Background: Weight bias internalisation (WBI) is the application of negative weight-based stereotypes to oneself and has been associated with preventing long-term weight-loss, low confidence managing eating behaviour (weight self-efficacy) and poor mental health. With few weight-loss interventions targeting WBI, this study aimed to determine if it could be improved in a tailored program for young women.
Methods: Overweight and obese young women (BMI>25; 18-25y; n=51) engaged in a dietitian-led weight-loss intervention, followed by one of two cognitive behavioural therapy (CBT) group programs. Participants randomised to the everyBODY arm (n=26) engaged in CBT addressing body dissatisfaction and WBI and those in the Standard Care arm (n=25) engaged in CBT best-practice care for weight management (that does not address WBI). Following the 12-week intervention, follow-up was conducted at 6 and 12-months.
Results: Participation in the everyBODY arm was associated with improved WBI, body attitudes, weight-self-efficacy, and binge eating. These improvements were sustained at follow-up. In comparison, participation in the Standard Care arm was associated with improved weight (post-treatment and maintained at follow-up) and improved binge eating (post-treatment but not maintained by 12-months). While WBI and weight self-efficacy did not improve over the course of the Standard Care intervention, improvements were observed at 12-months.
Conclusion: The study showed that engaging in a program designed to address weight bias is associated with improvements in WBI, body attitudes, weight self-efficacy and eating, and that these changes can be sustained long-term. While Standard Care also resulted in improved WBI and weight-self-efficacy, these changes occurred only after weight-loss. There was also evidence that positive changes to eating in the Standard Care arm (namely, reduced binge eating) were not maintainable. These findings provide support for addressing weight bias in weight-management programs. Further research is needed to understand the longer-term effects of doing so on weight and eating.