Open Access

ARTICLE

Tendency to Avoid Physical Activity and Sport: Associations with Weight Stigma, and Psychological Distress in a Two-Wave Longitudinal Study

Saffari Mohsen^1,2,#, Yi-Ching Lin^3,#, Po-Ching Huang⁴, Yu-Ting Huang⁵, Ru-Yi Huang^6,7, Chi Hsien Huang^8,9,*, Jung-Sheng Chen¹⁰, Wai Chuen Poon¹¹, Mark D. Griffiths¹², Chung-Ying Lin^5,13,14,15,*

1 Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, 1435916471, Iran
2 Health Education Department, Faculty of Health, Baqiyatallah University of Medical Sciences, Tehran, 1435916471, Iran
3 Department of Early Childhood and Family Education, National Taipei University of Education, Taipei, 106, Taiwan
4 School of Physical Therapy, Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
5 Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
6 Division of Family Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and School of Medicine, Tzu Chi University, Hualien, Taiwan
7 Data Science Degree Program, National Taiwan University and Academia Sinica, Taipei, Taiwan
8 Department of Family Medicine and Community Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 824, Taiwan
9 College of Medicine, I-Shou University, Kaohsiung, 840, Taiwan
10 Department of Medical Research, E-Da Hospital, I-Shou University, Kaohsiung, 840, Taiwan
11 Sunway Business School, Sunway University, Selangor, 47500, Malaysia
12 International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, NG1 4BU, UK
13 Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan
14 Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, 704, Taiwan
15 Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan

* Corresponding Authors: Chi Hsien Huang. Email: ,; Chung-Ying Lin. Email:
# Saffari Mohsen and Yi-Ching Lin shared equal contribution to the paper

International Journal of Mental Health Promotion 2024, 26(8), 633-641. https://doi.org/10.32604/ijmhp.2024.053432

Received 30 April 2024; Accepted 09 July 2024; Issue published 30 August 2024

Abstract

Background: Physical inactivity is a major public health problem worldwide that results in physical and mental health problems. One major issue for physical inactivity is weight stigma (WS), especially perceived WS, which could lead to a tendency to avoid physical activity (PA). To better understand the association between perceived WS and PA, knowledge of the likely mediators in this association such as weight bias internalization (WBI) and psychological distress were investigated in the present study. Methods: Using a two-wave longitudinal study and convenient sampling, 388 Taiwanese participants (55% females; mean age = 29.7 years [SD ± 6.3]) completed two surveys six months apart. Body mass index (BMI), Perceived Weight Stigma Scale (PWSS), Weight Bias Internalization Scale (WBIS), Depression, Anxiety, Stress Scale (DASS-21), and Tendency to Avoid Physical Activity and Sport Scale (TAPAS) were assessed. Results: A mediation model controlling for age, gender, and BMI with 5000 bootstrapping resamples was performed. Perceived WS exerted significant direct effects on WBI (β = 0.25; p < 0.001), psychological distress (β = 0.15; p = 0.003), and tendency to avoid PA (β = 0.10; p = 0.027); WBI exerted a significant direct effect on tendency to avoid PA (β = 0.47; p < 0.001). Standardized indirect effects of WBI and psychological distress on the association between perceived WS and tendency to avoid PA were 0.12 and 0.01, respectively. Conclusion: Given the direct association of perceived WS on the tendency to avoid PA and the mediating role of WBI in this association, interventions addressing perceived WS and WBI may contribute to promoting PA. Therefore, health interventionists (both when planning and executing PA programs) need to consider weight stigmawhen encouraging physical activity.

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