Weight Self-Stigma and Disordered Eating Behaviors in Iranian Women: The Mediating Roles of Self-Efficacy and Guilt

Objective: This study aimed to investigate the concurrent relationships between weight self-stigma and disordered eating behaviors, mediated by weight- and body-related shame and guilt, fear of negative appearance evaluation, and eating self-efficacy, among women with overweight and obesity. Materials and Methods: This study was a cross-sectional study. The sample consisted of 228 Iranian women, aged 18-70 years, with overweight and obesity (BMI≥ 25), who were purposively selected. Participants responded to online demographic questions and research measurement tools (Dutch Eating Behavior Questionnaire, Weight Self-Stigma Questionnaire, Weight- and Body-Related Shame and Guilt Scale, Weight Efficacy Lifestyle-Short Form, Fear of Negative Appearance Evaluation Scale). Statistical methods of descriptive statistics, Pearson correlation matrix, structural equation modeling and bootstrapping mediation analysis were used to analyze the data, through SPSS 23 and AMOS 23. Results: The results showed that weight self-stigma had significant paths to all research variables in a structural model (P< 0.05). Furthermore, mediation analysis showed that eating self-efficacy mediated the relationships between weight self-stigma and emotional (P< 0.001), external (P< 0.001), and restrained eating behaviors (P< 0.002). Additionally, weight and body-related guilt mediated the relationship between weight self-stigma and restrained eating behavior (P< 0.001). Totally, the research model explained 14.9% of the variance of emotional and external eating behaviors, and 36.2% of the variance of restrained eating behavior. Conclusion: The findings highlight the importance of considering weight self-stigma in obesity research. Additionally, improving eating self-efficacy and addressing guilt through psychological interventions are crucial for managing eating behaviors in this population.