Endorsement of Appearance‐Based Societal Biases Differentiates Women With Current Anorexia Nervosa From Those in Recovery

ABSTRACT Objective Many people relapse following treatment for Anorexia nervosa (AN). Internalization of appearance‐related societal biases, including weight stigma, idealization of thinness, and body self‐objectification, is related to eating disorder (ED) onset and maintenance, but their association with AN recovery is unclear. Method We recruited 425 women using Prolific: 136 with self‐reported active AN, 143 who self‐reported being recovered, and 146 controls with no ED history. They completed online measures of ED symptoms, internalized weight stigma, thin‐ideal internalization, and self‐objectification. Group differences were examined using two MANCOVAs: one based on self‐reported recovery status and one using ED symptom scores instead. We also compared those whose symptom scores did and did not match their self‐reported recovery status. Finally, unsupervised machine learning explored whether internalized bias profiles mapped onto recovery status. Results Using self‐reported status, the active group scored highest on all biases, followed by the recovered group, then controls (ps ≤ 0.002 ). When symptoms defined recovery, recovered participants no longer differed from controls (ps ≥ 0.92 ), whereas the active AN group scored higher than the other groups (ps ≤ 0.001 ). Participants who identified as recovered but scored above the symptom cut‐off resembled the active group, whereas those below the cut‐off resembled controls. Machine learning identified two severity‐based clusters: active AN participants were concentrated in a high‐bias cluster, controls in a low‐bias cluster, and recovered participants were split across these clusters. Discussion Internalized societal biases are strongly associated with AN recovery status, especially when it is defined based on symptom levels rather than self‐report. These biases may represent important targets for aftercare interventions.