Rebecca M Puhl

Rebecca M Puhl
University of Connecticut | UConn · Department of Human Development and Family Studies

PhD

About

201
Publications
67,737
Reads
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20,296
Citations
Additional affiliations
August 2005 - present
Yale University
Position
  • Managing Director

Publications

Publications (201)
Article
Little is known about parent and adolescent motivations for engaging in weight communication. To assess parent and adolescent motivations for engaging in, or avoiding, weight communication, and whether these reasons differed across sex, race/ethnicity, weight, and engagement in weight management. Independent samples of parents (N = 1936) and unrela...
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Background Health messages framed within the context of controlling body weight can negatively impact motivation to make health changes. However, it is unknown how health messages featuring childhood obesity affects parental “weight talk” behaviors (e.g., encouraging a child to lose weight). Objective Assess the effects of exposure to parent-targe...
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Background: Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioecon...
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Background Limited research has explored the relationship between weight bias and clinical attrition, despite weight bias being associated with negative health outcomes. Participants/method Experienced weight stigma (EWS), internalized weight bias (IWB), and clinical attrition were studied in a Medical Weight Loss clinic, which combines pharmacolo...
Article
Background: After bariatric surgery, some patients experience adverse psychiatric outcomes, including substance use, suicidality, and self-harm. These factors are commonly associated with posttraumatic stress disorder (PTSD) and related symptoms (PTSD-S) that develop following adverse childhood experiences (ACEs) and traumatic events. However, eme...
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Objective: Sexual and gender minority (SGM) adolescents disproportionately report disordered eating, yet have primarily been considered under a larger SGM umbrella. The current study 1) compared disordered eating between sexual minority (SM) and gender minority (GM) adolescents; 2) examined how general psychological factors (self-esteem, depressio...
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Research suggests that many parents make comments about their child’s weight, which is associated with negative adolescent health outcomes. Gaps in this literature include an underrepresentation of fathers, limited knowledge regarding positive versus negative parental weight comments and differences across race/ethnicity, and adolescent preferences...
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OBJECTIVES/GOALS: Weight stigma, or discrimination and devaluation of people due to high body weight, is associated with higher prevalence of concerning health consequences (e.g., depressive symptoms, body dissatisfaction). This public health research investigated how experiencing weight stigma affects weight-related health outcomes in a cohort of...
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Efforts to promote positive body image and body acceptance confront considerable challenges in the face of pervasive societal stigma against people who have a high body weight or large body size. Despite decades of evidence documenting the prevalence and harmful consequences of weight stigma and discrimination, policies to address this social injus...
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Weight-based bullying is among the most prevalent forms of peer harassment and carries significant health consequences—particularly among adolescents who identify as a sexual and/or gender minority (SGM). We examined how anti-bullying legislation that includes weight as a protected class (enumeration) contributes to the prevalence of weight-based b...
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Family members are some of the most common sources of weight stigma reported by youth and adults with higher body weight; however, little is known about the ways in which weight stigma manifests from different family members. To better understand the nature of weight stigma by family members, the current study qualitatively examined women's retrosp...
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Background: Despite the ubiquity of cybervictimization among youth, attention to weight-based cybervictimization is scarce. Aims: This study assessed the prevalence of electronic forms of weight-based peer victimization (i.e., cybervictimization) and its associations with adolescent health, as indicated by somatic symptoms, stress, depression, a...
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Background: Stigma towards children with obesity can begin as early as 3 years old, leading to increased risk for poorer mental health outcomes and lower quality of life. This includes discriminatory language used by peers and adults, which may be compounded by use within the medical community and in published research. Objectives: Our primary o...
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Objective Adolescents with chronic pain often experience symptom disbelief and social rejection by others secondary to “medically unexplained” symptoms. Although chronic pain is common in adolescents, limited research has conceptualized these social experiences as pain-related stigma in this population. The purpose of this study was to identify and...
