Weight bias internalisation (WBI) during preconception, pregnancy and postpartum undermines maternal health, yet factors promoting internalisation remain poorly understood. This cross-sectional study examined associations between WBI and weight stigma exposure, self-perceived weight and BMI among 511 women aged 18-45 years across reproductive stages in Western (Australia, UK, US) and non-Western (Singapore, Philippines) countries. Greater stigma exposure was consistently associated with higher WBI across all reproductive stages and countries. Higher self-perceived weight was associated with greater WBI during preconception and postpartum, but not during pregnancy. Self-perceived weight did not moderate the stigma-WBI relationship, and BMI was not independently related to WBI. Exploratory analyses revealed women in non-Western countries reported greater stigma exposure despite similar WBI levels. Findings suggest WBI is more strongly associated with stigmatisation and weight perceptions than BMI, challenging BMI-centric risk models and highlighting the need for multi-level strategies that reduce weight stigma while strengthening women's resilience to internalisation.
Dever et al. (Fri,) studied this question.