change. Weight Bias Internalisation may actually be correlated with poorer health and increased risk of metabolic syndrome.