Maria Fernanda Laus

People living with obesity (PLWO) frequently experience weight stigma (WS) in healthcare settings, leading to disparities in treatment. Although research shows that healthcare professionals (HCPs) often hold stigmatising views, this issue remains underexplored in Brazil. The objective of this study is to examine WS and beliefs about obesity amongst Brazilian HCPs. Five hundred seven Brazilian HCPs completed a survey assessing sociodemographic data, beliefs about obesity and the Fat Phobia Scale‐Short Form (FPS‐SF) for assessing WS. Linear regression models analysed the association between these variables. HCPs who are men ( p = 0.007) and physicians ( p < 0.001) had significantly higher WS. Participants who attributed overeating to physiological dysfunction ( p = 0.004) or the food environment ( p = 0.020) reported significantly lower WS compared to those who attributed it to emotional eating. Those who attributed weight loss difficulty to genetic or metabolic factors ( p < 0.001) had significantly lower WS compared to those that reported lack of motivation or self‐discipline. People who reported a belief that there are factors beyond patients' control ( p = 0.001), inadequate care by HCP ( p = 0.018) or biological mechanisms ( p = 0.007) that prevent weight loss reported significantly lower WS compared to HCPs who believe it's the result of a lack of motivation/self‐discipline. In conclusion, higher levels of WS were observed in HCPs who are men, physicians and HCPs who attribute the causes and management of obesity to personal responsibility. These findings emphasise the need for interventions to address WS in HCPs and to improve care for PLWO.

The Eating Disorder Examination-Questionnaire (EDE-Q) is a widely used 28-item instrument for screening eating disorders, of which 22 are attitudinal items used to compute subscale scores and to assess factorial structure, while six open-ended items assess behavioral frequency and are excluded from dimensional analyses. Shorter versions, such as the EDE-Q7, EDE-Q8, and EDE-Q18, have been proposed to enhance accessibility and psychometric properties. This study aimed to evaluate different factorial structures of the EDE-Q and identify the model that best fits a sample of Brazilian adult women. A total of 712 women completed the EDE-Q and measures of body satisfaction and sociocultural pressures. The factorial structure was analyzed through confirmatory factor analysis (CFA), and convergent validity and internal consistency were also assessed. The multifactorial structure of the original EDE-Q and the 18-item model did not fit the sample well. Although the 7-item model showed acceptable fit, the 8-item version demonstrated the best fit. The EDE-Q8 factors showed a negative association with appearance evaluation and body area satisfaction, and a positive association with internalization of the thin and muscular body ideal and body mass index. Internal consistency was adequate. The 8-item short version of the EDE-Q is a reliable and practical psychometric tool for assessing disordered eating behaviors in Brazilian adult women. Future studies should explore the psychometric performance of the EDE-Q8 across different age ranges, gender groups, and clinical populations to strengthen evidence for its cross-cultural validity and generalizability. Level III, well-designed cohort or case-control analytic studies.

Weight stigma and discrimination occur daily, especially among healthcare professionals, leading to repercussions on physical and mental health. This study aimed to examine the content of discussions associated with a video about judging a healthcare professional’s competence based on their physical appearance on an Instagram profile. The comments linked to the post were analyzed using thematic content analysis and grouped into two themes: 1) “We cannot judge anyone”: a fat body is not an incapable body, and 2) “Those who have an image sell more”: the stigmatization of healthcare professionals. It was observed that judging professional competence based on body shape led to divergent opinions. The negative ones had elements of fatphobia and weight stigma and associated a fat individual with laziness, asserting that, as healthcare professionals, they should set an example. The positive ones conveyed messages of empathy and support.

Internalized weight stigma refers to individuals’ self-stigmatization, leading to self-devaluation. This research aimed to conduct an adaptation and validation study of the Modified Weight Bias Internalization Scale (WBIS-M) for Brazil. A sample of 418 adults (253 women; mean age = 30.8 years, SD = 10.4) completed the WBIS-M and measures of anti-fat attitudes, body image, disordered eating, binge eating, and self-esteem. Exploratory factor analyses (EFA) and confirmatory factor analyses (CFA) were conducted to examine the factor structure of the WBIS-M. Measurement invariance across gender was tested with multigroup CFA. Internal consistency was assessed using omega and alpha. Relationships between the WBIS-M scores and external measures were analyzed using Pearson’s and Spearman’s correlations, t-tests, and Cohen’s d for effect size. EFA and CFA showed that the 10-item and 1-factor WBIS-M model fit reasonably well (CFI and TLI ≥ .98, SRMR ≤ .06, although RMSEA ≤ .12). Full metric and full scalar invariance evidenced equivalence across genders. The internal consistency reliability coefficients were satisfactory (α and ω = .94). A higher WBIS-M score was linked to greater body dissatisfaction, restrictive/compensatory behaviors, food/weight concerns, binge eating severity, and lower self-esteem. Women and those with a higher BMI had higher WBIS-M scores. Finally, the Brazilian WBIS-M’s 10-item score is a valid and reliable measure for assessing weight self-stigma in adults.

