Weight Bias Internalisation and Health‐Related Quality of Life in Adolescents: What Role Do Family Meals Play?

OBJECTIVE: Weight bias internalisation (WBI) has been associated with poorer health-related quality of life (HRQoL), however, evidence in community-based adolescent samples remains scarce. Family meals have shown protective effects on adolescent health, yet their role in the relationship between WBI and HRQoL has not yet been explored. This study investigated associations between WBI, HRQoL, and family meals in Spanish adolescents. METHOD: We conducted a cross-sectional study with a representative sample of 1016 adolescents aged 11-16 from Terrassa, Spain (random multistage cluster sampling). Validated instruments were used to assess WBI (WBIS-M), HRQoL (KIDSCREEN-27), and family dinner quality and frequency. Anthropometric data were objectively measured. Adjusted regression models were conducted. RESULTS: Lower WBI and a higher frequency and quality of family dinners were associated with higher HRQoL scores across KIDSCREEN-27 domains. Further analyses revealed that family dinners moderated the effect of WBI on two HRQoL factors, attenuating its negative impact. However, this moderating impact became substantially weaker at higher levels of WBI. CONCLUSIONS: This study of Spanish adolescents is the first to show a negative association between WBI and HRQoL and that this relationship is moderated by the frequency and quality of shared family meals, suggesting that supportive family environments can buffer WBI's negative impact, although this protective role is attenuated at the highest levels of WBI, highlighting the vital need for early prevention, and warranting further investigation.