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There has been little recognition that people with type 2 diabetes are vulnerable to weight stigma and diabetes stigma and almost no research examining the implications of these forms of stigma for their health and well-being. This study examined health behavior correlates of weight stigma and diabetes stigma in 1,227 adults with type 2 diabetes. R...
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Objective: Across the world, it remains legal to discriminate against people because of their weight. Although US studies demonstrate public support for laws to prohibit weight discrimination, multinational research is scarce. The present study conducted a multinational comparison of support for legislative measures to address weight discriminatio...
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Participation in physical activity and sport is on the decline and there is a poor understanding of the psychosocial factors that contribute to people’s reluctance to participate. We examined whether there were relationships between factors such as weight stigma, weight bias internalization, appearance evaluation, and fears of negative appearance e...
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Body weight is often viewed as personally controllable. This belief, however, ignores the complex etiology of body weight. While such attributions of personal willpower may help some individuals regulate their eating patterns, they have also been associated with increased internalized weight stigma which, itself, is associated with more disinhibite...
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Background/Objectives Despite substantial evidence documenting weight stigma toward people with higher body weight, international comparative studies are lacking in this field. The few studies that have compared weight stigma across different countries focus on explicit weight-biased attitudes rather than people’s experiences of weight stigma. The...
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BACKGROUND Educators' negative weight biases toward students with high body weight have been well-documented. The present investigation examined whether inclusion of body weight in school anti-bullying policies is associated with lower levels of weight bias among educators. METHODS Data on explicit weight bias was collected from a sample of second...
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Objective The COVID-19 pandemic has increased attention to the proliferation of pediatric obesity amidst significant changes in weight-related health functioning (e.g., compromised physical activity, limited food access, increased stress). The present cross-sectional study investigated adolescents’ feelings about their bodies and perceived changes...
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Despite recognition of the potential impact of the COVID-19 pandemic on secondary schooling experiences, little empirical evidence has captured adolescents' perspectives on the extent of academic and social disruption resulting from the pandemic. The present study examined adolescents' academic worries amid the COVID-19 pandemic and their perspecti...
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Background Emotional eating in bariatric surgery patients is inconsistently linked with poor post-operative weight loss and eating behaviors, and much research to date is atheoretical. To examine theory-informed correlates of pre-operative emotional eating, the present cross-sectional analysis examined paths through which experienced weight bias an...
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Objective Despite considerable evidence of chronic pain in adolescents, and its adverse consequences for their health and well-being, less is known about pain-related stigma that these youth face, such as pain disbelief by others. Adolescents with chronic pain may conceal their symptoms as a coping strategy to avoid pain-related stigma, contributin...
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Objective Weight stigma is prevalent across the world. However, little is known about whether and how the harmful health consequences of weight stigma may vary across countries. The current study examined the association between experiences of weight stigma and multiple eating and exercise-related indicators among a large, multinational sample of a...
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Background/Objectives Considerable evidence from U.S. studies suggests that weight stigma is consequential for patient-provider interactions and healthcare for people with high body weight. Despite international calls for efforts to reduce weight stigma in the medical community, cross-country research is lacking in this field. This study provides t...
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Although scholarship continues to document higher rates of alcohol use for sexual and gender minority (SGM) youth compared with heterosexual and cisgender youth, research identifying factors that mitigate SGM youths’ risk is nascent. Youth spend substantial time in schools; therefore, teachers could play significant roles in attenuating these healt...
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Weight bias internalization (WBI) is an understudied form of internalized stigma, particularly among treatment-seeking adults with overweight/obesity. The current study surveyed 13,996 adults currently engaged in weight management in the first multinational study of WBI. From May to July 2020, participants in six Western countries completed the Mod...
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Objective Patients with obesity may experience less patient-centered care. We assessed whether medical students’ implicit/explicit weight-related attitudes and perceptions of normative attitudes are associated with patient-centered care for patients with obesity. Methods Third and fourth year medical students (N = 111) at one medical school comple...
