(PS6-A23) Examining the Relationship Between Weight Stigma, Mental Health, and Quality of Life in a Sample Experiencing Food Insecurity

Experiencing WS is an increasingly important topic of research within mental health and eating disorders (ED) research. WS refers to negative attitudes or beliefs about individuals living in higher weight bodies (Brown et al., 2022). Research suggests that experiencing WS contributes to poor psychological functioning (e.g., depression, anxiety, ED pathology) and compromised physical health (e.g., diabetes, cardiovascular disease) ( Brown et al., 2022 ; Warnick et al., 2021) . Of note, most of the existing WS literature centers on predominantly wealthy and White populations, thus neglecting underrepresented groups such as food insecure populations. 

Food insecurity (FI) is defined as having insufficient access to food in both quantity and quality. Research indicates that individuals experiencing high levels of FI report more experiences of WS and higher levels of ED pathology than individuals who are food secure. While the negative outcomes associated with experiencing WS are well-established, less is known about how experiencing stigma may affect quality of life (QOL) and contribute to psychosocial impairment. Because of the interconnected nature of mental health with WS, QOL, and psychosocial impairment, it is possible psychological health may mediate the relationship between experiencing WS with QOL and psychosocial impairment. Additionally, evidence suggests food insecure populations experience elevated rates of internalized WS, depression, anxiety, and ED pathology (Becker et al., 2021). Thus, it is possible psychological health may be especially important to examine in relation to WS and QOL and psychosocial impairment in this subpopulation.

Therefore, the present study investigates whether the relationship between experiencing WS and QOL is mediated by various psychological indicators in a sample experiencing FI; we examine psychosocial impairment as an outcome, as well. A total of 1085 participants were recruited from the San Antonio Food Bank to complete a questionnaire assessing FI, experiences of WS, ED pathology, anxiety, depression, psychosocial impairment related to eating and body image concerns, and QOL. We conducted a series of single mediation models with experiencing WS as the x variable and QOL as the y variable; depression, anxiety, ED pathology were mediators in separate models. We also ran these models with psychological impairment as the outcome. The indirect path from experiencing WS to QOL was significant for all models, such that anxiety, depression, and ED pathology mediated the relationship between WS and QOL. These psychological factors also mediated the relationship between WS and psychosocial impairment. 

Our results suggest that experiencing WS has a negative impact on QOL and psychosocial impairment through its relationship with mental health. Of note, health and food justice communities often utilize anti-fat and stigmatizing messages surrounding physical health, especially in lower-resource communities. This messaging may have repercussions on mental health, which then affects QOL and psychosocial functioning. It is imperative we re-evaluate public health messaging surrounding weight and the impacts this has not only on mental health, but QOL and psychosocial impairment, as well.