The purpose of this study was to address a noteworthy gap in the literature through the development of an instrument that assesses a comprehensive range of behaviors comprising social support and social undermining for managing weight in a sample of adults in the overweight/obese weight range. The results provided preliminary support for the psychometric properties of the WRIS.
In terms of the construct validity of the WRIS, factor analyses yielded a three-factor solution comprised of Criticism, Minimization, and Collaboration that was replicated across both samples, despite significant differences in some demographic variables. All three subscales, as well as the total scale, were highly internally consistent.
Items indexing Critical social input are comprised of negative, intrusive, and judgmental comments and behaviors engaged in by significant others regarding the weight and weight-control behaviors of individuals with obesity. They include unsolicited advice and/or criticism on what individuals ‘should’ and ‘should not’ be doing about their weight, negative comments regarding the person’s weight status or capabilities, and instances of obesity stigma. Minimizing an individual’s weight-related concerns can be understood as significant others providing an environment that discourages healthy, and encourages unhealthy, weight-related behaviors (e.g., through modeling an unhealthy lifestyle). In contrast, the Collaboration subscale items depict significant others who affirm individuals for their weight-control efforts, engage in problem-solving, express confidence in the individual’s abilities in weight management, and/or co-participate in the individual’s weight management plan. In essence, these behaviors by significant others are responsive, affirming, and supportive of the individual’s weight-related goals rather than imposing their own goals on the individual (as in Critical behaviors) or disregarding the individual’s goals (as in Minimizing behaviors). The WRIS total score indexes the overall quality of the weight management support received by people with obesity. Individuals with high total scores experience minimal criticism and pressure to change their weight-related behaviors (Criticism), as well as low levels of behaviors by others that indicate disengagement from the individual’s weight-related goals (Minimization), while instead receiving high levels of sensitive, affirming, and responsive input from others to pursue their weight-related goals (Collaboration).
This tripartite structure of social input (i.e., Collaboration, Criticism, and Minimization) regarding weight management among adults with obesity has some convergence with the structure found in pediatric obesity of authoritative, authoritarian, and indulgent/uninvolved caregiver responses, respectively . It also has some overlap with the support evident among the carers of people with eating disorders, which similarly shows the use of effective support as well as ineffective forms of support characterized by input of a critical, hostile nature from others (referred to as expressed emotion in the eating disorders literature) and minimizing behaviors (referred to as accommodating and enabling behaviors in eating disorders research such as co-participating in problematic behaviors) .
In addition to construct validity, there was also some support for the concurrent validity of the WRIS. Specifically, higher Collaboration was strongly associated with higher weight-specific support (WMSI), with all correlations of a large effect size. On the other hand, rather than an expected inverse relationship, higher WMSI scores were also positively linked with Criticism (medium effect sizes) and Minimization (small effect sizes). Despite the fact that the WMSI was developed to measure effective weight management support, these results suggest that it might also be indexing ineffective forms of support. For instance, the WMSI items “others remind me to watch what I eat” or “others tell me about the calorie or fat content of foods” might be perceived as critical and controlling by someone in the obese weight range, especially given the pervasive nature of obesity stigma . Since the WMSI appears to be comprised of at least some forms of ineffective support, this might also account for its negative correlations with the WRIS total score. However, since these correlations were of a small effect size, their significance might also be an aterfact of the large sample size.
Evidence also emerged for the convergent validity of the WRIS, with the total scale having the expected pattern of results across each of the measures. That is, a support network characterised by higher support (i.e., higher Collaborative input and lower Critical and Minimizing input) from significant others for weight management was associated with lower internalized stigma, higher self-efficacy in managing one’s eating even in challenging situations, and less emotional eating in response to negative emotions. Regarding the latter, weight-specific support might help to buffer against the effects of distressing emotions on eating. For instance, it is possible that individuals with higher WRIS total scores have less vulnerability to engage in emotional eating because of lower social stressors (less Critical and Minimizing input), lower access to unhealthy food when emotionally vulnerable (less Minimizing input), and more effective support for them to adhere to or get back on track with their weight management goals in the context of distressing emotions (more Collaborative input).