Article
Weight-based victimization (WBV) is a common and consequential experience for adolescents with overweight and obesity. The current study examined the relative contributions of different school-based sources of WBV (i.e., peers, friends, teachers, coaches) on academic grades, as well as the role of teachers in mitigating the academic consequences of...
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Purpose of review: This review summarizes recent evidence on weight stigma experienced by youth with overweight or obesity. We examine the prevalence and sources of weight-based victimization targeting youth, consequences of these stigmatizing experiences for their psychological and physical health, and considerations for addressing weight stigma...
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Purpose: Weight teasing from family members is common during adolescence. However, little is known about parental factors that increase adolescents' risk for family weight teasing and its adverse health sequelae. Using multi-informant data from adolescents, mothers and fathers, the current longitudinal study examined how parental concerns about the...
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As the prevalence of overweight and obesity have risen over the past few decades, so have weight control attempts. Research has shown, however, that intentional weight loss results are often short-lived, with people regaining the weight over time. This can lead to weight cycling-losing and gaining weight repeatedly. Previous research, mostly done o...
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Background: Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic. Purpose: We examined longitudinal associations between prepandemic experiences of weight sti...
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Objective Psychopathology in bariatric surgery patients may contribute to adverse postoperative sequelae, including weight regain, substance use, and self‐harm. This cross‐sectional study aimed to advance the understanding of the risk and protective paths through which weight bias associates with depressive and anxiety symptoms in bariatric surgery...
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Aims Diabetes stigma and weight stigma have been identified as important but neglected issues that warrant attention among people with type 2 diabetes. This study assessed associations of diabetes stigma and weight stigma with diabetes self-care behaviors and health care in adults with type 2 diabetes. Methods U.S. adults with type 2 diabetes (N=1...
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Introduction Adolescents who identify as a sexual or gender minority are vulnerable to multiple health disparities because of stigma-based peer harassment. Given that sexual and gender minority adolescents may be bullied for several stigmatized identities that may exacerbate health risk, it is important to examine factors that can simultaneously re...
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Background Coping responses to weight stigma can adversely affect health. Using data from a large commercial weight management sample, this study examined how adults cope with weight stigma, relationships among experienced weight stigma, weight bias internalization, and coping, as well as coping strategies as mediators of the stigma-health relation...
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Adolescents identifying as sexual and/or gender minorities face many challenges at school due to stigma-based peer harassment. This study examined the extent to which sexual and gender minority adolescents experience bias-based bullying across a range of stigmatized identities and attributes, as well as the potential of gay-straight alliances (GSAs...
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An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Article
Objective This study examines weight stigma experiences in a population-based sample of young adults from diverse ethnic/racial and socio-economic backgrounds, and explores cross-sectional associations between weight stigma and self-compassion, including gender differences in this relationship. Methods Data come from EAT 2018, a population-based s...
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Background Weight stigma impairs health. Few studies have disentangled the associations of experienced versus internalized stigma with weight-related outcomes. Purpose To examine weight and health variables associated with weight stigma experiences and internalization in the largest-to-date sample of adults in weight management. Methods WW (forme...
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People with obesity commonly face a pervasive, resilient form of social stigma. They are often subject to discrimination in the workplace as well as in educational and healthcare settings. Research indicates that weight stigma can cause physical and psychological harm, and that affected individuals are less likely to receive adequate care. For thes...
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Evidence of weight stigma and its harmful consequences have led to increased attention to the words that are used to talk about obesity and body weight, including calls for efforts to carefully consider weight‐related terminology and promote respectful language in the obesity and medical fields. Despite increased research studies examining people's...
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Weight stigma is a key aspect of the lived experience of individuals with obesity, and adversely affects health. This article provides an overview of recent evidence examining links between experiences of weight stigma and weight-related behaviors and health (e.g., maladaptive eating, physical activity, stress, obesity, weight loss), including heal...
