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Introduction and Objective: Weight bias internalization (WBI) is the self-application of weight-related stereotypes, leading to negative self-evaluation due to one’s weight. This study examined associations between WBI and HbA1c in youth with T1DM. Methods: Patients (11-18 years) with T1DM for ≥1 year completed validated surveys at clinic visits via REDCap, including the Modified Weight Bias Internalization Scale (WBIS-M), the Diabetes Eating Problem Survey Revised (DEPSR), and on measures of weight based teasing (WBT), body appreciation, and diabetes stigma. Additional data was obtained via chart review. Descriptive statistics and comparisons were performed. Linear regression models examined the association between WBIS-M scores and HbA1c (averaged over the past year), both unadjusted and adjusted for covariates. Results: Out of 170 youth, 29 met the cutoff for elevated WBI (WBIS-M score ≥ mean + 1 SD). Youth with elevated WBI were more often female (69% vs 47.5%, p=0.042), had a mental health condition (62.1% vs 27%, p<0.001) or diabetes-related complication (13.8% vs 3.5%, p=0.047), and experienced WBT (p <0.001). Elevated WBI was associated with higher mean DEPSR [mean(SD): 29.6(13.1) vs 10.1(7.9), p<0.001] and diabetes stigma scores [29.6(13.1) vs 10.1(7.9), p <0.001], and lower body appreciation scores [21.7(6.1) vs 35.1(5.1), p<0.001]. In an unadjusted model, elevated WBI was associated with increased HbA1c levels (coefficient 0.35, p<0.001). However, this relationship became non-significant (p 0.42) when adjusted for DEPSR and diabetes stigma scores, and prior mental health conditions. Conclusion: This is a novel study of WBI in youth with T1DM, identifying characteristics more prevalent in those with higher WBI, including female sex, mental health disorders, WBT, disordered eating, and diabetes stigma. While WBI initially correlated with higher HbA1c, this association did not hold independent of disordered eating, diabetes stigma, and mental health. Further research is warranted. Disclosure C. Figgie: Stock/Shareholder; Wishbone Medical, Sylke Inc, Icarus Medical. S. Acselrod: None. R. Puhl: Research Support; Eli Lilly and Company. Consultant; Eli Lilly and Company. Research Support; Weight Watchers International. C. Trapp: Advisory Panel; Rhythm Pharmaceuticals, Inc. C.S. Demirci: None. Funding Chase Chair for Juvenile Diabetes