(PS5-81) Weight Bias Internalization and Eating Disorder Pathology in Adolescents with Higher Weights: Examining the Role of Emotion Regulation

Abstract Text: Weight bias internalization (WBI), or the internalization of weight-related stigma, has been implicated in the development and maintenance of eating disorder (ED) pathology in adults by fostering body-related shame and self-criticism, reinforcing cognitive distortions, and promoting maladaptive eating behaviors (e.g., dietary restraint, purging, binge eating) as attempts to cope with distress or adhere to societal body ideals. However, limited research has explored this relationship in adolescents, a critical period for the emergence of ED pathology. Adolescents with higher body weights may be particularly vulnerable to WBI due to increased exposure to weight stigma, which can heighten body dissatisfaction and trigger pathological eating behaviors, further contributing to the development and maintenance of ED pathology. Additionally, difficulties in emotion regulation (ER) have been linked to both WBI and ED pathology in adults, and ER may function as a mediator in this relationship by amplifying the psychological distress associated with WBI, which in turn increases the likelihood of engaging in ED behaviors as a coping mechanism. Thus, the current study examined whether WBI predicts ED pathology in a diverse sample of adolescents with higher weights and tested whether ER mediates this association. Secondary analyses were conducted using an NIH-funded novel acceptance-based healthy lifestyle intervention for diverse adolescents. Forty adolescents with higher weights (≥ 85% BMI percentile; Mage = 16.65, SDage = 1.69; 62.5% Black or African American) completed measures of WBI (Weight Bias Internalization Scale), ER (Difficulties in Emotion Regulation Scale), and ED pathology (Eating Disorder Examination Questionnaire) prior to the group intervention. Analyses revealed a significant association between WBI and ED pathology, F(1, 38) = 62.70, p < .001, with higher WBI linked to greater ED pathology, β = .06, t = 7.98, p < .001. ER did not significantly mediate this association. Findings demonstrated a relationship in which higher WBI scores were associated with greater ED pathology. Although adolescents with elevated WBI reported greater difficulties in ER, ER difficulties were not significantly associated with ED pathology, suggesting that additional factors may contribute to this relationship. These findings highlight the importance of addressing WBI in interventions for adolescents with higher weights. Given that ED pathology may also contribute to increased WBI, longitudinal research is needed to explore underlying mechanisms and enhance treatment strategies.