Weight stigma and bariatric surgery: Prospective improvements, psychological health, and weight.

Abstract

Objective: Weight stigma among patients with obesity is a major risk factor for psychological and physical health comorbidities. Little is known, however, about experienced weight stigma (EWS) among metabolic bariatric surgery (MBS) patients in terms of pre- to post-MBS changes and correlates in the setting of significant weight loss. The current study utilized psychometrically validated measures to examine change in weight stigma from pre- to post-MBS and prospective associations with mental health, eating behaviors, and body mass index.

Method: Patients (N = 148) completed both pre-MBS psychological evaluation and follow-up assessment 1.5-3 years post-MBS, including measures of EWS, depressive symptoms, anxiety, binge eating, and disordered eating.

Results: EWS improved significantly pre- to post-MBS (by both statistical and clinically meaningful standards), and this change was associated with improvements in mental health, dysregulated eating, and reduced BMI. In regression models controlling demographic covariates and each outcome at baseline, both changes in and post-MBS EWS predicted mental health, dysregulated eating, and body mass index.

Conclusions: EWS improves significantly from pre- to post-MBS, and this is associated with improvements in mental health, decreases in dysregulated eating, and reduced weight. However, patients who continue to experience stigma are at elevated risk for ongoing psychological, eating, and weight challenges. Interventions must be designed to buffer the impacts of weight stigma to optimize the quality of life and long-term outcomes following MBS. (PsycInfo Database Record (c) 2025 APA, all rights reserved).