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People react to, and are affected by, stigmatizing experiences in different ways. The current study examined different reactions to weight stigma to identify who may be vulnerable to lasting distress from these experiences. Using a mixed methods approach, this study compared qualitative descriptions of reactions to experiences of weight stigma in c...
Article
Adolescence is a time of identity exploration, and preliminary evidence indicates the ways adolescents are describing their sexual and gender identities (SOGI) are changing. A nuanced understanding of SOGI is necessary for valid assessment in developmental research. Current measures do not capture the diversity of emerging identities among young pe...
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There is increasing scientific and public support for the notion that some foods may be addictive, and that poor weight control and obesity may, for some people, stem from having a food addiction. However, it remains unclear how a food addiction model (FAM) explanation for obesity and weight control will affect weight stigma. In two experiments (N...
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Purpose: We examined how substance use differed as a function of sex assigned at birth and gender identity (cisgender, transgender, or nonbinary/genderqueer) by type of substance. We sought to test whether current gender identity and sex assigned at birth were key factors in substance use among a large contemporary sample that included transgender...
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Objective: Despite elevated rates of obesity among some groups of sexual minority (SM) adults, research examining weight stigma in this population is scarce. Methods: Weight stigma and weight-related health correlates were assessed in SM adults (N = 658) versus heterosexual adults (N = 658) matched on sex, race/ethnicity, age, education, and BMI...
Article
Background As many as 40% of adults have experienced weight stigma, yet little is known about why some individuals are more distressed by weight stigma than others. Qualitative research is limited in this field but may help inform this understudied question. Objective Using a mixed method design, we compared individuals who described lasting impac...
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Objective: A substantial amount of literature has suggested that weight stigma impairs health. Evidence on gender differences in weight stigma has been mixed, but studies of weight stigma within men have been primarily absent from the literature. Methods: In two samples of men recruited nationally from across the United States (N = 1,753), parti...
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Background There is a high prevalence of cardiovascular disease across diverse groups in the U.S. population, and increasing research has identified stigma as a potential barrier to cardiovascular disease prevention and treatment. This systematic review examines evidence linking discrimination and cardiovascular health among socially stigmatized gr...
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Objective: Weight-based victimization (WBV) involves being the target of intentional physical, verbal, or psychological harm because of one's body weight. Youth experience harmful health consequences from WBV, but this literature has neglected sexual and gender minority (SGM) youth, despite their high rates of overweight and obesity, and mental he...
Article
Weight-based victimization (WBV) is a common form of bullying associated with maladaptive eating, and poor weight-related health. Although sexual and gender minority (SGM) youth experience a number of eating and weight-related health disparities, the link between WBV and these outcomes has not been investigated in this vulnerable population. Data c...
Article
Background Many parents engage in “weight talk” with their child, such as encouraging their child to lose weight or making comments about their own weight or others' weight. What parents say to their children about weight can affect children's well‐being, yet little is known about parental characteristics that may be at play regarding this common p...
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Objectives Children and adolescents with overweight and obesity are vulnerable to weight‐based victimization. Research on weight‐based victimization and sexual identity have been largely isolated from one another; little is known about the nature of weight‐based victimization in sexual and gender minority (SGM: eg, lesbian, gay, bisexual, and trans...
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Background: Emerging evidence has demonstrated a high prevalence of weight bias internalization (WBI) among adults, as well as consistent links between internalization and adverse psychological and physical health. However, research examining WBI in youth and its impact on their health is scarce, especially among youth seeking weight loss treatment...
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Parenthood increases gender inequality in paid (employment) and unpaid labor (e.g., caretaking). New parental leave plans aim to increase gender equality by reducing managerial discretion and offering gender-neutral benefits. However, coworkers may undermine these inclusive aims, particularly if they show variable support per employee characteristi...
