Internalized Fat Bias Impacts Bariatric Surgery Success

Dr. Michelle Lent PhD Geisinger Health Interview with
Dr. Michelle Lent PhD
Geisinger Health System

Medical Research: What is the background for this study?

Dr. Lent: Previous study findings indicate that weight bias relates to a number of adverse outcomes in overweight and obese populations, including binge eating, psychological disorders and body image issues. In this study, we measured the degree to which people undergoing weight-loss surgery translate “anti-fat” attitudes into negative beliefs about themselves before surgery (known as “internalized weight bias”) and if this influences weight loss outcomes after surgery.

Medical Research: What are the main findings?

Dr. Lent: We found that greater internalized weight bias before weight-loss surgery was associated with greater depressive symptoms before surgery, as well as less weight loss one year after surgery. We also found no differences in levels of weight bias by race or geographic locations (urban versus rural participants).

Medical Research: What should clinicians and patients take away from your report?

Dr. Lent: Before going through weight-loss surgery, most patients participate in a comprehensive pre-operative preparation program. Patients may benefit from screening for high levels of internalized weight bias during this preparation period and if appropriate, be offered counseling to better cope with this bias.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Lent: Future studies could examine potential pathways underlying the relationship between internalized weight bias and diminished weight loss after bariatric surgery, such as reluctance to engage in physical activity (especially in public), lower self-efficacy, or greater overeating as a means of coping with this bias. Additionally, future studies could focus on developing pre-operative weight bias interventions and then evaluate their impact on weight loss and psychological health in bariatric surgery patients.


Michelle R. Lent, Melissa A. Napolitano, G. Craig Wood, George Argyropoulos, Glenn S. Gerhard, Sharon Hayes, Gary D. Foster, Charlotte A. Collins, Christopher D. Still. Internalized Weight Bias in Weight-Loss Surgery Patients: Psychosocial Correlates and Weight Loss Outcomes. Obesity Surgery, 2014; DOI: 10.1007/s11695-014-1455-z

Last Updated on October 24, 2014 by Marie Benz MD FAAD