Weight Bias Internalization Statistically Mediates the Association Between Positive Body Image and Intuitive Eating: A Cross-Sectional Study

BACKGROUND: Two facets of positive body image, body appreciation and functionality appreciation, are positively associated with an adaptive eating style known as intuitive eating. Little is known about the mechanisms underlying the association between positive body image and intuitive eating, although it is well established that weight bias internalization is associated with unfavorable views of the self and body and interferes with health behavior engagement.

OBJECTIVE: The present cross-sectional study examined weight bias internalization as a statistical mediator of the association between positive body image (ie, body appreciation and functionality appreciation) and intuitive eating.

DESIGN: An online cross-sectional survey was conducted with a convenience sample of adults who were recruited through social media from February to April 2019.

PARTICIPANTS AND SETTING: The final sample included 178 participants (120 women, 55 men, 2 gender nonbinary; mean age = 26.34 years, SD = 9.53 years) who completed the study online.

MAIN OUTCOME MEASURES: Participants completed the Intuitive Eating Scale-2 as the main outcome measure.

STATISTICAL ANALYSES: The PROCESS macro was used to conduct 2 mediation analyses with body appreciation and functionality appreciation as the antecedents, intuitive eating as the outcome, and weight bias internalization as the mediator.

RESULTS: As expected, body appreciation (b = .34, SE = .06; P < .001) and functionality appreciation (b = .13, SE = .06; P = .043) had significant positive associations with intuitive eating. Weight bias internalization statistically mediated the association between body appreciation and intuitive eating (b = .24, SE = .07, 95% CI .114 to .376), and functionality appreciation and intuitive eating (b = .04, SE = .03, 95% CI .004 to .104).

CONCLUSIONS: These findings contribute to better understanding the mechanisms connecting positive body image and intuitive eating. Results from this cross-sectional study indicate weight bias internalization statistically mediates the associations between body appreciation and intuitive eating and functionality appreciation and intuitive eating.