Ecological Momentary Assessment of Weight Stigma and Eating Behavior in Everyday Life

Ann Behav Med. 2024 May 23;58(6):457-462. doi: 10.1093/abm/kaae012.

Abstract

Background: Weight stigma is widespread, but the existing literature on its harmful consequences remains largely limited to lab-based experiments and large-scale longitudinal designs.

Purpose: The purpose of this study was to understand how weight stigma unfolds in everyday life, and whether it predicts increased eating behavior.

Methods: In this event-contingent ecological momentary assessment study, 91 participants reported every time they experienced weight stigma and documented whether they ate, how much they ate, and what they ate. These reports were compared against a timepoint when they did not experience stigma.

Results: Participants reported a wide variety of stigmatizing events from a variety of sources, with the most common ones being the self, strangers, the media, and family. Multilevel models showed that participants were no more likely to eat post-stigma (vs. the comparison point), but if they did eat, they ate more servings of food (on average consuming 1.45 more servings, or 45% more). Moderation analyses indicated that this effect was amplified for men versus women.

Conclusion: Experiencing weight stigma appears to beget behavioral changes, potentially driving future weight gain, placing individuals at ever more risk for further stigmatization.

Keywords: Eating; Eating behavior; Ecological momentary assessment; Weight stigma.

Plain language summary

This study looked at how weight stigma in everyday life impacts eating. People reported on episodes of weight stigma and their eating in the next 30 min. Weight stigma came from many different places, including family, strangers, media, and even themselves. Even though people did not necessarily eat more after weight stigma episodes, if they did eat, they ate significantly more food—about 45% more. This relationship was stronger in men than in women. The study also explored whether different kinds of people react differently to weight stigma. Weight stigma experiences led to even more food eaten among people who tended to have high buy-in about negative stereotypes of heavier people, as well as people who thought weight was an important part of their identity. The opposite was seen among people who worried the most about experiencing weight stigma in the future. These findings suggest that experiencing weight stigma may not always prompt people to eat immediately, but when they do eat, they tend to eat more, challenging the idea that weight stigma motivates people to eat less.

MeSH terms

  • Adolescent
  • Adult
  • Body Weight
  • Ecological Momentary Assessment*
  • Feeding Behavior* / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Social Stigma*
  • Young Adult