Michael Levine's Eating Disorders Prevention/Sociocultural Factors Newsletter
NO. 154: Objectification/Dehumanization (n = 2); (ii) Social Media, Part 2 (n = 2); (iii) Access to Treatment, Part 2 (n = 2); Orthorexia Nervosa (n = 2); and (v) Weight Stigma, Part 1 (n = 3)
Colleagues (N now = 1375 in 49 countries),
Please (a) continue to send me any and all announcements (e.g., conferences, awards, webinars, prevention resources, your recent publications); and (b) pass along the following to anyone who would like to join this free email list.
EVERYTHING IS ADVOCACY Announcement
Fat Joy Festival and Weight Stigma Conference
The Public Health group at Griffith University (Gold Coast, Australia) is hosting, at no cost to participants, the
inaugural Fat Joy Festival
Saturday, 5 July 2025
followed by the
11th Annual International Weight Stigma Conference
Sunday 6 July and Monday 7 July — also hosted by the Public Health group
Received 8 June 2025 via a “Fat Joy Festival and Weight Stigma Conference” announcement/email from our own Dr. Lily O’Hara (Australia).
ML NOTE 1: Dr. O’Hara, her colleagues, and I would appreciate it if you would, as she writes, “help others learn about these events by forwarding this email to your colleagues and networks, and letting your clients, friends, and family know about them too.”
[Dr. O’Hara writes; bold added by ML]
There is less than four weeks to go until the long weekend of fat liberation, weight and size inclusiveness, and bringing down weight stigma. You may know about the International Weight Stigma Conference, you may even be presenting or already registered, but if you’ll be on the Gold Coast in early July, you need to know about both events.
On Saturday 5 July, the Public Health group at Griffith University is hosting the inaugural Fat Joy Festival, which will provide opportunities for joy, connection, and being in community for people with larger bodies. This community festival will include sessions on fat joy on the screen and in poetry, crafting workshop, dance class, friendship making, panel discussion, and a flea market featuring clothing, accessories, arts and craft for people with larger bodies. ABC Radio National’s Big Ideas program will record the panel discussion on the radical practice of fat joy for broadcast on radio and online.
Although it may sound confronting, the term “fat” has been reclaimed by the weight inclusive and fat liberation movements as a neutral descriptor rather than a pejorative term. We recognize that not everyone is comfortable with using the term fat to describe themselves or others, but we have chosen to use it as part of broader efforts to challenge weight stigma and enhance inclusivity and liberation, in a similar way to other communities who have chosen to reclaim descriptors used to try and hurt them.
Why a fat joy festival? Evidence shows that fat people face widespread exclusion from joyful opportunities due to societal stigma, systemic bias, and structural barriers. The Fat Joy Festival will actively counter these barriers by fostering a sense of community, representation, and belonging for fat people. This community-based health promotion event aims to enhance health and wellbeing by addressing some of the social determinants of health inequity for people with larger bodies.
The Fat Joy Festival is free to attend thanks to the support of sponsors, and fat allies are welcome. Register your attendance here. Follow the Fat Joy Festival Facebook and Instagram accounts for up to date information.
From the community health promotion event on Saturday, we transition to a professional development event on Sunday 6 July and Monday 7 July, when the Public Health group hosts the 11th Annual International Weight Stigma Conference. Weight stigma is present in almost every aspect of society, including health services and public health. It is imperative that health professionals in all fields become more aware of how weight stigma manifests and the negative impact it has on health, wellbeing, social, and economic outcomes. Only by addressing weight stigma can we hope to reduce the significant inequities that people with larger bodies face and create more weight and size inclusive health systems and society.
This year’s conference presents the largest program ever, and promises to be an inspiring and transformative event, bringing together national and international keynote speakers and experts, advocates, and professionals to discuss groundbreaking research, strategies, and solutions for addressing weight stigma and enhancing weight and size inclusiveness. ABC Radio National’s Big Ideas program will also record the panel discussion on reimagining weight and size inclusive health services and public health for broadcast on radio and online.
Go to conference site to register. The conference is a not for profit event and provides a limited number of bursaries that cover the registration fee are available for those with financial need. Follow the Weight Stigma Conference Instagram account for more details.
Finally, I would also like to request your assistance in helping others learn about these events by forwarding this email to your colleagues and networks, and letting your clients, friends, and family know about them too.
I hope to see you at one or both events.
Warm regards
Lily
Chair of the inaugural Fat Joy Festival and 11th Annual International Weight Stigma Conference
Lily O’Hara PhD LMAHPA (she/her) | Senior Lecturer in Public Health School of Medicine and Dentistry | Griffith University | E: l.ohara@griffith.edu.au
Received 16 June 2025 (California time) via an everything-is-advocacy email from our own Shivani Dutt, Manager, Mission Initiatives for the U.S.’s National Eating Disorders Association (NEDA).
