A meta-analysis of associations between weight bias internalization and conceptually-related correlates: A step towards improving construct validity

Weight bias internalization (WBI), a process of weight-based self-devaluation, has been associated with adverse mental and physical health. However, there are limitations with the existing conceptualization and operationalization of WBI that raise questions about the implications of this evidence-base. To address these limitations, the present study investigated the construct validity of WBI by conducting a meta-analysis of associations between WBI (as currently operationalized) and conceptually-related correlates. Studies identified through October 2021 that provided zero-order correlations for associations between WBI and conceptually-related constructs were examined. Meta-regression determined whether these associations differed across WBI measures and demographic (age, sex/gender, race, BMI) and study-level (publication status, sample type, study quality) moderators. Data for 128 (sub)samples were identified (Msample size = 477.83, SD = 1679.90; Mage = 34.46, SD = 12.17; range = 10.21-56.60). Greater WBI exhibited large to very large associations with factors suggested to have considerable overlap with this construct (negative and positive body image, self-devaluation), general and weight-specific experiential avoidance, and individuals' anticipation of future weight stigma. Associations varied for other constructs that have been differentially included in conceptualizations of WBI (endorsing weight bias, weight stigma stereotype awareness, weight stigma experiences), and via measurement-related, demographic, and study-level factors. These findings provide important information that can advance WBI conceptualization and measure-refinement.