Article
Background: With high rates of adolescent obesity, many parents are talking to adolescents about their body weight. Parental "weight talk" is linked with adverse health behaviors in youth, but we know little about what parents say in these conversations. Using a weight loss treatment-seeking sample of adolescents, the present study assessed adoles...
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Purpose of Review Weight stigma and discrimination are significant issues facing people who are overweight. There is growing acceptance that obesity is caused by a neurobiologically driven addiction to some foods. This review examines the evidence that obesity is due to a food addiction and the impact that this may have on attitudes towards excess...
Chapter
Obesity is one of the defining health challenges of our generation. Studies project that, if current trends continue, more than 50% of the US population will have obesity within the next 20 years. https://shop.aap.org/pediatric-collections-obesity-stigma-trends-and-interventions-paperback/
Chapter
Obesity is one of the defining health challenges of our generation. Studies project that, if current trends continue, more than 50% of the US population will have obesity within the next 20 years. https://shop.aap.org/pediatric-collections-obesity-stigma-trends-and-interventions-paperback/
Article
Objective This study assessed the weight stigma experiences of men, examining characteristics of men who experienced weight stigma versus men who did not. Methods Data from three samples of men were examined (N = 1,513). Sample 1 consisted of men with obesity at elevated risk for weight stigma. Sample 2 comprised a convenience online panel. Sample...
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Background In light of high rates of obesity and weight stigma in youth, the American Academy of Paediatrics recommends that paediatric health care professionals use appropriate, sensitive and non‐stigmatizing language in communication about weight with youth. For these efforts to be effective, there is a need to identify weight‐based language pref...
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Weight-based discrimination is pervasive and increases vulnerability to poor mental health among targeted individuals. Legislation prohibiting weight discrimination has been proposed as an avenue for reducing social injustice. The present research examines how mere knowledge of such legislation may improve the psychological well-being of individual...
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The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of h...
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Objective: Considerable evidence has documented links between weight stigma and poor health, independent of weight. However, little research has assessed how individuals cope with weight stigma, and how stigma-specific coping responses contribute to health. The present study examined multiple stigma-specific coping responses as mediators of the re...
Chapter
AM:STARs is the official publication of the AAP Section on Adolescent Health. Published 2 times per year, it offers adolescent specialists and primary care physicians timely information on matters relating to adolescent health and wellness.
Article
Objective: This study aimed to conduct a comprehensive assessment of the presence, severity, and sociodemographic correlates of weight bias internalization (WBI) across three distinct samples of US adults. Methods: Levels of WBI were compared in (1) a sample of adults with obesity and heightened risk of weight stigma (N = 456), (2) an online com...
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Objective Pervasive weight stigma and discrimination have led to ongoing calls for efforts to reduce this bias. Despite increasing research on stigma‐reduction strategies, perspectives of individuals who have experienced weight stigma have rarely been included to inform this research. The present study conducted a systematic examination of women wi...
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Introduction Obesity is an ongoing public health concern in the U.S. Weight stigma is linked to a number of obesogenic health outcomes, which complicate obesity treatment and prevention. Despite higher rates of obesity in female and minority populations, little research has examined weight stigma in non-white women and men. This study investigated...
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Objective: Weight-related discrimination is prevalent and associated with health impairments for those who are targeted, which underscores the need of antidiscrimination legislation. This study is the first to examine public support of weight-related antidiscrimination laws or policies in Germany, compared to the US and Iceland. Methods: In a re...
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Weight-based teasing is common among youth, but little is known about its long-term impact on health outcomes. We aimed to 1) identify whether weight-based teasing in adolescence predicts adverse eating and weight-related outcomes 15 years later; and 2) determine whether teasing source (peers or family) affects these outcomes. Data were collected f...
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Background Challenges of maintaining long-term weight loss are well-established and present significant obstacles in obesity prevention and treatment. A neglected but potentially important barrier to weight-loss maintenance is weight stigmatization. PurposeWe examined the role of weight stigma—experienced and internalized—as a contributor to weight...