Psychosocial determinants of food cravings in women with overweight and obesity: self-stigmatisation, weight bias and self-esteem

BACKGROUND: Weight-related self-stigma and internalised weight bias may intensify food cravings and undermine psychological resources such as self-esteem, yet their combined contribution to food cravings among women with overweight and obesity is not well characterized. This study compared these psychosocial factors between women with overweight and those with obesity and examined their independent associations with food craving. METHODS: The sample included 179 women with BMI ≥ 25 who completed a sociodemographic questionnaire and validated measures of weight-related self-stigma, internalised weight bias, food craving, and self-esteem. Group differences were examined, and hierarchical multiple regression was used to identify psychosocial predictors of food craving. RESULTS: Compared with women with overweight, women with obesity reported higher levels of weight-related self-stigma (p = 0.001), internalised weight bias (p = 0.001), and food craving (p = 0.003). Self-esteem did not differ by weight status but was significantly negatively associated with weight-related self-stigma, internalised weight bias, and food craving. Hierarchical regression analysis showed that greater weight-related self-stigma (β = 0.260) and internalised weight bias (β = 0.222), along with lower self-esteem (β = 0.184), independently predicted higher food craving, explaining 38.9% of the variance (R²=0.389). Age remained a significant negative predictor of food craving. Importantly, aside from age, BMI category and other sociodemographic variables were included as covariates in the hierarchical model but did not emerge as significant predictors. CONCLUSIONS: Food craving in women with overweight and obesity appears to be significantly associated with modifiable psychosocial mechanisms, particularly weight-related self-stigma, internalised weight bias, and self-esteem. Integrating stigma-reduction and self-esteem-supportive components into obesity management may help improve psychological and behavioral outcomes beyond standard dietary advice.