5 - (IOP 23) Weight Stigma, Body Trust, and Suicide Ideation Among Adolescents: A Longitudinal Study

Suicide is the fourth leading cause of mortality among adolescents worldwide, with rates rising sharply from early to late adolescence. In the United States, suicide deaths increased significantly among 15–24-year-olds and more than doubled among 10–14-year-olds from 2008 to 2018, with approximately one in six adolescents experiencing suicidal ideation (SI) in a year. Emerging evidence suggests that weight stigma (WS), both experienced and internalized, is a significant risk factor for SI. Adolescents who experience WS from family or peers report higher SI rates relative to individuals without WS. Furthermore, low body trust—feeling unsafe in one’s body—has been linked to SI. Additionally, WS can lead to internalized negative beliefs about one’s body, fostering feelings of shame and self-doubt. Over time, these experiences may erode body trust, making individuals less confident in their body’s signals and needs. However, no studies have examined WS, body trust, and SI together. Accordingly, the current study tested whether low body trust mediated the relation between WS (experienced weight stigma and weight bias internalization) and SI severity within a sample of Iranian adolescents. Adolescents (N=1,243) were recruited virtually and completed measures at three timepoints (baseline, one-month, three months). Two parallel mediation models were tested in MPlus to examine relations between constructs. WS and SI severity demonstrated reciprocal relations in both models, such that WS and SI severity at baseline predicted the other at one-month follow-up. Body trust at baseline predicted SI severity at three-month follow-up in both models, as well as weight bias internalization at one-month follow-up in Model 1. WS was not indirectly associated with SI severity through low body trust in either model. These findings highlight the independent relationships between WS, body trust, and SI severity, emphasizing the need for targeted interventions. Clinicians can play a crucial role in assessing and addressing these factors in adolescents at risk for suicidality. Interventions that challenge weight-biased beliefs and enhance body trust, such as mindfulness-based or acceptance-focused approaches, may help reduce distress. Integrating weight-inclusive strategies into suicide prevention efforts could provide critical support for adolescents experiencing weight-related distress. Given that body trust did not mediate the relationship between WS and suicidal ideation, future studies should examine other potential mediators.