Fatmisia and Clinical Counseling Decision-Making in Master’s-Level Counselor Trainees

The Centers for Disease Control and Prevention and the World Health Organization have documented an increase in fat people in recent decades, which is being met with a backlash of anti-fat biases, or fatmisia. Fatmisia is prevalent in most aspects of society, especially among fat people who have internalized fatmisia. Utilizing a diagnostic questionnaire in combination with the Fat Phobia Scale–Short Form and the Weight Bias Internalization Scale, this study explored the relationship between client body size, the presence of a major depressive disorder (MDD) diagnosis, and if applicable, the severity of MDD symptoms assigned by counselor trainees (N = 113). Results were analyzed using one-way analysis of variance and covariance. This sample (N = 113) significantly differed in diagnoses assigned to obese clients by assigning more severe MDD. Study limitations and implications are discussed.

The Relationship between Weight Stigma, Physical Appearance Concerns, and Enjoyment and Tendency to Avoid Physical Activity and Sport

Participation in physical activity and sport is on the decline and there is a poor understanding of the psychosocial factors that contribute to people’s reluctance to participate. We examined whether there were relationships between factors such as weight stigma, weight bias internalization, appearance evaluation, and fears of negative appearance evaluations, and enjoyment and avoidance of physical activity and sport. Undergraduate students (N = 579) completed a survey assessing demographics, and the variables described above. In hierarchal multivariate regression models, weight stigma (β = −0.16, p < 0.001), appearance evaluation (β = 0.19, p = 0.001), and weight bias internalization (β = −0.19, p = 0.003) were associated with lower enjoyment of physical activity and sport. Weight stigma (β = 0.46, p = 0.001), weight bias internalization (β = 0.42, p = 0.001), and fear of negative appearance evaluations (β = 0.16, p = 0.000) were also significantly associated with the tendency to avoid physical activity and sport. Serial mediation analysis showed the relationship between weight stigma and enjoyment of physical activity and sport was through appearance evaluation and weight bias internalization (indirect effect = −0.007, SE = 0.002, 95% CI = −0.01, −0.02). Similarly, the relationship between weight stigma and avoidance of physical activity and sport was through weight bias internalization and fear of negative appearance evaluations (indirect effect = 0.11, SE = 0.03, 95% CI = 0.05, 0.16). These results suggest that weight stigma and concerns about one’s physical appearance influence people’s enjoyment and reasoning for avoiding physical activity and sport. Research is needed to identify ways to reduce body-related stigma and increase enjoyment and participation in physical activity and sport.

Food Addiction and Its Relationship to Weight- and Addiction-Related Psychological Parameters in Individuals With Overweight and Obesity

Background and Aims: It is assumed that a relevant subgroup of individuals experiences an addiction-like eating behaviour (Food Addiction), characterized by an impaired control over eating behaviour, emotional eating and food craving. Individuals experiencing Food Addiction partially share common symptomatology with Binge-Eating-Disorder and Bulimia Nervosa. The aim of this study was to investigate the prevalence of Food Addiction, general psychopathology, and associations with weight- and addiction-related constructs in individuals with overweight and obesity, who did not suffer from Binge-Eating-Disorder or Bulimia Nervosa.Methods:N=213 (67.1% female; MBMI=33.35kg/m2, SDBMI=3.79kg/m2) participants who were included in a weight loss program (I-GENDO project) reported BMI and completed questionnaires before the start of the treatment. Food Addiction severity, depressive symptoms, alcohol use disorder, internet use disorder, psychological distress, impulsivity personality trait, impulsive and emotional eating behaviour, food related inhibitory control, weight bias internalization, and self-efficacy were assessed.Results: The prevalence of Food Addiction was 15% with higher, although not statistically significant, prevalence in female (18.2%) compared to male (8.6%) participants. Food Addiction was associated with higher BMI at baseline assessment, low self-esteem, impulsive and emotional eating behaviour, weight bias internalization, and deficits in food-related inhibitory control. In addition, correlations were found between Food Addiction and severity of depressive symptoms, internet use disorder, and psychological distress.Conclusion: A relevant subgroup of participants experiences Food Addiction even when controlling for Binge-Eating-Disorder and Bulimia Nervosa. Future studies are warranted that investigate whether Food Addiction affects treatment success.

Designing Ruby: a brief digital randomized controlled trial for internalized weight bias (Preprint)

UNSTRUCTURED Weight bias internalization – also known as weight self-stigma - is a serious health concern for individuals at higher body weights. Weight bias internalization is associated with more avoidance of healthcare and health-promoting activities, more disordered eating, more social isolation, and weight gain. Elevated weight bias internalization has been associated with low self-compassion, yet few investigations have explored self-compassion as a potential mechanism in reduction of internalized weight bias. Ruby is a two-arm randomized controlled trial designed to test the efficacy of a 4-week digital self-compassion intervention to reduce internalized weight bias, compared to wait list control. Adults with elevated internalized weight bias and a body mass index over 30 kg/m2 (n=80) will be recruited. Ruby is a standalone digital trial and will be delivered entirely via smartphone using web-based data collection and text messages. Intervention content will include psychoeducation and daily mindfulness practices with a focus on self-compassion and body concerns. We will use intent-to-treat analyses to examine changes in weight bias internalization over time by treatment arm using one-way analysis of covariance (ANCOVA) models and linear mixed models. The present protocol was designed in May 2020 and approved in December 2020. Data collection is currently underway. Ruby will be the first digital standalone self-compassion based intervention designed to reduce internalized weight bias. Due to its standalone digital delivery, Ruby may be a highly-scalable treatment for internalized weight bias that can be delivered on its own or combined with other treatments. We expect Ruby to be accessible to many, as participants can access the digital intervention at times of the day most convenient in their schedule and are not burdened by in-person time commitments, which can be a barrier for participants with competing demands on their time and resources. If efficacious, Ruby will be poised to expand a burgeoning body of literature related to psychological intervention in this area of need.