The weight of stigma: pressures for a healthy weight from health professionals can predict binge eating symptoms through the mediation of internalised weight stigma

Background: This study explored the mediating role of internalised weight stigma in the relationship between the pressures exerted by health professionals to maintain a healthy weight and the symptoms of binge eating disorder (BED). Methods: A sample of 114 participants who screened positive for eating disorder symptoms, with a BMI of 28 kg/m2 or higher, primarily female, were enrolled at the Integrated Service for Eating Disorders at Sapienza University of Rome. BED symptoms, sociocultural influences on weight, internalised weight stigma, and psychological distress were assessed using report measures. Results: Our findings show that pressures from health professionals were significantly associated with binge eating symptoms through an indirect pathway via internalised weight stigma, controlling for patients' BMI. This mediation effect lessens when exposure to general conversations about healthy weight is included as the independent variable. Conclusions: These findings contribute to a deeper understanding of the complex dynamics at play in obesity management and highlight the potential implications of healthcare communication strategies in overweight and obesity care. The study advocates for further research into developing more empathetic and effective approaches to obesity care.