Spanish study links internalised weight stigma to increased disordered eating risk among teenagers

A two-year study in Spain reveals that internalisation of weight-based prejudice among teenagers, especially girls, significantly increases the likelihood of developing eating disorders, highlighting the importance of early prevention efforts.

A two-year study of Spanish teenagers has found that adolescents who absorb weight-based prejudice and turn it inward are more likely to develop disordered eating later on, strengthening the case that internalised weight stigma is not just associated with eating problems but may help drive them. Published in the Journal of Eating Disorders, the research followed young people in Terrassa, near Barcelona, and found that higher levels of weight bias internalisation at the start of the study predicted worse eating-related outcomes two years later, with the clearest effects seen among girls. According to the study authors, the pattern suggests that self-directed weight stigma is a modifiable risk factor that prevention efforts should address early.

Weight bias internalisation, or WBI, refers to the process by which people take in negative stereotypes about body weight and apply them to themselves. Rather than simply disapproving of larger bodies in general, a person with high WBI may blame their own shape or size for perceived failings and judge themselves through a moralised lens. The Spanish team, led by Clara Almazán and David Sánchez-Carracedo of the Universitat Autònoma de Barcelona, used a longitudinal design because earlier work had largely relied on one-time surveys, which cannot show which comes first: the stigma or the eating disorder symptoms. A study in China published on PubMed has also pointed to a similar pathway, finding that experienced weight stigma can feed later internalisation, which then predicts thinness-focused disordered eating.

The researchers recruited a representative school sample in Terrassa and assessed 1,016 adolescents in 2022 before following 551 of them in 2024, a retention rate of 54.2 percent overall. Among those still in compulsory secondary education, retention was 81.3 percent. The team measured WBI with the WBIS-M scale and then tracked several outcomes, including drive for thinness, body dissatisfaction, bulimic symptoms, binge eating and unhealthy weight-control behaviours such as meal skipping and fasting. After adjusting for baseline symptoms, weight status and social factors, higher WBI still predicted poorer outcomes two years later. The strongest signals were in girls: baseline internalised stigma was linked to more than double the relative risk of severe binge eating and to a higher likelihood of unhealthy weight-control behaviour.

The findings fit with a broader body of research showing that weight-related teasing, parental weight talk and perceived stigma can shape eating behaviour in young people. Earlier studies in adolescents have linked weight teasing to later binge eating and dieting, while other research has connected weight-related comments from mothers with higher internalised weight bias. In this new study, the fact that WBI predicted later outcomes even after accounting for starting symptoms and body weight strengthens the argument that internalised stigma has an effect of its own. The public health message is straightforward: if schools, families and health campaigns can reduce shame and stop framing weight as a test of character, they may also lower the risk of disordered eating in a group already vulnerable to it.