Elsevier

Body Image

Volume 36, March 2021, Pages iii-v
Body Image

Editorial
Inconsistencies in the conceptualisation and operationalisation of internalized weight stigma: A potential way forward

https://doi.org/10.1016/j.bodyim.2020.12.002Get rights and content

Introduction

Weight stigma refers to the stereotyping and devaluation of individuals who deviate from societal body ideals, processes most often experienced by people with higher body weights (Tomiyama et al., 2018). Evidence suggests that experiencing weight stigma facilitates negative outcomes, including disordered eating, anxiety, and depression, in part through internalized weight stigma (IWS): a process of self-devaluation due to body weight (Pearl & Puhl, 2018; Wellman, Araiza, Solano, & Berru, 2019).

In their recent paper, Meadows and Higgs (2020) investigated the conceptual overlap of one widely used measure of IWS, the Weight Bias Internalization Scale (WBIS; Durso & Latner, 2008), with measures of self-esteem and body image. The authors hypothesised that these constructs may be better represented by an underlying self-judgement trait. This prediction was supported through a bifactor analysis examining the shared and unique variance among these measures, which revealed that more than three quarters of the variance in both IWS and body image were accounted for by an overarching body image-related self-judgement factor. Notably, taking into account the shared variance of IWS with body image and self-esteem, IWS was no longer a significant mediator of the relationship of experienced weight stigma with eating behaviours. Although Meadows and Higgs address just one specific relationship of weight stigma experiences and adverse outcomes mediated by IWS, their findings raise the question of why IWS was not fully distinct from related self-esteem and body image constructs.

In light of this challenge of delineating IWS (as measured by the WBIS) from other related measures, Meadows and Higgs (2020) called for greater conceptual clarity in IWS research. We agree with this recommendation, and expand upon it in this commentary by identifying three related processes that limit conceptual clarity in this area of research: (i) the interchangeable use of terms to refer to IWS, (ii) the inconsistent definitions of those terms, and (iii) the varying operationalisations of those terms.

Section snippets

Interchangeable use of terms to refer to internalized weight stigma

Meadows and Higgs (2020) proposed that the conceptual ambiguity of measures of global self-esteem, body image, and IWS, may lead to a jangle fallacy: a circumstance wherein multiple terms, treated as different constructs, are used to describe ostensibly identical processes (Kelley, 1927). We extend this notion of a jangle fallacy in IWS research specifically to the term internalized weight stigma, in that this is one of many terms researchers have used to describe identical or highly similar

Inconsistent definitions of the terms used to refer to internalized weight stigma

Further limiting conceptual clarity is the fact that these terms, although referring to similar if not identical processes, are themselves defined inconsistently. Seemingly all existing definitions of IWS (and its alternative terms listed above) describe it as a process of self-devaluation due to body weight (Durso & Latner, 2008; Lillis et al., 2010; Pearl & Puhl, 2014). Facets of IWS addressed by some, but not all, definitions include one’s awareness of their stigmatized identity (Pearl &

Varying operationalisations of internalized weight stigma

The interchangeable terms and inconsistent definitions of IWS have likely contributed to the varied operationalisations (i.e., self-report questionnaires) of IWS. If existing definitions do not capture the processes subsumed in IWS in their entirety, neither will their resulting operationalisations. This sequence of consequences is demonstrated in Meadows and Higgs’ (2020) findings that the WBIS may not fully capture the multidimensionality of IWS, nor its distinctiveness from alternative

A way forward: bringing conceptual clarity to internalized weight stigma

Meadows and Higgs (2020) suggested that one way to tackle the inconsistent conceptualisation of IWS is to replicate their research with alternative IWS measures (e.g., WSSQ, WBIS-2F), to tease out the elements of IWS that are distinct from self-esteem and body image processes. We suggest that addressing these issues at their conceptual roots is another useful approach. A promising next step could be a Delphi study: a process wherein a panel of ‘experts’ (i.e., people with experience or

Conclusion

Meadows and Higgs’ (2020) findings highlight the need for greater conceptual clarity in IWS research. Specifically, the clarification of the specific components subsumed in IWS is one step that should be considered if researchers wish to observe the full impacts of this process upon mental and physical health outcomes. Developing a consensus definition, and subsequent operationalisations, of IWS will ultimately help to achieve what is the overarching goal of this body of research: that is, to

CRediT authorship contribution statement

Emma Austen: Conceptualization, Writing - original draft, Writing - review & editing. Rebecca L. Pearl: Conceptualization, Writing - review & editing. Scott Griffiths: Conceptualization, Writing - review & editing.

Acknowledgements

Emma Austen is supported by an Australian Government Research Training Program Scholarship.

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