DIETING AND WEIGHT CYCLING ARE ASSOCIATED WITH WEIGHT STIGMA

A Professional Paper
By:
Crystal Vasquez

Spring 2016

APPROVED BY THE GRADUATE ADVISORY COMMITTEE:

___________________________________ ___________________________________
Kathryn Silliman, PhD, RD Dawn Clifford, PhD, RD
Graduate Coordinator Chair

___________________________________
Michelle Morris, PhD, RD

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 ABSTRACT

Weight stigma includes the negative attitudes and stereotypes towards an

individual based on body size. Weight discrimination and stigma negatively

influence physical and mental health. Efforts are often made to lose weight in an

attempt to negate weight stigma. Repeated dieting attempts, known as weight

cycling, also appears to have negative effects on physical and mental health. Many

of the same negative health consequences that are linked to weight stigma are also

associated with repeated dieting and weight cycling. The purpose of this study was

to determine the association between perceived weight stigma, dieting behaviors,

and weight cycling. This cross-sectional study included surveys from 328

participants ages 18-78. Participants completed the Stigmatizing Situations

Inventory and questions regarding their dieting behaviors. Of participants, 89%

were female, and average BMI was 29.9 kg/m2. There was a strong, positive

correlation between weight stigma and the likelihood of a person dieting, which was

statistically significant (r= .484, p = <.001). In hierarchical regression analysis

accounting for confounding variables, perceived weight stigma significantly

predicted the likelihood of an individual weight cycling. In addition, perceived weight

stigma and gender significantly predicted the likelihood of dieting. There was a

positive relationship between perceived weight stigma and the likelihood of dieting,

when controlling for gender (r=.20, n=192, p=.005) and gender had a small effect.

Perceived weight stigma, which has negative health consequences, is associated

with dieting and weight cycling. Results suggest that individuals experiencing

weight stigma may turn to dieting to reduce stigma. Given the rate of weight regain

following most weight loss attempts, this solution is rarely effective and may initiate

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weight cycling, thereby worsening health status and perceived weight stigma. More

research is needed to explore further these associations and health consequences.

Keywords: Weight stigma, weight cycling, dieting, disordered eating, obesity

Introduction

Weight Stigma/Discrimination

Weight discrimination, or the unequal, unfair treatment of individuals because

of their weight, is increasingly prevalent in Western cultures (Andreyeva, Puhl, &

Brownell, 2008). Weight discrimination is often a result of weight stigma, which is

defined as negative attitudes and stereotypes towards an individual based on body

size. Stigma, bias, and discrimination can manifest in several forms from verbal

ridicule to physical abuse or other barriers (such as medical equipment or seating

that is too small for obese individuals) (Obesity Society, 2010). Some common

weight-based stereotypes are that overweight or obese people are lazy, sloppy, lack

willpower or discipline, and have lower intelligence levels than their lower weight

peers (Brownell, Puhl, Schwartz, & Rudd, 2005).

Perceived weight discrimination is associated with increased physical health

risks. Individuals who perceive higher levels of weight discrimination suffer

significantly more functional disabilities and health problems typically associated

with obesity (Schafer & Ferraro, 2011). Perceived weight discrimination is shown to

increase the likelihood that a person will become obese or remain obese over time

(Sutin & Terracciano, 2013). In the Health and Retirement (HRS) longitudinal study,

participants who were not obese, yet experienced weight discrimination were 2.5

3
times more likely to become obese after four years compared to participants who

were not obese and did not experience discrimination.

One proposed mechanism for the associated health problems in individuals

who experience weight stigma is inflammation. Those who experience weight

stigma are more likely to have higher C-reactive protein levels than those who are

obese and do not experience discrimination (Sutin, Stephan, Luchetti, & Terracciano,

2014; Sutin, Stephan, Luchetti, & Terracciano, 2014). Independent of adiposity

levels, weight stigma is associated with higher biochemical stress marker levels,

such as cortisol and oxidative stress (Tomiyama, et al., 2014). Increased cortisol

levels are a risk factor for multiple health conditions, including hypertension,

cardiovascular disease and diabetes (Muennig, 2008). Increased cortisol levels also

increase food consumption and decrease the psychological and physiological reward

centers in the brain (Tomiyama, 2014; Adam & Epel, 2007). Weight stigma, body-

related shame and guilt may also lead to increased caloric consumption and

disordered eating patterns (Schvey, Puhl, & Brownell, 2011; O'Hara, Tahboub-

Schulte, & Thomas, 2016).

