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Internalized Shame in Treatment-Seeking Adults with Obesity Class II-III and its Association with Quality of Life, Body Image, and Self-Esteem

Lagerström, Marcus ; Johnsson, Per LU ; Orrenius, Bengt ; Järvholm, Kajsa LU ; Olbers, Torsten and Engström, My (2025) In Obesity Facts p.1-21
Abstract

INTRODUCTION: Health-related quality of life (HRQoL) may be impaired in individuals living with obesity, possibly due to exposure to obesity-related stigma which may in turn activate shame. Few studies have been conducted on shame in relation to obesity and its potential association with other constructs such as HRQoL, self-esteem, and body image. In this study, internalized shame and the potential association with HRQoL, self-esteem, and body image were investigated in treatment-seeking patients with obesity class II-III.

METHODS: In total, 228 patients referred for obesity treatment at a tertiary clinic in Sweden participated in the study. The cohort was stratified into two groups using a clinical cutoff (≥ 50) indicating... (More)

INTRODUCTION: Health-related quality of life (HRQoL) may be impaired in individuals living with obesity, possibly due to exposure to obesity-related stigma which may in turn activate shame. Few studies have been conducted on shame in relation to obesity and its potential association with other constructs such as HRQoL, self-esteem, and body image. In this study, internalized shame and the potential association with HRQoL, self-esteem, and body image were investigated in treatment-seeking patients with obesity class II-III.

METHODS: In total, 228 patients referred for obesity treatment at a tertiary clinic in Sweden participated in the study. The cohort was stratified into two groups using a clinical cutoff (≥ 50) indicating pathological levels of shame as reported on the Internalized Shame Scale (ISS): a high shame group (HSG) and low shame group (LSG).

RESULTS: The mean ISS score for the overall cohort was 41.6, with a mean of 28.1 for the LSG and 66.5 for the HSG. Compared to the LSG, the HSG reported a lower quality of life in seven of eight HRQoL domains as well as a lower obesity-specific health-related quality of life. Furthermore, a higher shame score was associated with poorer body image and lower self-esteem. Conclusion Taken together, these findings indicate that a substantial number of patients with obesity report high internalized shame and that these individuals could benefit from extra support in treatment settings.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
epub
subject
in
Obesity Facts
pages
21 pages
publisher
Karger
external identifiers
  • pmid:39908007
ISSN
1662-4033
DOI
10.1159/000543448
language
English
LU publication?
yes
additional info
The Author(s). Published by S. Karger AG, Basel.
id
dd9669ec-2e77-42da-9c13-fda60d21dac3
date added to LUP
2025-02-12 08:23:23
date last changed
2025-04-04 15:16:19
@article{dd9669ec-2e77-42da-9c13-fda60d21dac3,
  abstract     = {{<p>INTRODUCTION: Health-related quality of life (HRQoL) may be impaired in individuals living with obesity, possibly due to exposure to obesity-related stigma which may in turn activate shame. Few studies have been conducted on shame in relation to obesity and its potential association with other constructs such as HRQoL, self-esteem, and body image. In this study, internalized shame and the potential association with HRQoL, self-esteem, and body image were investigated in treatment-seeking patients with obesity class II-III.</p><p>METHODS: In total, 228 patients referred for obesity treatment at a tertiary clinic in Sweden participated in the study. The cohort was stratified into two groups using a clinical cutoff (≥ 50) indicating pathological levels of shame as reported on the Internalized Shame Scale (ISS): a high shame group (HSG) and low shame group (LSG).</p><p>RESULTS: The mean ISS score for the overall cohort was 41.6, with a mean of 28.1 for the LSG and 66.5 for the HSG. Compared to the LSG, the HSG reported a lower quality of life in seven of eight HRQoL domains as well as a lower obesity-specific health-related quality of life. Furthermore, a higher shame score was associated with poorer body image and lower self-esteem. Conclusion Taken together, these findings indicate that a substantial number of patients with obesity report high internalized shame and that these individuals could benefit from extra support in treatment settings.</p>}},
  author       = {{Lagerström, Marcus and Johnsson, Per and Orrenius, Bengt and Järvholm, Kajsa and Olbers, Torsten and Engström, My}},
  issn         = {{1662-4033}},
  language     = {{eng}},
  month        = {{02}},
  pages        = {{1--21}},
  publisher    = {{Karger}},
  series       = {{Obesity Facts}},
  title        = {{Internalized Shame in Treatment-Seeking Adults with Obesity Class II-III and its Association with Quality of Life, Body Image, and Self-Esteem}},
  url          = {{http://dx.doi.org/10.1159/000543448}},
  doi          = {{10.1159/000543448}},
  year         = {{2025}},
}