Weight Bias Internalization and Eating Disorder Psychopathology in Treatment-Seeking Patients with Obesity

This study aimed to investigate the relationship between weight bias internalization and eating disorder psychopathology in treatment-seeking patients with severe obesity using a network approach. Two thousand one hundred and thirteen patients with obesity were consecutively admitted to a specialist clinical unit for obesity and were recruited from January 2016 to February 2023. Body mass index was measured, and each patient completed the Weight Bias Internalization Scale (WBSI) and the Eating Disorder Examination Interview (EDE). Network analysis showed that the most central and highly interconnected nodes in the network were related to the EDE items exposure avoidance, dissatisfaction with shape, and wanting an empty stomach. Bridge nodes were found, but the bootstrap difference test on expected bridge influence indicated non-significant centrality differences. Nevertheless, the eating disorder psychopathology and weight bias internalization network structure in patients seeking treatment for obesity indicate the prominent roles of body dissatisfaction and control of eating and weight in these psychological constructs. This finding, if replicated, could pave the way for a new understanding of the psychological mechanisms operating in patients with obesity.