OBJECTIVE To test the long-term effects of a group-based, psychological intervention designed to reduce internalized weight stigma (IWS, i.e., self-stigma), delivered in combination with behavioral weight loss (BWL) treatment, compared to BWL alone. METHOD Adults with obesity who had experienced and IWS (N = 105, Mage = 49 years, 90.5% women, 70.5% White, 24.8% Black, MBMI = 38 kg/m²) were randomized to receive BWL with the Weight Bias Internalization and Stigma (BIAS) Program or BWL alone. Participants received weekly group treatment for 20 weeks, followed by 52 weeks of monthly and every-other-month sessions. Percent weight change at Week 72 was the primary outcome, with secondary outcomes of weight change at other time points; physical activity (measured by accelerometry, interview, and self-report); cardiometabolic risk factors; and psychological and behavioral outcomes. Intention-to-treat analyses used linear mixed models to test for between-group differences. Treatment acceptability was assessed. RESULTS Participants in the BWL + BIAS versus BWL group lost 2 percentage points more of baseline weight at Week 72, which was not a significant difference (mean weight change = -7.2% vs. -5.2%, 95% CI [-4.6 to 0.6], p = 0.14, d = 0.18). The BWL + BIAS (vs. BWL) group produced significantly greater improvements in weight self-stigma, eating self-efficacy, and some aspects of quality of life at specific time points. Most outcomes improved significantly over time but did not differ between groups. The trial had high retention and treatment acceptability, with higher ratings in the BWL + BIAS versus BWL group. CONCLUSIONS No significant differences in weight loss were observed between the BWL + BIAS versus BWL group. Possible benefits of addressing weight stigma in weight management warrant further investigation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

中文翻译：

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内化体重耻辱干预的长期影响：一项随机对照试验。


目的 测试旨在减少内化体重耻辱（IWS，即自我耻辱）的基于团体的心理干预与行为减肥（BWL）治疗相结合的长期效果，与单独使用 BWL 相比。方法 经历过 IWS 的肥胖成人（N = 105，Mage = 49 岁，90.5% 女性，70.5% 白人，24.8% 黑人，MBMI = 38 kg/m²）被随机分配接受带有体重偏差内化和耻辱感的 BWL (BIAS) 单独的程序或 BWL。参与者每周接受为期 20 周的团体治疗，随后接受为期 52 周的每月和每隔一个月的治疗。第 72 周时的体重变化百分比是主要结果，次要结果是其他时间点的体重变化；身体活动（通过加速度测量、访谈和自我报告来测量）；心脏代谢危险因素；以及心理和行为结果。意向治疗分析使用线性混合模型来测试组间差异。评估治疗的可接受性。结果 与 BWL 组相比，BWL + BIAS 组的参与者在第 72 周时基线体重减少了 2 个百分点，但没有显着差异（平均体重变化 = -7.2% 与 -5.2%，95% CI [-4.6 至 0.6] ]，p = 0.14，d = 0.18）。 BWL + BIAS（与 BWL）组在体重自我耻辱感、饮食自我效能以及特定时间点生活质量的某些方面产生了显着更大的改善。大多数结果随着时间的推移显着改善，但组间没有差异。该试验具有较高的保留率和治疗可接受性，BWL + BIAS 组的评分高于 BWL 组。结论 BWL + BIAS 组与 BWL 组之间没有观察到体重减轻的显着差异。 解决体重管理中的体重耻辱可能带来的好处值得进一步研究。 （PsycInfo 数据库记录 (c) 2023 APA，保留所有权利）。