The Development of Internalized Weight Stigma and the Process of Healing: A Critical-Constructivist Grounded Theory Analysis

Abstract

Weight stigma is pervasive and persistent despite growing body liberation advocacy. This potent social phenomenon is destructive to the biopsychosocial health of large-bodied individuals. In particular, internalization of bias and negative stereotypes related to weight has been shown to both mediate and moderate the relationship between stigmatizing experiences and several psychosocial outcomes including psychological distress, perceived loneliness, life satisfaction, sleep quality, depression, anxiety, engagement in physical activity, application of effective coping skills, healthcare avoidance, and disordered eating. However, not much is known about the developmental pathways of internalized weight stigma or the ways in which large-bodied individuals can heal from and develop resilience against its damaging effects in the face of unrelenting systemic stigmatization. Moreover, efforts to reduce internalized weight stigma have taken a theory- and researcher-driven approach to intervention development, rather than highlighting the voices of large-bodied individuals who experience internalized weight stigma and have navigated these processes. Using a critical-constructivist grounded theory approach, the present study explores three questions: (1) What is it like to feel internalized weight stigma, in the words of those who experience it? (2) What is the process by which large-bodied individuals internalize weight stigma? and (3) How do large-bodied individuals heal from internalized weight stigma? In response to the first research question, findings emphasized that the experience of internalized weight stigma is a deeply felt, visceral experience in which individuals experience intense internal conflict, avoidance, and self-betrayal. In articulating the processes by which they internalized weight stigma, participants described the powerful combination of pervasive and persistent weight stigma messaging across relationships, healthcare, and media with the deeply painful experience feeling that their bodies and other core identities drove disconnection, powerlessness, and failure. Lastly, participants described several key components of their journeys towards healing internalized weight stigma: (a) nurturing an authentic and intentional relationship with themselves, (b) healing in and through relationships with others, (c) disentangling themselves from harmful ideas, beliefs, and patterns, and (d) taking up space and creating the worlds within which they could thrive.