Understanding Internalized Weight Bias and Its Psychological Consequences: Implications for Improving Quality of Life

Conducted in a French clinical context, this study examines the association between experiences of weight stigma, internalized weight bias (IWB), coping strategies, quality of life (QoL), and obesity-specific self-efficacy (OSSE) among adults living with obesity. It also tests whether coping mediates the relationship between IWB and QoL or OSSE. A cross-sectional sample of 132 adults (mean age = 49.3 years; mean BMI = 41.5 kg/m²) completed questionnaires assessing experienced weight stigma, IWB, coping strategies (adaptive and maladaptive), QoL (Mental Health Continuum-Short Form), and OSSE. Analyses included Pearson correlations, linear regressions, and bootstrap mediation models. Experiences of weight stigma were positively associated with IWB. Higher IWB predicted lower QoL and reduced OSSE. It was linked to less use of adaptive coping strategies and greater use of maladaptive strategies. Mediation analyses showed that coping strategies fully mediated the relationship between IWB and QoL, explaining approximately 43.7% of the variance. Similar patterns were observed across emotional, social, and psychological subdimensions. With respect to OSSE, the effects of IWB on all subdimensions were completely mediated by coping; adaptive strategies were particularly important for interpersonal and emotional facets, whereas maladaptive strategies were more influential for behavioral facets. Internalized weight bias plays a central role in the relationship between weight stigma and psychosocial outcomes in individuals living with obesity. Coping strategies are key mechanisms linking IWB to QoL and OSSE. Interventions aimed at reducing internalization and strengthening adaptive coping may improve well-being and confidence in weight management.