An interpretative phenomenological analysis of lived experiences and psychological processes in internalized weight stigma.

Objective: Internalized weight stigma (IWS) refers to the internalization of societal weight-based prejudices. While research on external weight stigma is well-established, the psychological mechanisms underlying IWS remain underexplored. This study aims to provide a deeper understanding of IWS by examining the lived experiences of individuals with obesity and identifying key psychological processes contributing to IWS.

Design: A qualitative design was employed, using both in-depth interviews and photo-elicitation to explore the lived experiences of nine participants.

Methods: Participants were invited to take pictures of situations which made them feel stigmatized about their body size during a 2-week-long photography task. Subsequently, participants reflected on the implications of their photographs during a 60-minute research interview. IPA was used to guide the analysis of the interview data.

Results: Four key psychological processes contributing to IWS were identified: (1) Self-application of negative stereotypes, where participants internalized societal stigma, sometimes resisting it but still experiencing self-critical thoughts; (2) Imposition of an undesired identity, where societal labels restricted self-expression, leading participants to adopt socially acceptable personas; (3) Heightened anxiety and social vigilance, where participants experienced anxiety, hyper-awareness, and discomfort in public settings; and (4) Distress and coping, where emotional distress and coping strategies like social withdrawal appeared to reinforce IWS.

Conclusions: These findings extended existing literature by providing a data-driven conceptualization of IWS. The findings underscore the importance of developing psychological interventions that address both IWS and external societal weight stigma, focusing on strategies that challenge self-critical narratives and promote more adaptive self-concepts.