Gender differences in weight bias internalization and its association with quality of life among overweight and obese high school students in Upper North Thailand. 10.55131/jphd/2025/230201
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Abstract
Adolescents who are overweight and obese often experience the impact of weight bias internalization (WBI) on their quality of life (QoL). However, there is limited research on how WBI and its effects on QoL vary by gender in Thailand. This study aims to describe gender differences in WBI and its association with QoL among overweight and obese high school students. A cross-sectional study was conducted on 1,012 overweight and obese students from the upper northern region of Thailand, selected through a multi-stage random sampling process. Data were collected using a self-administered questionnaire, and hierarchical linear regression was applied to assess the relationship between WBI and QoL. The results revealed that 52.6% of the participants were girls, with a mean BMI of 25.7 kg/m2 (SD = 1.6). Girls reported greater WBI and body image dissatisfaction (BD) than boys (P = 0.014, P = 0.024, respectively), while boys reported significantly higher overall QoL scores and across all domains (physical health, psychological health, social relationships, and environment) compared to girls (P< 0.001). The association between WBI and QoL varied by gender, particularly in the psychological health domain (β = -0.573, P < 0.001 for girls; β = -0.403, P=0.105 for boys), but no significant gender differences were observed in other QoL domains. In conclusion, WBI and its effects on the psychological health aspects of QoL differed by gender among overweight and obese high school students. Therefore, intervention strategies aimed at reducing WBI should consider gender-specific approaches to improve QoL.
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