Association Between Weight Bias Internalization And Metabolic Syndrome Among Treatment-Seeking Individuals With Obesity

Objective: Weight stigma is a chronic stressor that may increase cardiometabolic risk. Some individuals with obesity self-stigmatize ( i. e., weight bias internalization, WBI). No study to date has examined whether WBI is associated with metabolic syndrome.Methods: Blood pressure, waist circumference, and fasting glucose, triglycerides, and high-density lipoprotein cholesterol were measured at baseline in 178 adults with obesity enrolled in a weight-loss trial. Medication use for hypertension, dyslipidemia, and prediabetes was included in criteria for metabolic syndrome. One hundred fifty-nine participants ( 88.1% female, 67.3% black, mean BMI541.1 kg/m(2)) completed the Weight Bias Internalization Scale and Patient Health Questionnaire ( PHQ-9, to assess depressive symptoms). Odds ratios and partial correlations were calculated adjusting for demographics, BMI, and PHQ-9 scores.Results: Fifty-one participants ( 32.1%) met criteria for metabolic syndrome. Odds of meeting criteria for metabolic syndrome were greater among participants with higher WBI, but not when controlling for all covariates ( OR=1.46, 95% CI=1.00-2.13, P=0.052). Higher WBI predicted greater odds of having high triglycerides ( OR=1.88, 95% CI=1.14-3.09, P=0.043). Analyzed categorically, high ( vs. low) WBI predicted greater odds of metabolic syndrome and high triglycerides ( Ps<0.05).Conclusions: Individuals with obesity who self-stigmatize may have heightened cardiometabolic risk. Biological and behavioral pathways linking WBI and metabolic syndrome require further exploration.