(see Poster Gallery) Validation of the Modified Weight Bias Internalization Scale (WBIS-M) Among First-Generation Asian Immigrants

Background and Purpose: Internalized weight bias (i.e., the application of negative weight-based stereotypes to one's self-evaluation) is associated with adverse mental health outcomes. The 10-item version of the Modified Weight Bias Internalization Scale (WBIS-M) is one of the most commonly used measures to assess internalized weight bias. However, studies examining the psychometric properties of the WBIS-M are limited in racially minoritized U.S.-based populations. Validating measures cross-culturally is an important part of conducting inclusive and socially just research. To this end, the current study sought to examine the factor structure of the 10-item version of the WBIS-M in a sample of first-generation Asian immigrants, as both native and foreign-born Asian populations have consistently demonstrated higher rates of weight-related concerns relative to other racially minoritized groups.

Methods: A total of 118 first-generation Asian immigrants were recruited via Qualtrics survey panels as part of a larger, cross-sectional study. The majority of participants identified as women (n= 74, 63%) and did not perceive themselves as overweight (n= 88, 75%). Approximately half of participants (n= 64, 54%) had lived in the U.S. for less than ten years. Confirmatory factor analysis was conducted using maximum likelihood estimation with robust standard error errors. After reaching an acceptable fit, a multiple indicator multiple cause (MIMIC) modeling approach was used to examine associations between internalized weight bias and gender, subjective weight status, and length of residence in the U.S. Internal reliability was estimated using McDonald's omega.

Results: The initial 10-item single-factor model did not demonstrate adequate fit. Although the CFI (.977), TLI (.970), and SRMR (.037) were within respective cut off ranges, the scaled chi square (x²_SB(35) = 51.97) was significant (p = .032) and the RMSEA (.064) slightly exceeded the cut point. In addition, one item had a standardized factor loading below the recommended ≥.70 threshold (λ= .42). Respecifying the model by removing the item with the low factor loading and adding an error covariance between two items with the same question stem improved model fit (x²_SB (26) = 34.76 p = .117, RMSEA =.054, CFI = .986, TLI= .981, SRMR = .034). All standardized factor loadings were significant and ≥ .79. McDonald's omega was .96, indicating strong internal reliability. The MIMIC model fit the data well (x²_SB (50) = 63.73, p = .092, RMSEA =.054, CFI = .983, TLI= .978, SRMR = .037). Identifying as a woman (β = .18, p = .023) and perceiving oneself as overweight (β = .44, p < .001) were significantly associated with greater internalized weight bias. However, length of residence in the U.S. was not (p > .05).

Conclusions and Implications: Mental health service providers working with Asian immigrants should be aware of potential weight-related concerns and may consider using the WBIS-M to assess for internalized weight bias. Having access to brief and reliable measures is important. Findings from the present study indicate that, when compared to the commonly used 10-item WBIS-M, the 9-item WBIS-M may be a better fit for measuring internalized bias among weight-diverse members of this demographic.