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Psychological Pathway from Obesity-Related Stigma to Anxiety via Internalized Stigma and Self-Esteem among Adolescents in Taiwan

Author

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  • Chung-Ying Lin

    (Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong)

  • Meng-Che Tsai

    (Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 700, Taiwan)

  • Chih-Hsiang Liu

    (Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 700, Taiwan)

  • Yi-Ching Lin

    (Department of Early Childhood and Family Education, College of Education, National Taipei University of Education, Taipei 100, Taiwan)

  • Yi-Ping Hsieh

    (Department of Social Work, College of Nursing and Professional Disciplines, University of North Dakota, Grand Forks, ND 58202, USA)

  • Carol Strong

    (Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 700, Taiwan)

Abstract

The objective of this research was to examine the pathway from public stigma, to perceived stigma, to depression in adolescents via internalized stigma. Adolescents in grade 7 through 9 from a junior high school in Changhua County in Taiwan completed self-administered surveys from March to July in 2018. Adolescents were asked questions regarding depressive symptoms, obesity-related perceived stigma, and internalized stigma. Structural equation modeling was used to fit the pathway model. The pathway was first analyzed with the full sample and then stratified by actual and perceived weight status. Our final analytic sample consisted of 464 adolescents. The pathway model suggested an acceptable model fit. Perceived weight stigma (PWS) was significantly associated with internalized stigma regardless of actual or self-perceived weight status. Internalized stigma was significantly associated with anxiety for both actual (β = 0.186) and self-perceived nonoverweight (non-OW) participants (β = 0.170) but not for overweight (OW) participants (neither actual nor self-perceived). For OW adolescents, perceived weight stigma was associated with anxiety. However, the internalization process did not exist. It may be that the influence of perceived weight stigma is larger than internalized stigma on anxiety. It may also be that the level of internalization was not yet high enough to result in anxiety.

Suggested Citation

  • Chung-Ying Lin & Meng-Che Tsai & Chih-Hsiang Liu & Yi-Ching Lin & Yi-Ping Hsieh & Carol Strong, 2019. "Psychological Pathway from Obesity-Related Stigma to Anxiety via Internalized Stigma and Self-Esteem among Adolescents in Taiwan," IJERPH, MDPI, vol. 16(22), pages 1-9, November.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:22:p:4410-:d:285781
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    References listed on IDEAS

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    1. Hatzenbuehler, M.L. & Phelan, J.C. & Link, B.G., 2013. "Stigma as a fundamental cause of population health inequalities," American Journal of Public Health, American Public Health Association, vol. 103(5), pages 813-821.
    2. Pik Chu Wong & Yi-Ping Hsieh & Hoi Hin Ng & Shuk Fan Kong & Ka Lok Chan & Tsz Yeung Angus Au & Chung-Ying Lin & Xavier C. C. Fung, 2019. "Investigating the Self-Stigma and Quality of Life for Overweight/Obese Children in Hong Kong: a Preliminary Study," Child Indicators Research, Springer;The International Society of Child Indicators (ISCI), vol. 12(3), pages 1065-1082, June.
    3. Małgorzata Lipowska & Ha Truong Thi Khanh & Mariusz Lipowski & Joanna Różycka-Tran & Mariola Bidzan & Thu Tran Ha, 2019. "The Body as an Object of Stigmatization in Cultures of Guilt and Shame: A Polish–Vietnamese Comparison," IJERPH, MDPI, vol. 16(16), pages 1-17, August.
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    2. Chung-Ying Lin & Hector W. H. Tsang, 2020. "Stigma, Health and Well-Being," IJERPH, MDPI, vol. 17(20), pages 1-12, October.

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