Changes to Weight Bias Internalization and Eating Behaviors in Adults Aged 50+ With Overweight or Obesity During a Structured 12-Week Behavioral Weight Management Intervention.

Abstract

Background: Weight stigma is a prevalent issue among individuals with overweight and obesity pursuing weight loss; however, few studies have examined this issue in middle-aged and older adults. Treatment-seeking populations may also be at risk of disordered eating or excess concern about weight and shape; thus, it is important to evaluate how these parameters may change over the course of a weight loss intervention.

Methods: Adults aged 50+ (n = 83; 60 F, 23 M) completed measures of experiences of weight stigma, weight bias internalization (WBIS-M), the Eating Disorder Examination Questionnaire (EDE-Q), and binge eating (BES) at baseline and after completion of a structured 12-week behavioral weight loss intervention.

Results: Forty-five percent of participants reported previous experiences of weight stigma at baseline through either teasing, unfair treatment, or discrimination. At baseline, the mean WBIS-M score was 3.37 (SD 1.03). From baseline to post-intervention, there were decreases (all p < 0.05) in WBIS-M scores (adjusted mean difference -0.46), scores on the shape concern subscale of the EDE-Q (adjusted mean difference -0.75), and BES scores (adjusted mean difference -3.75). Scores on the restraint subscale of the EDE-Q increased by an adjusted mean of 1.77 units.

Conclusions: These findings suggest that participating in a structured behavioral weight loss program may have beneficial effects on weight bias, body shape concern, and binge eating, consistent with previous findings in weight management interventions in younger populations. Future work is needed to determine if changes to weight bias internalization and eating behaviors persist during weight loss maintenance.