The mediating role of physical activity avoidance in the association between weight stigma and physical activity

Background and aims Low levels of physical activity (PA) are a global issue that contribute to worse health outcomes in the general population. PA avoidance and weight stigma may play a significant role in lower levels of PA. Therefore, the present study examined the (i) associations between perceived weight stigma, weight-related self-stigma, PA avoidance and PA, and (ii) mediating role of PA avoidance between weight-related self-stigma and PA. Methods Using a cross-sectional study design, a total of 1383 university students from Taiwan and Hong Kong (mean age = 25.34 years; 40.20 % men) completed a survey. More specifically, they completed the Perceived Weight Stigma Scale, Weight Bias Internalized Scale, Tendency to Avoid Physical Activity and Sport Scale (TAPAS), and the International Physical Activity Questionnaire. Measurement invariance of the TAPAS was tested to ensure that the combining of data from Hong Kong and Taiwan participants was appropriate for further analysis. Results Structural equation modeling showed that weight-related self-stigma was significantly associated with PA avoidance (standardized coefficient [beta] = 0.67, p < 0.01), and negatively associated with PA (beta = -0.14, p < 0.01). In addition, PA avoidance mediated the association between weight-related self-stigma and PA (beta = -0.09, p < 0.01). Conclusions Higher weight-related self-stigma was associated with lower PA through higher PA avoidance. Strategies such as psychoeducation, or the development of weight-stigma-free exercise settings could be adopted to ameliorate weight-related self-stigma and PA avoidance, resulting in greater rates of physical activity.