Examining the effects of implicit and internalized weight bias on physical activity participation for women in larger bodies

Weight stigma represents discrimination associated with the social beliefs that people in larger bodies have low willpower, are unmotivated, and are personally responsible for their elevated weight. Internalized weight stigma is the extent to which social perceptions of weight stigma are attributed to the self by people in larger bodies. Dual process models may be uniquely situated to help us understand how weight stigma becomes internalized and whether this impacts (physical activity) PA participation. Within dual process models two systems regulate how we think; the associative system reflects automatic associations and feelings, whereas the propositional system represents deliberate and controlled reasoning. Past research has examined social perceptions of explicit weight stigma alongside implicit measures, rather than examining the internalized form of weight bias. The purpose of this study was to examine whether implicit weight bias (an associative process) and internalized weight bias (a propositional process) are significantly associated with the expectation of experiencing weight stigma, self-regulatory efficacy, the tendency to avoid PA, PA intention, and PA. All eligible participants (n = 154) were over 18, self identified as a woman, had a BMI over 25 and self-identified as a person living in a larger body. Implicit weight bias was measured using a single category Implicit Association Test, while the other study variables were measured using validated survey measures. We conducted a series of hierarchical multiple regression analysis, entering covariates in step 1, implicit weight bias in step 2, and internalized weight bias in step 3. In step 3, both implicit and internalized weight bias were significantly associated with self-regulatory efficacy (p <.001, r2 = .183) and light past PA (p < .05, r2 = .065). Contrarily, the expectation of experiencing weight stigma (p <.05, r2 =.120) and the tendency to avoid PA (p <.001, r2 = .297) were both significantly associated with implicit weight bias in step 2. However, once internalised weight bias was added into the equation in step 3, the implicit association became not significant. No relationship was observed between PA intention, implicit weight bias and internalized weight bias. Similarly, there was no relationship observed between moderate to vigorous physical activity, implicit weight bias and internalized weight bias (p > .05). Implicit weight bias and explicitly measured internalized weight bias were associated with psychological cognitions that may deter PA. They seemed to be more strongly related to cognitions than behaviours, which might suggest that they have indirect relationships with PA. Examining both implicit and internalized weight bias together, through a dual process lens provided insight into the nuanced relationship that people in larger bodies have with PA participation. Future health promotion strategies should consider these findings and must work to shift away from their weight centric approach that may exacerbate internalized weight bias and instead, adopt a more weight-neutral approach towards PA participation.

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