Association of Weight-Related Stigmas With Daily Pain Symptoms Among Individuals With Obesity

Background: Individuals with obesity are disproportionately impacted by pain-related symptoms.

Purpose: This study evaluated experienced weight stigma and internalized weight bias (IWB) as predictors of pain symptoms in daily life among individuals with obesity.

Methods: Adults with obesity (n = 39; 51% female, 67% White, 43.8 ± 11.6 years old, BMI = 36.8 ± 6.7 kg/m2) completed a baseline assessment (demographics, experienced weight stigma, IWB) and a 14-day Ecological Momentary Assessment (EMA) period involving five daily prompts of pain/aches/joint pain, muscle soreness, experienced weight stigma, and IWB. Generalized linear models were used to assess experienced weight stigma and IWB at baseline as prospective predictors of EMA pain/soreness symptoms. Multi-level models were used to test the association of momentary weight stigma experiences and IWB with pain/soreness at the same and subsequent EMA prompts.

Results: IWB at baseline, but not experienced weight stigma, was associated with more frequent pain symptoms (p < .05) and muscle soreness (p < .01) during EMA. Momentary IWB (but not experienced stigma) was associated with more pain/aches/joint pain and muscle soreness at the same and subsequent prompt.

Conclusions: Internalized (but not experienced) weight bias was prospectively associated with pain symptoms in daily life among individuals with obesity. Results are consistent with growing evidence that weight-related stigmas represent psychosocial factors that contribute to weight-related morbidity typically attributed to body size.