Psychology Ph.D. Dissertations

Do Psychological Distress and Maladaptive Eating Patterns Mediate the Relationship Between Overt Weight Stigma and Weight Loss Treatment Outcomes?

Date of Award


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)



First Advisor

Robert Carels (Committee Chair)

Second Advisor

William O'Brien (Committee Member)

Third Advisor

Steve Jex (Committee Member)

Fourth Advisor

Amy Morgan (Committee Member)


Prevalence rates of overweight and obesity continue to rise and the majority of Americans are considered either overweight or obese (Flegal, Carroll, Ogden & Johnson, 2002). Although overweight and obesity are common phenomena, anti-fat bias is pervasive and results in overt discrimination and stigma towards overweight and obese individuals (Puhl & Brownell, 2001). Evidence suggests that experiencing overt weight-based stigma is associated with greater depression, binge eating behaviors and body image dissatisfaction (e.g., Ashmore, Friedman, Reichmann & Musante, 2008; Jackson, Grilo & Masheb, 2000; Matz, Foster, Faith & Wadden, 2002). Additionally, a small body of research indicates that overt stigma (i.e., stigmatizing situations) may negatively influence health behaviors that are consistent with weight loss (e.g., Vartanian & Shaprow, 2008). The current investigation assessed whether the relationship between encountering stigmatizing situations in the past and weight loss outcomes in a behavioral weight loss program were mediated by psychological distress (i.e., depression, negative affectivity and body image dissatisfaction) and maladaptive eating patterns (i.e., binge eating). Their was no evidence for the hypothesized mediation, however, stigmatizing experiences were significantly associated with weight loss treatment outcomes such as percent weight loss during the intervention, average caloric intake and caloric expenditure through physical activity. Additionally, stigmatizing experiences were significantly associated with increased reports of depression, binge eating, negative affectivity, and poorer body image. These findings support the need for interventions designed to reduce the harmful impact of overt weight stigma on the psychological well-being and health of overweight/obese adults.