Weight Bias Internalization and Thinness-Oriented Body Dissatisfaction Explain the Link Between Experienced Weight Stigma and Thinness-Oriented Disordered Eating: A Four-Wave Longitudinal Study in Chinese Adolescents.

OBJECTIVES

Experienced weight stigma and weight bias internalization pose deleterious effects on physical and psychological health. Existing research largely relies on cross-sectional studies and frequently omits non-Western populations. This study examined the temporal pathways between experienced weight stigma, weight bias internalization, thinness-oriented body dissatisfaction, and thinness-oriented disordered eating in Chinese adolescents.

METHOD: Participants included 10th-grade Chinese students (N = 985) enrolled in a longitudinal study between 2022 and 2024. Four waves of data were collected across 18 months (baseline = T1, 6 months after baseline = T2, 12 months after baseline = T3, and 18 months after baseline = T4). Experienced weight stigma, weight bias internalization (Weight Bias Internalization Scale-Modified), thinness-oriented body dissatisfaction (body dissatisfaction subscale of the Eating Disorders Inventory), and thinness-oriented disordered eating (Eating Disorder Examination Questionnaire-Short) were assessed, and serial mediation analyses were conducted to assess the theorized temporal relationships.

RESULTS

More experienced weight stigma at T1 (baseline) predicted increased weight bias internalization 6 months later (T2), which predicted greater thinness-oriented disordered eating 12 months later (T4). More experienced weight stigma at T1 predicted increased T2 weight bias internalization, which predicted greater thinness-oriented body dissatisfaction 12 months after baseline (T3), and ultimately, more T4 thinness-oriented disordered eating. T3 thinness-oriented body dissatisfaction did not mediate the relationship between T1 experienced weight stigma and T4 thinness-oriented disordered eating.

DISCUSSION: Findings indicate the mediating role weight bias internalization has on the prospective relationship between experienced weight stigma and thinness-oriented disordered eating in Chinese adolescents. Reducing weight bias internalization may be advantageous in reducing thinness-oriented eating disorder concerns.