Weight stigma as a predictor of distress and maladaptive eating behaviors during covid-19: Longitudinal findings from the eat study

Rebecca M. Puhl, Leah M. Lessard, Nicole Larson, Marla E. Eisenberg, Dianne Neumark-Stzainer

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


BACKGROUND: Weight stigma is common for people with obesity and harmful to health. Links between obesity and complications from COVID-19 have been identified, but it is unknown whether weight stigma poses adverse health implications during this pandemic.

PURPOSE: We examined longitudinal associations between prepandemic experiences of weight stigma and eating behaviors, psychological distress, and physical activity during the COVID-19 pandemic in a diverse sample of emerging adults.

METHODS: Participants (N = 584, 64% female, mean age = 24.6 ± 2.0 years, mean body mass index [BMI] = 28.2) in the COVID-19 Eating and Activity over Time (C-EAT) study were cohort members of the population-based longitudinal study EAT 2010-2018. Weight stigma reported by participants in 2018 was examined as a predictor of binge eating, eating to cope, physical activity, depressive symptoms, and stress during COVID-19. Data were collected via online surveys during the U.S. outbreak of COVID-19 in 2020.

RESULTS: Prepandemic experiences of weight stigma predicted higher levels of depressive symptoms (β = 0.15, p < .001), stress (β = 0.15, p = .001), eating as a coping strategy (β = 0.16, p < .001), and an increased likelihood of binge eating (odds ratio = 2.88, p < .001) among young adults during the COVID-19 pandemic but were unrelated to physical activity. Although associations remained after accounting for demographic characteristics and BMI, the magnitude of longitudinal associations was attenuated after adjusting for prior levels of the outcome variables.

CONCLUSIONS: Young adults who have experienced weight stigma may have increased vulnerability to distress and maladaptive eating during this pandemic. Public health messaging could be improved to support people of diverse body sizes and reduce the harmful consequences of weight stigma.

Original languageEnglish (US)
Pages (from-to)738-746
Number of pages9
JournalAnnals of Behavioral Medicine
Issue number10
StatePublished - Oct 1 2020

Bibliographical note

Funding Information:
Funding: This work was supported by grant number R35HL139853 from the National Heart, Lung, and Blood Institute (PI: Neumark-Sztainer). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health.

Publisher Copyright:
© 2020 Oxford University Press. All rights reserved.


  • COVID-19
  • Eating
  • Stigma
  • Stress
  • Weight
  • Body Weight
  • Pandemics
  • Exercise/psychology
  • Feeding and Eating Disorders/psychology
  • Humans
  • Psychological Distress
  • Male
  • Young Adult
  • SARS-CoV-2
  • Coronavirus Infections/psychology
  • Betacoronavirus
  • Female
  • Obesity/psychology
  • Pneumonia, Viral/psychology
  • Social Stigma
  • Longitudinal Studies

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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