Evidence was also found for the convergent validity of each of the WRIS subscales, with the social undermining subscales related to negative constructs and the social support subscale related to positive constructs. Specifically, greater Criticism and Minimization were both moderately to strongly associated with higher internalized stigma and emotional eating. These associations are concerning given that obesity stigma has been found to predict increases in obesity over time, theorised to be due at least in part to the distressing emotions induced by stigma that can result in emotional eating . There was less evidence for an association between either Critical or Minimizing input and self-efficacy in managing one’s eating, with the significant, negative correlations of a small effect size. In contrast, scores on the Collaboration subscale were consistently correlated with self-efficacy for managing one’s eating across challenging situations of a small to moderate effect size. These consistent associations were to be expected since the Collaboration subscale items either directly (e.g., others ‘Told me they believe in my ability to make healthy changes and manage my weight’) or indirectly (e.g., others ‘Helped me to identify solutions to weight loss problems’) assess support behaviors likely to increase people’s self-efficacy for managing their eating even in challenging situations. However, there were significant, albeit small, correlations between Collaboration and self-stigma, indicating that Collaborative support for weight management may not be sufficient to counteract the negative impacts of Critical and Minimizing behaviors of others on self-stigma, especially if these effective and ineffective forms of weight management support are engaged in by the same support network (e.g., there was a correlation of .30 between the Criticism and Collaboration subscale scores). Also unexpected was the positive correlation (again of a small effect size) between Collaboration and emotional eating in response to anxiety/anger. One possibility is that people with obesity who are experiencing more problems with urges to eat in response to negative emotions elicit more helpful support from others given that the Collaboration subscale includes such items (e.g., others ‘Helped me to manage food cravings effectively’).
Finally, results supported the discriminant validity of the WRIS, with no evidence that people with higher engagement in socially desirable responding are less likely to endorse criticial or minimizing input from others or more likely to report collaborative input.
Strengths and Limits
Despite the promising findings for this novel measure of weight-related social interactions, there are limitations stemming from the study’s cross-sectional design that should be considered when interpreting the results and informing future research. First, the use of a cross-sectional study limits the ability to specify any causal impact of different types of social input on self-stigma, emotional eating, and self-efficacy. Second, the test-retest reliability and prospective validity of the WRIS (e.g., whether WRIS scores predict weight changes) awaits investigation. Relatedly, future experimental and prospective research is required to provide stronger evidence for characterizing the behaviors in the Collaboration subscale as indeed effective forms of support and the behaviors in the Criticism and Minimization subscales as ineffective forms of social input by investigating the impact of these behaviors on eating, physical activity, and weight.
Overall, the findings of the present study support the reliability and validity of the WRIS. Its tripartite structure suggests that the social landscape experienced by people with obesity is characterized by both effective and ineffective forms of weight-related interactions with significant others, indicating that a comprehensive measure must include both types of social input. A focus on the social networks of people with obesity is consistent with calls for shared responsibility for the promotion of healthier eating and physical activity patterns by individuals, government agencies, industry, educational and occupational settings, the media [41,42] and, as the current research suggests, the social network members of people with obesity.
What is already known on this subject?
Results are inconsistent regarding the impact of social support on weight-related variables. Studies have utilized measures with questionable psychometric properties in overweight/obese populations. There is no psychometrically-sound instrument that comprehensively assesses the effective and ineffective behaviors of social network members regarding weight management.
What this study adds?
Social responses for weight management can be categorized as Critical, Minimizing or Collaborative. There is support for the reliability and validity of the WRIS as a new self-report questionnaire that comprehensively indexes the weight-related interactions experienced by people with overweight/obesity. The WRIS enables research focused on enhancing understanding of the effective and ineffective forms of support for weight management and for informing weight-loss interventions.