The Satisfaction With Life Scale (SWLS) is a widely used self-report measure of subjective well-being, but studies of its measurement invariance across a large number of nations remain limited. Here, we utilised the Body Image in Nature (BINS) dataset–with data collected between 2020 and 2022 –to assess measurement invariance of the SWLS across 65 nations, 40 languages, gender identities, and age groups (N = 56,968). All participants completed the SWLS under largely uniform conditions. Multi-group confirmatory factor analysis indicated that configural and metric invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional SWLS model has universal applicability. Full scalar invariance was achieved across gender identities and age groups. Based on alignment optimisation methods, partial scalar invariance was achieved across all but three national groups and across all languages represented in the BINS. There were large differences in latent SWLS means across nations and languages, but negligible-to-small differences across gender identities and age groups. Across nations, greater life satisfaction was significantly associated with greater financial security and being in a committed relationship or married. The results of this study suggest that the SWLS largely assesses a common unidimensional construct of life satisfaction irrespective of respondent characteristics (i.e., national group, gender identities, and age group) or survey presentation (i.e., survey language). This has important implications for the assessment of life satisfaction across nations and provides information that will be useful for practitioners aiming to promote subjective well-being internationally.

This quantitative study associated the search for information about food and nutrition with body image and eating behavior in men and women. An online survey was conducted from December 2021 to March 2022, with 518 adults participating via social media and email invites. The survey included demographic questions, information-seeking behavior, beauty ideals, media influence, body satisfaction, investment in appearance, and disordered eating. Two-way ANOVAs and Path analysis were used. Most participants were women, white, heterosexual, and single, with an average age of 31 years and body mass index (BMI) of 25.9 kg/m². Most participants looked up information about food and nutrition (81.7%; n = 423) and used Google® as their primary source (45.2%; n = 191). Path analysis revealed that searching for information is positively associated with satisfaction with appearance, BMI, media pressure, and time spent on social networks. Conversely, there is a negative relationship between satisfaction with appearance and seeking information and between investment in appearance and searching for such information.

Background Weight stigma is a complex construct formed by various components. This study aimed to compile these components and classify them into the multilevel intervention levels of stigma (structural, interpersonal, and intrapersonal).Methods A non-systematic literature review was conducted to identify the most commonly used definitions of weight stigma components. Subsequently, a proposal was made to classify these components into different intervention levels as proposed (Structural, Interpersonal, Intrapersonal). The components were categorized based on their definitions and specificities at each level. A panel of experts evaluated the proposal, and the degree of agreement was assessed using Fleiss' Kappa coefficient (₭). Values of ₭ between 0.40 and 0.60 indicated moderate agreement; between 0.61 and 0.75, good agreement; and above 0.75, excellent agreement.Results Ten terms were identified and classified in the different levels of stigma, except “Weight stigma” and “Weight bias”. At the structural level were included "fatphobia" and "weight-based stereotypes"; at the interpersonal level, "weight discrimination" and "explicit weight bias"; and at the intrapersonal level, "implicit weight bias", "lipophobia," "fat stigma", and "internalized weight bias". Agreement among the experts' responses for the structural and interpersonal levels was 100% (₭ = 1.0). For the components allocated at the intrapersonal level, there were some disagreements in the classification of the “Fat stigma” component (₭ = 0.4), and “Lipophobia” and “Implicit weight bias” were considered inappropriate by one specialist (₭ = 0.6).Conclusion The proposed classification of weight stigma components across multi-level interventions is novel and deemed appropriate by the experts. In future studies, this classification can help assess associations between weight stigma components across inter- and intra-levels and guide interventions across different levels for more effective outcomes in combating weight stigma.

Weight stigma (WS) is a significant global health issue and this study explored WS experiences in 214 general population (Public) and 329 healthcare professionals (HCPs). Participants indicated prior experiences of WS as well as the influence of WS on their healthcare experiences. Approximately one-quarter of both groups were “overweight” by BMI; however, more of the public (46.4%) than HCPs (27.8%) were in the “obese” category. Despite this, similar numbers reported prior weight stigma experiences (71.0% and 66.9%, respectively). Controlling for weight, member of the public who had (vs had not) experienced WS were more likely to report avoiding seeing a doctor and feeling judged by a doctor because of their weight, and reported reduced quality healthcare (all ps < .008). In contrast, prior experiences of WS among HCPs only resulted in greater feelings of being judged by doctors (p = .013), with no difference in healthcare avoidance or perceived care quality. Results emphasizing emphasize the need for interventions against WS across all environments, including healthcare settings.