ML NOTE 2: Shivani, her NEDA colleagues, and I would appreciate it if you would pass this resource along to (a) any and all who do eating disorders and/or eating pathology research; and/or those who work with or otherwise know such researchers.
[Shivani writes; bold added by ML]
[I want to] share that NEDA has a dedicated research study participation listings page on our website. This [email] comes from a place of ensuring that the community is aware of more places they can recruit participants for the important work they're doing!
Shivani Dutt | Manager, Mission Initiatives | National Eating Disorders Association |nationaleatingdisorders.org | Instagram | Facebook | LinkedIn
Register for a NEDA Cares event near you! Join us in promoting education and connection.
Research Publication Categories in This Newsletter
(i) ) Objectification/Dehumanization (n = 2); (ii) Social Media, Part 2 (n = 2); (iii) Access to Treatment, Part 2 (n = 2); Orthorexia Nervosa (n = 2); and (v) Weight Stigma, Part 1 (n = 3)
CONGRATULATIONS to our own
Dr. Scott Griffiths (Australia; see also #9) and colleagues for publication of the Social Media research article in #4.
Dr. Stuart Murray (USA) and colleagues for publication of the Access to Treatment research article in #6.
Drs. Jeff Hunger (USA) and Scott Griffiths (Australia) and colleagues for publication of the Weight Stigma research article in #9.
Dr. Carli Pacanowski (USA) and colleagues for publication of the Access to Weight Stigma review article in #11
OBJECTIFICATION/DEHUMANIZATION
1. Di Bernardo, G. A., Pecini, C., Tallone, B., Raguso, G., & Andrighetto, L. (2025). No hard feelings: The role of self-objectification and self-dehumanization in understanding emotions and mental states in cisgender heterosexual women. Psychology of Women Quarterly. Advance online publication. https://doi.org/10.1177/03616843251340962
Email address for correspondence: gianantonio.dibernardo@unimore.it
ABSTRACT. In the current research, we investigated whether self-objectification (i.e., giving priority to physical appearance over other personal attributes) and self-dehumanization (i.e., the denial of one's humanity) are associated with an impaired ability to understand others’ emotions, as reflected in empathy (both affective and cognitive) and mental state understanding, as measured by theory of mind i.e., the ability to comprehend others’ mental and emotional states). Across three studies (Ntot = 750 Italian, heterosexual, cisgender women), we examined the relation between self-objectification with empathy (Studies 1a and 1b) and theory of mind (Study 2); additionally, we tested the mediating role of self-dehumanization.
Results consistently showed that self-objectification was related to reduced empathy (both affective and cognitive) and diminished theory of mind. However, these latter associations were primarily indirect; that is, self-dehumanization represented the key psychological mechanism explaining the link between self-objectification and the recognition of others’ emotions and mental states. Findings underscore the need for continued understanding of how self-objectification and self-dehumanization may be associated with factors related to intraindividual and interpersonal consequences.
2. Cervone, C., Vezzoli, M., Ruzzante, D., Galdi, S., Formanowicz, M., Guizzo, F., & Suitner, C. (2025). Reveal or conceal your body? Differential manifestations of self-objectification are related to different patterns for women. Body Image, 54. Advance online publication. https://doi.org/10.1016/j.bodyim.2025.101920
Full text available for download at: https://tinyurl.com/4x6kx4yy
ABSTRACT. Body concealment, namely the attitudes and strategies specifically aimed at avoiding the other’s gaze towards one’s body, is here advanced as a relevant manifestation of chronic self-objectification. We juxtapose it to body exposure, that is the pursuit of being the object of others’ gaze.
Three validation studies conducted in Italy (Studies 1 and 2) and the UK (Study 3), and an additional focus group, showed that body concealment and exposure are distinct responses, both positively linked to self-objectification. Importantly, distinct dimensions of self-objectification were associated with body concealment and body exposure: the internalization of the observer's perspective was linked to body concealment via body shame; the internalization of objectifying ideals, instead, was associated with greater exposure (Study 4, Italy). Notably, body concealment, but not body exposure, was related to health issues typically linked to self-objectification, such as depression and disordered eating (Study 5, UK).
Together, these studies (Ntotal = 2853) introduce body concealment as a new phenomenon within the sexual objectification framework, distinct from body exposure. From a theoretical perspective, this distinction reconciles seemingly contradictory evidence. From an applied point of view, body concealment has specific negative implications for women's well-being, deserving the attention of scholars and practitioners.
MEDIA, Part 2 of 3
ML NOTE 3: The article described below in #3 was edited by our own Dr. D. Catherine Walker (USA), and one of the two reviewers was our own Dr. Paula Brochu (USA).