Weight stigma also affects mental health. Those who have perceived weight

stigma had an increased risk of depression, anxiety, lower self-esteem, poor body

image and disordered eating (Puhl & Heuer, 2009; Weiss, 2007; Puhl & Latner,

2007; Greenleaf, Petrie, & Martin, 2014).

Weight Cycling

Efforts are often made to lose weight in an attempt to negate weight stigma.

Given the rate of weight regain following most weight loss attempts (Mann, et al.,

2007), this solution is rarely effective. Repeated dieting attempts is known as

4
weight cycling, which appears to have negative effects on physical and mental

health. In a nested study of the Nurses Health Study II, 2,476 young and middle-

aged women provided information regarding weight cycling over a five-year period

(Field A. E., Manson, Taylor, Willett, & Colditz, 2004). Field and colleagues reported

that weight cycling was associated with greater weight gain, decreased physical

activity, and higher prevalence of restrictive and binge eating patterns. They also

found that amongst weight cyclers, the higher the baseline BMI, the more weight

was gained during the re-gain period of weight cycling. In a cross-sectional survey

of 923 German adults de Zwaan and colleagues reported that weight cyclers

exhibited more depressive symptoms than non-cyclers (de Zwaan, Engeli, & Muller,

2015).

Not only can weight cycling have mental health consequences, but it can also

have physical health consequences, such an increased risk of metabolic syndrome

(Montani, Schutz, & Dulloo, 2015). Metabolic syndrome is characterized by central

adiposity, elevated blood pressure, elevated fasting plasma glucose, high serum

triglycerides, and low high-density lipoprotein (HDL) levels (NIH, 2011). In addition,

weight cycling is associated with increased risk for hypertension (Guegnono, et al.,

2000), excess body fat and excess abdominal fat (Cereda, et al., 2011), as well as

decreased HDL levels in women (Olson et al., 2000).

Other physiological consequences linked to weight cycling include increased

heart rate and insulin levels (Montani, Schutz, & Dulloo, 2015; Yatsuya, Tamakosi, &

Yoshida, 2003). Short-term weight cycling may also have an impact on glucose

levels. In an experimentally induced weight cycling study of 10 healthy weight-

stable men, participants had impaired insulin-sensitivity at the end of the induced

weight cycling (Lagerpusch, Bosy-Westphal, Kehden, Peters, & Muller, 2012).

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 The overall relationship between weight stigma, dieting and weight cycling is

explained and summarized by Tomiyamas Cyclic Obesity/Weight-Based Stigma

(COBWEBS) model (Tomiyama, 2014). According to Tomiyama, weight stigma begets

weight gain and in a positive feedback loop. In analyzing the research on weight

stigma and health, Tomiyama concluded that weight stigma is a psychological

stressor and explains mechanisms of stress-induced weight gain (physical,

physiological, and emotional). She hypothesizes that obesity/weight-based stigma

leads to stress, which then leads to increased eating and increased cortisol levels,

which then leads to increased weight gain, followed by increased obesity/weight-

based stigma, furthering the cycle. Exiting this cycle may prove to be difficult.

Many health care professionals promote losing weight and maintaining that

weight loss as the optimal strategy for breaking the cycle. However, long-term

weight loss maintenance is illusive for many and is stressful (Tomiyama, Ahlstrom, &

Mann, 2013). Exercise may help individuals exit the COBWEBS cycle, as physical

activity is shown to reduce depression, anxiety and stress (Salmon, 2011), and

improve body image, even in the absence of weight loss or body shape change

(Appleton, 2013). However, weight stigma is linked to the avoidance of exercise

(Vartanian & Novak, 2011; Field A., Manson, Taylor, Willett, & Colditz, 2004).

Weight stigma and body dissatisfaction may both be linked to dieting

behaviors, which appear to ultimately worsen instead of improve health outcomes.

Farrow and Tarrant examined the relationship between body dissatisfaction and

weight stigma and reported a significant positive correlations between weight-based

stigma/discrimination, body dissatisfaction and emotional eating (Farrow & Tarrant,

2009). OBrien, et al reported that weight stigma was correlated with greater

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emotional eating and uncontrolled eating in a study of 634 college students

(O'Brien, et al., 2016).

Body dissatisfaction often leads to dieting behaviors. In a study by Andres

and Saldana, 38% percent of participants had dieted within the past year and 44%

of participants reported some degree of body dissatisfaction (Andres & Saldana,

2014). Researchers determined that those who dieted and over-evaluated their

weight and shape were 2.31 times more likely to binge eat than those who did not

diet.

Based on the COBWEBS model, stigma and discrimination are a source of

stress, as are dieting behaviors and weight cycling. Furthermore, the ineffectiveness

of dieting in the long-term is often blamed on the individual, furthering shame and

stress (Tomiyama, 2014). Many of the same health consequences that are linked to

weight stigma are also associated with weight cycling. If weight stigma and weight

cycling are associated, these consequences could be exacerbated.

The purpose of this research was to determine the association between

weight stigma and the incidence of dieting behaviors and weight cycling among

overweight adults. It was hypothesized that individuals who report experiencing

weight stigma will be more likely to diet, and also to report weight cycling.

Material and Methods

Subjects

Adult participants were recruited to participate in this cross-sectional

research study via a convenience sampling technique through social media, email,

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and word-of-mouth. Approval from the Human Subject Review Committee at a mid-

sized Western state university was obtained before collecting data. All participants

were 18 years or older and provided informed consent. Past cross-sectional studies

that used survey data analyzing weight stigma have had sample sizes ranging from

55-1013 (Papadopoulos & Brennan, 2015). Using G*Power version 3.0.10, it was

calculated with alpha level of .05, Power of .95 and an effect size of .15 that one-

hundred twenty-nine participants are required in order to determine if there is a

correlation between weight stigma and weight cycling, while controlling for BMI and

age (Faul, Erdfelder, Lang, & Buchner, 2009).

Measures and procedure

Participants completed an anonymous online survey on SurveyMonkey

consisting of demographic questions. Participants self-reported their gender, age,

marital status, ethnicity/race, economic status, highest education level received,

height and weight. Body Mass Index (BMI) for each participant was calculated as

reported body weight divided by reported body height squared (kg/m2).

Participants also completed two validated surveys. The level of perceived

weight stigma was measured using the Stigmatizing Situations Inventory (SSI)

(Myers & Rosen, 1999). Dieting behavior and weight cycling was measured using

The Dieting and Weight History Questionnaire (DWHQ) (Witt, Katterman, & Lowe,

2013).

Stigmatizing Situations Inventory (SSI)

The SSI assesses lifetime frequency of experiencing stigmatizing situations on

a 10-point Likert scale from never to daily (Myers & Rosen, 1999). The SSI is a

50-item questionnaire that evaluates participants experiences with 11 types of

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stigmatizing situations including comments from children, others making negative

assumptions, physical barriers, being stared at, inappropriate comments from

doctors, nasty comments from family, nasty comments from other, being avoided

excluded or ignored, loved ones embarrassed by their size, job discrimination and

being physically attacked. Myers and Rosen determined that obese participants

faced stigmatizing experiences several times in their lives (mean overall score 1.9,

SD=2.0), and reported high internal consistency of the SSI (=.95).

The Dieting and Weight History Questionnaire (DWHQ)

The DWHQ was based on the Three-Factor Model of Dieting (Lowe, 1993) and

developed by Witt, Katterman and Lowe (2012) to evaluate (1) frequency of past

dieting and overeating, (2) current dieting to lose weight, and (3) weight

suppression. The 16-item survey includes questions regarding current weight,

reasons for dieting, history of weight cycling and level of cycling while controlling for

weight loss and weight gain due to medications and medical conditions (Witt,

Katterman, & Lowe, 2013). This survey measures the act of dieting, not only the

intention to lose weight, but also as a method to avoid weight gain. The frequency

of weight loss attempts (dieting) and degree of weight fluctuation were measured

with this instrument.

Statistical Analysis

Survey results were analyzed using IBM SPSS 23 with a significance level of p

< 0.05 (IBM Corp., 2015). Descriptive statistics were used to analysis demographic

information, mean and standard deviation.

Chi-Square tests were used to determine differences in perceived weight

stigma and dieting behaviors within demographic variables. To determine the level

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of participants perceived weight stigma, the SSI was scored as follows: The 10-

point Likert scale was converted to a numerical scale, where "Never" equaled 0 up

to "Daily" equaling 9. The SSI was totaled; a score of 0 meant the participant

perceived "no weight stigma" in their lifetime, 1-149 is considered "mild weight

stigma," 150-299 "moderate weight stigma" and 300-450 "severe weight stigma."

To determine dieting behaviors participants were asked if they had never dieted,

dieted in the past, were currently dieting or both.

One-Way ANOVA was used to determine whether there are any statistically

significant differences in mean times dieted and demographic variables. To

determine if participants were weight cyclers, they were asked how many times

they had lost and regained 1-4 lbs, 5-10 lbs, 10-20 lbs and more than 20 pounds,

excluding loss or regain due to medical issues. The sum of these weight fluctuations

was categorized as a scale variable to determine the amount of times a person

weight cycled.

Hierarchical regression analysis was used to assess correlations between perceived

weight stigma and dieting behavior and weight cycling while controlling for the

influence of BMI, age, gender, race, marital status, education and economic level.

Perceived weight stigma (Total SSI score) was coded as a scale variable, higher

scores indicating that participants experienced more weight stigma in their lifetime.

Dieting behaviors was coded as an ordinal variable; 0 never dieted, 1 past or

current dieter, and 2 as both past and current dieting behaviors. Age and

participants actual BMIs were used as scale variables. Gender (male/female), race

(white/non-white) and marital status (married/un-married) were coded as binary

variables. Education level and economic level were categorized into scale variables,

eliminating decline to state responses from analysis.

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Results

A total of 328 participants completed the survey, aged 18-78 years old (mean

38.6, SD= 13.2). A majority of participants were female (89%) and Caucasian (86%).

Mean BMI of participants was 29.9 (SD= 10.1), based on self-reported height and

weight. Participants were divided into BMI categories with 2% being classified as

underweight, 28% normal, 15% overweight, and 54% obese (Centers for Disease

Control and Prevention, 2015). Demographics are presented in Table 1.

Of participants, 27% reported experiencing no weight stigma, 69%

experienced mild weight stigma, and 4% experienced moderate weight stigma.

Mean SSI score was 30.9 (SD = 44.4). Nineteen percent of participants were weight

cyclers and reported losing and gaining weight an average of 22 times (SD= 23).

Forty-nine percent of participants were either current or past dieters. The mean age

that participants first dieted was 18.75 years old (SD = 9.8).

Women were more likely than men to report experiencing weight stigma

(p<.001) and dieting (p=.002). There was also a significant difference between BMI

categories and perceived weight stigma (p<.001) and the likelihood of dieting

(p=.006). There were no significant differences in perceived weight stigma and

dieting behaviors in other demographic categories. Participants aged 40-64 years

old (p=.008) were more likely to have weight cycled than other age groups. Married

individuals were more likely to have weight cycled than other marital status groups

(p=.041). There were no significant differences in weight cycling in other

demographic categories. Results are presented Table 2.

Perceived Weight Stigma and Weight Cycling

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 Preliminary analysis indicated that assumptions of normality were violated for

SSI score, weight cycling and BMI. Therefore, log transformation was performed on

total SSI score, dieting attempts and BMI. Pearson correlation was run to determine

the relationship between level of perceived weight stigma and weight cycling. There

was a strong, positive correlation between weight stigma and the likelihood of a

person weight cycling, which was statistically significant (r= .484, p = <.001).

Hierarchical multiple regression was used to assess the correlation between

perceived weight stigma and weight cycling after controlling for the influence of

BMI, age, gender, race, marital status, education and economic level. BMI, age,

gender, race, marital status, education and economic level were entered at step 1,

explaining 22% of the variance in weight cycling. However, after the addition of

perceived stigma scores at step 2, the total variance explained by the model as a

whole was 33%, F (8,62) = 3.84, p=.001. In the final model, only perceived stigma

scores were statistically significant (beta =.508, p=.002; Table 3).

Perceived Weight Stigma and Dieting Behaviors

A similar hierarchical multiple regression model was used to assess the

correlation between perceived weight stigma and the likelihood of dieting. Model 1

explained 16% of the variance in the likelihood of dieting. After the addition of

perceived stigma scores at step 2, the total variance explained by the model as a

whole was 16%, F (8,178) = 5.04, p=.001. Perceived weight stigma explained an

additional 1.9% of the variance in the likelihood of dieting, after controlling for BMI,

age, gender, race, marital status, education and economic level (R squared change

= .019, F change (8, 178) = 4.94, p<.001). In the final model, only gender and

perceived stigma scores were statistically significant, with gender recording a

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higher beta value (beta = .247, p<.001) than the perceived weight stigma score

(beta =.207, p=.041; Table 3).

There was a positive partial correlation between perceived weight stigma and

the likelihood of dieting, when controlling for gender (r=.20, n=192, p=.005), with

higher levels of weight stigma being associated with the likelihood of dieting. An

inspection of the zero order correlation (r=.22) suggested that controlling for gender

had very little effect on the strength of the relationship between these variables.

In addition, those who dieted at a younger age were more likely to report

experiencing more weight stigma (r=-.340, p = <.001).

Discussion/Conclusions

While there is more research emerging on the negative health effects of

perceived weight stigma, there is little research exploring the relationship between

perceived weight stigma, dieting behaviors and weight cycling. Researchers are

beginning to understand the physiological ramifications of disordered eating and

weight cycling behaviors, which supports the need to educate others on the

potential harm of dieting.

To the best of the authors knowledge, this is the first study that specifically

examines the relationship between perceived weight stigma and its effects on

dieting behaviors, the likelihood to diet and repeated dieting attempts (weight

cycling). Previous studies examining the relationship between weight stigma and

eating behaviors have focused on university students, whereas in this study

participants were middle-aged. Participants represented a variety of life stages,

educational and economic backgrounds. By surveying young, middle aged and older

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adults, the researchers were able to capture attitudes representative of life

experiences.

Findings from this study indicate that perceived weight stigma is associated

with the likelihood that an individual will diet and that he or she will have repeated

dieting attempts, resulting in weight cycling. Results of this study support the

findings of previous research examining weight stigma and eating behaviors.

OBrien and colleagues reported that internalized weight bias and psychological

stress appear to be underlying factors in weight stigma and disordered eating

behaviors (O'Brien, et al., 2016). In addition, researchers at the American University

of Sharjah found that weight- and body-related shame was a strong predictor of

eating disorder symptomatology (O'Hara, Tahboub-Schulte, & Thomas, 2016).

BMI had no significant effect on the relationship between perceived weight

stigma and weight cycling and dieting behaviors, indicating that stigma affected

weight cycling and dieting behaviors amongst participants regardless of their body

weight. This finding is consistent with recent research by OHara et al; they reported

that BMI and eating disorder symptomology were not related (O'Hara, Tahboub-

Schulte, & Thomas, 2016). Perceived weight stigma was a significant predictor of

dieting and repeated dieting attempts. While it was determined that gender was a

greater predictor of the likelihood to diet than perceived weight stigma, the effect of

gender on total SSI score was small.

Some association was found between dieting at a younger age and perceived

weight stigma. This finding may be a result of the increased incidence of bullying in

childhood, which can have lasting effects (Adams & Lawrence, 2011). Teenagers

who are subjected to weight-related bullying are more likely to have low self-

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esteem, depressive symptoms, and report body dissatisfaction and dieting

behaviors (Lampard, MacLehose, Eisenberg, Neumark-Sztainer, & Davison, 2014).

This is an area that warrants further research.

The current study did not account for mental health, such as depression or

self-esteem. These issues could account for differences in perceived weight stigma.

While the researchers asked participants to reflect on the stigma they have

perceived over their lifetime, this study was cross-sectional and perceptions can

change. Recruitment methods may have also affected results. Given the

convenience sampling recruitment methodology, participants may have been more

likely to respond because they have experienced weight stigma. An additional

limitation of this study is that participants were predominantly white, well-educated

females; results may not be representative of different cultural and economic

backgrounds.

The results of the current study support the COBWEBS model (Tomiyama,

2014), in that findings demonstrate a relationship between weight stigma and

dieting. Tomiyama proposes that the stress caused by weight stigma may contribute

to overeating and increased cortisol levels with can result in weight gain, followed

by additional dieting attempts. While the design of the current study was not

conducive to exploring the etiology of the connection, the findings support that the

proposed relationship between weight stigma and dieting exists.

Combating weight stigma is essential is when planning health intervention

programs. Public health media campaigns using degrading or blaming images, or

using fat jokes and humor promote weight stigma by creating negative attitudes

towards the obese, and reducing the likelihood of making a positive health-related

15
behavior change (Vartanian & Smyth, 2013). When individuals are shown positive

health messages that do not mention obesity or weight they are more motivated to

make health improvements (Puhl, Peterson, & Luedicke, 2013).

Even when voluntarily enrolling in weight-loss programs, those who

experience more weight stigma are more likely to have increased caloric intake,

higher program attrition, exercise less and lose less weight than those who have not

experienced weight-based stigma (Carels, et al., 2009). Furthermore, promoting

weight loss may be a futile effort. In a meta-analysis by Amigo and Fernandez, they

determined that even with short-term weight loss, results are not maintained as

most people returned to their original or higher weight (Amigo & Fernandez, 2007).

Given the evidence of the damaging effects of weight stigma on health and

the negative impact it may have on lifestyle behaviors, combating weight stigma

would benefit those seeking assistance in making positive health-related changes.

Health programming should not only reduce weight stigma, but provide resources to

individuals experiencing weight stigma that can promote emotional health and

healing. Replacing weight-centered health programming with weight-neutral health

programming is one viable strategy for minimizing weight stigma (Tylka, et al.,

2014) However, even when participating in weight-neutral programs, those who

have experienced more weight stigma are more likely to exhibit disordered eating

(Mensinger, Calogero, & Tylka, 2016). The findings of this study support the need for

minimizing weight stigma when promoting healthy behaviors for individuals of all

sizes while discouraging individuals from participating in dieting or restrictive

dietary patterns.

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 The authors declare no conflicts of interest. The research conducted for this

article was supported by the California State University, Chico Nutrition and Food

Sciences Department.

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 Table 1. Demographics

N=328 N(%)
GENDER
Male 35 (11)
Female 293
(89)
AGE (YEARS)
<20 14 (4)
21-39 182
(56)
40-64 120
(37)
>65 12 (4)
RACE
White 283
(86)
Hispanic/Latino 17 (5)
Asian/Pacific Islander 16 (5)
Black/African American 5 (2)
American Indian/Alaskan 2 (1)
Native
Other 5 (2)
MARITAL STATUS
Never Married 119
(36)
Married 175
(53)
Divorced/Separated 30 (9)
Widowed 3 (1)
EDUCATION LEVEL
Completed High School 3 (1)
Some college 73 (22)
College Graduate or 252
higher (77)
ECONOMIC LEVEL
Decline to State 27 (8)
<$18,000 42 (13)
$18,001-23,050 12 (4)
$23,051-32,050 12 (4)
$32,051-60,000 63 (19)
$60,001-75,000 41 (13)
$75,001-100,000 49 (15)
>$100,000 82 (25)
BMI
Underweight (<18.5) 7 (2)
Normal (18.5-24.9) 92 (28)
Overweight (25.0-29.9) 48 (15)
Obese (>30) 177
(54)

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Table 2. Prevalence of Perceived Weight Stigma, Dieting Behaviors, and Weight Cycling by demographic variables
PERCEIVED WEIGHT STIGMA** DIETING BEHAVIORS** WEIGHT
N (%) N (%) CYCLING***
DEMOGRAPHIC No Mild Moderat p- Never Current or Current & p- n Mean SD p-
VARIABLE Stigm Stigma e value* Dieted Past Past value* Times value
a Stigma Dieters Dieting Diete
d
AGE (YEARS) 0.23 .122 .008
<20 2 (14.3) 11 (78.6) 1 (7.1) 6 (50) 5 (41.7) 1 (8.3) 0 - -
21-39 53 125 (68.7) 4 (2.2) 32 84 (70) 4 (3.3) 40 14.5 14.
(29.1) (26.7) 2
40-64 29 84 (70) 7 (5.8) 11 59 (79.7) 4 (5.4) 27 53 74.
(24.2) (14.9) 6
>65 6 (50) 6 (50) 0 (0) 1 (16.7) 5 (83.3) 0 (0) 1 40 -
GENDER <.001 0.002 .973
MALE 12 22 (62.9) 1 (2.9) 14 (58) 10 (40) 1 (4.0)0% 4 22 21.
(34.3) 3
FEMALE 78 204 (69.9) 10 (3.4) 36 142 (76.8) 7 (3.8) 69 21.6 23.
(26.7) (19.5) 3
RACE 0.791 0.082 .354
WHITE 77 195 (68.9) 11 (3.9) 42 133 (73.9) 5 (2.8) 58 23.9 24
(27.2) (23.3)
HISPANIC/LATINO 3 (17.6) 13 (76.5) 1 (5.9) 4 (28.6) 9 (64.3) 1 )7.1% 4 13.5 9
ASIAN/PACIFIC 6 (37.5) 10 (62.5) 0 (0) 4 (36.4) 54.5% 9.1% 3 10 1.4
ISLANDER
BLACK/AFRICAN 1 (20) 4 (80) 0 (0) 0 (0) 1 (50) 1 (50) 2 10 1.4
AMERICAN 0
AMERICAN INDIAN 0 (0) 100.0% 0 (0) 0 (0) 1 (100) 0 (0) - - -
/ALASKAN NATIVE
OTHER 3 (60) 2 (40) 0 (0) 0 (0) 3 (100) 0 (0) 1 3
MARITAL STATUS 0.048 0.273 .041
NEVER MARRIED 40 73 (61.3) 6 (5) 24 48 (64.9) 2 (2.7) 25 15 15.
(33.6) (32.4) 3
MARRIED 45 127 (72.6) 3 (1.7) 22 87 (77.0) 4 (3.5) 36 23 23.
(25.7) (19.5) 3
DIVORCED/SEPARATED 4 (13.3) 23 (76.7) 3 (10) 4 (19) 15 (71.4) 2 (9.5) 7 39 35.
4
WIDOWED 0 (0) 3 (100) 0 (0) 0 (0) 3 (100) 0 (0) - - -
EDUCATION LEVEL 0.575 0.263 .719
COMPLETED HIGH 2 (66.7) 1 (33.3) 0 (0) 2 (66.7) 1 (33.3) 0 (0) 1 3 -
SCHOOL
SOME COLLEGE 22 48 (65.8) 3 (4.1) 12 29 (65.9) 3 (6.8) 12 21 17.
(30.1) (27.3) 5
COLLEGE GRADUATE OR 66 177 (70.2) 9 (3.6) 36 (22) 123 (75) 5 (3) 55 22
HIGHER (26.2)
ECONOMIC LEVEL 0.725 0.566 .259
DECLINE TO STATE 10 (37) 16 (59.3) 1 (3.7) 5 (33.3) 10 (66.7) 0 (0) 5 19 16.
2
<$18,000 10 28 (66.7) 4 (9.5) 11 16 (57.1) 1 (3.6) 6 14 15.
(23.8) (39.3) 1
$18,001-23,050 4 (33.3) 8 (66.7) 0 (0) 0 6 (100) 0 (0) 3 4 1
$23,051-32,050 2 (16.7) 9 (75) 1 (8.3) 0 7 (100) 0 (0) 5 22 20.
7
19
 $32,051-60,000 18 42 (66.7) 3 (4.8) 11 (25) 31 (70.5) 2 (4.5) 11 38 42.
(28.6) 2
$60,001-75,000 13 27 (65.9) 1 (2.4) 6 (22.2) 19 (70.4) 2 (7.4) 10 21 16.
(31.7) 4
$75,001-100,000 13 35 (71.4) 1 (2.0) 5 (15.2) 27 (81.8) 1 (3.0) 13 17 5.2
(26.5)
>$100,000 20 61 (74.4) 1 (1.2) 12 37 (72.5) 2 (3.9) 15 21 16.
(24.4) (23.5) 9
BMI <.001 0.006 .504
UNDERWEIGHT (<18.5) 0 (0) 7 (100) 0 (0) 3 (42.9) 3 (42.9) 1 (14.3) 2 10 4.2
NORMAL (18.5-24.9) 20 72 (78.3) 0 (0) 30 53 (62.4) 2 (2.4) 16 15 27.
(21.7) (35.3) 9
OVERWEIGHT (25.0-29.9) 1 (2.1) 47 (97.9) 0 (0) 7 (18.4) 30 (78.9) 1 (2.6) 13 22 14.
6
OBESE (>30) 69 (39) 96 (54.2) 12 (6.8) 9 (11.4) 65 (82.3) 5 (6.3) 36 25 23.
9
*P VALUE OF < .05 INDICATES A SIGNIFICANT DIFFERENCESDIFFERENCE BETWEEN SUBJECT GROUPS ** CCHI-SQUARE TEST. ***
IINDEPENDENT SAMPLES T-TEST OR ONE-WAY ANOVAANOVA, AS APPROPRIATE FOR VARIABLES

Table 3. Hierarchical Regression of the effects of Perceived Weight Stigma on Weight Cycling and Past/Current Dieting
Behaviors
WEIGHT CYCLING PAST/CURRENT DIETING BEHAVIORS
2
VARIABLE B SE( p- R VARIABLE B SE( p- R2
B) val B) val
ue ue
STEP 1 0.222 STEP 1 .162
(p=.0 (p<.00
22) 1)
BMI .922 .482 .223 .061 BMI .371 .233 .112 .113
GENDER -.539 .346 -.177 .125 GENDER .420 .109 .266 <.0
01
AGE .017 .007 .302 .019 AGE .007 .003 .172 .029
RACE -.037 .196 -.022 .851 RACE .166 .096 .121 .086
MARITAL .005 .147 .037 .971 MARITAL .072 .076 .077 .344
STATUS STATUS
EDUCATIONAL -.092 .185 -.058 .621 EDUCATIONAL --.079 .091 -.069 .389
LEVEL LEVEL
ECONOMIC -.012 .036 -.040 .748 ECONOMIC .024 .018 .116 .192
LEVEL LEVEL
STEP 2 0.109 STEP 2 .019
(p=.0 (p=.04
20
 02) 1)
BMI -.539 .643 -.130 .405 BMI -.129 .335 -.039 .700
GENDER -.336 .330 -.110 .312 GENDER .389 .109 .247 <.0
01
AGE .014 .007 .260 .064 AGE .006 .003 .168 .063
RACE -.031 .183 -.018 .866 RACE .164 .095 .120 .087
MARITAL .013 .138 .011 .924 MARITAL .076 .075 .081 .314
STATUS STATUS
EDUCATIONAL -.068 .173 -.043 .696 EDUCATIONAL -.074 .090 -.065 .413
LEVEL LEVEL
ECONOMIC .023 .035 .079 .924 ECONOMIC .026 .018 .126 .157
LEVEL LEVEL
PERCEIVED .590 .185 0.50 0.00 PERCEIVED .187 .091 .207 .041
WEIGHT 8 2 WEIGHT
STIGMA SCORE STIGMA SCORE
NOTE. F (8,62) = 3.84, P=.001, ADJUSTED R2 Note. F (8,178) = 4.94, p<.001, adjusted r2 = .145
= .245

21
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