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Title: Psychological pathway from obesity-related stigma to anxiety via internalized stigma and self-Esteem among adolescents in Taiwan
Authors: Lin, CY 
Tsai, MC
Liu, CH
Lin, YC
Hsieh, YP
Strong, C
Keywords: Overweight
Internalized stigma
Issue Date: 2019
Publisher: Molecular Diversity Preservation International (MDPI)
Source: International journal of environmental research and public health, 11 Nov. 2019, v. 16, no. 22, 4410, p. 1-9 How to cite?
Journal: International journal of environmental research and public health 
Abstract: The objective of this research was to examine the pathway from public stigma, to perceived stigma, to depression in adolescents via internalized stigma. Adolescents in grade 7 through 9 from a junior high school in Changhua County in Taiwan completed self-administered surveys from March to July in 2018. Adolescents were asked questions regarding depressive symptoms, obesity-related perceived stigma, and internalized stigma. Structural equation modeling was used to fit the pathway model. The pathway was first analyzed with the full sample and then stratified by actual and perceived weight status. Our final analytic sample consisted of 464 adolescents. The pathway model suggested an acceptable model fit. Perceived weight stigma (PWS) was significantly associated with internalized stigma regardless of actual or self-perceived weight status. Internalized stigma was significantly associated with anxiety for both actual (beta = 0.186) and self-perceived nonoverweight (non-OW) participants (beta = 0.170) but not for overweight (OW) participants (neither actual nor self-perceived). For OW adolescents, perceived weight stigma was associated with anxiety. However, the internalization process did not exist. It may be that the influence of perceived weight stigma is larger than internalized stigma on anxiety. It may also be that the level of internalization was not yet high enough to result in anxiety.
ISSN: 1661-7827
EISSN: 1660-4601
DOI: 10.3390/ijerph16224410
Rights: © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
The following publication Lin, C.-Y.; Tsai, M.-C.; Liu, C.-H.; Lin, Y.-C.; Hsieh, Y.-P.; Strong, C. Psychological Pathway from Obesity-Related Stigma to Anxiety via Internalized Stigma and Self-Esteem among Adolescents in Taiwan. Int. J. Environ. Res. Public Health 2019, 16, 4410, 1-9 is available at
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