3. Kilby, R., & Mickelson, K. D. (2025). Combating weight-stigmatization in online spaces: the impacts of body neutral, body positive, and weight-stigmatizing TikTok content on body image and mood. Frontiers in Psychiatry, 16, 1577063. https://doi.org/10.3389/fpsyt.2025.1577063
Full text available for download at: https://tinyurl.com/5add78tu
ABSTRACT. Social media movements centered on body positivity and body neutrality both encourage healthy attitudes toward the physical body; however, these movements are conceptually distinct and may have unique influences on body image. This study examined how brief exposure to different types of body acceptance and weight-stigmatizing content affects body image and mood. Participants consisted of women and gender-diverse individuals (N = 326) who completed an online survey and were randomly assigned to view one of four TikTok video compilations: body neutrality, body positivity, weight-stigmatizing, or travel (control) content. E
Exposure to body positivity and body neutrality content was associated with improvements in functional appreciation, self-objectification, body dissatisfaction, and negative affect. Moreover, although participants across body-focused conditions reported thinking about their appearance to a similar extent, those in the body-positive and body-neutral groups reported more frequent positive appearance-related thoughts than those in the weight-stigmatizing or control conditions.
Importantly, differences emerged between the two body acceptance conditions, such that body neutrality was uniquely effective in reducing self-objectification relative to weight-stigmatizing content, while body positivity significantly enhanced positive affect. Moderation analyses revealed marginal interactions, suggesting that the effect of content on body dissatisfaction varied by gender identity, while positive affect varied by perceived body silhouette.
Overall, these findings indicate that body-positive and body-neutral content on TikTok may serve as beneficial alternatives to weight-stigmatizing media, though each approach may yield distinct benefits especially in consideration of individual identity characteristics.
4. Park, K. E., Harris, E. A., Grey, W., & Griffiths, S. (2025). Is #bodypositivity influential for sexual minority men? An ecological momentary assessment study on the effects of viewing body positivity content on social media. Body Image, 54. Advance online publication. https://doi.org/10.1016/j.bodyim.2025.101915
Full text available for download at: https://tinyurl.com/29tmz894
ABSTRACT. Body positivity content on social media refers to content that rejects narrowly defined beauty standards and celebrates body diversity. Previous research has found that viewing body positivity content is associated with more positive body image (e.g., higher body satisfaction). However, no research to date has examined the links between body positivity social media content and body image among sexual minority men.
Our primary aim was to determine whether exposure to body positivity was associated with body satisfaction and mood. Our secondary aim was to explore how comparing oneself to body positivity influences body satisfaction and mood. Sexual minority men recruited from Grindr (N = 530; Mage = 33.36) completed a 1-week ecological momentary assessment protocol reporting whether they encountered body positivity content on their own social media feeds and completing self-report measures of state body satisfaction, positive affect and negative affect.
Contrary to hypotheses, unique exposure to body positivity had no significant association with body satisfaction, negative affect or positive affect. Furthermore, comparing oneself to body positive content was associated with lower body satisfaction (b = −1.88, p = .002), reduced positive affect (b = −1.85, p = .004), and heightened negative affect (b = 2.21, p = .004).
Our findings suggest that while body positivity content on social media may be well-intentioned, it does not improve body image among sexual minority men and could worsen mood and body image. Further research is needed to examine the extent to which body positivity content targeting sexual minority men aligns with academic and lay definitions of body positivity.
ACCESS TO TREATMENT, Part 1 of 2
5. Valenta, S. T., Marcolini, F., Scalise, M., Verrastro, M., Rugo, M., Panariello, F., De Ronchi, D., & Atti, A. R. (2025). Still waiting: Referral patterns, delays, and key factors in accessing specialized eating disorder treatment in an Italian cohort. Eating Behaviors, 57. Advance online publication. https://doi.org/10.1016/j.eatbeh.2025.10196
Full text available for download at: https://tinyurl.com/e6wcnm2
ABSTRACT. Background: Eating disorders (EDs) are prevalent psychopathological conditions with significant psycho-physical consequences. Despite advances in diagnostic tools and treatment approaches, many patients experience barriers to accessing specialized ED care (SEDC). This study aimed to (1) examine the timeline of the care pathway from symptom onset to referral to a regional SEDC; (2) assess the association between referral to SEDC and factors such as the initial healthcare provider and clinical symptoms; and (3) investigate the relationship between the care pathway and clinical severity at the time of referral.
Methods: This study analyzed data from 174 patients accessing the SEDC in Bologna, Italy, between 2022 and 2024. Chi-square tests and Kendall Tau correlations were used to assess the associations between referral patterns, healthcare professionals, symptom severity, and healthcare contacts prior to referral. Results: On average, participants took 26.3 months from symptom onset to seek help and 53.7 months before reaching the SEDC. General practitioners and psychiatric services had higher referral rates to SEDC. