Psychological pathway from obesity-related stigma to depression via internalized stigma and self-esteem among adolescents in taiwan

Chung Ying Lin, Meng Che Tsai, Chih Hsiang Liu, Yi Ching Lin, Yi Ping Hsieh, Carol Strong

Research output: Journal article publicationJournal articleAcademic researchpeer-review

11 Citations (Scopus)


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 (β = 0.186) and self-perceived nonoverweight (non-OW) participants (β = 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.

Original languageEnglish
Article number4410
JournalInternational Journal of Environmental Research and Public Health
Issue number22
Publication statusPublished - 2 Nov 2019


  • Anxiety
  • Internalized stigma
  • Overweight
  • Stigma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

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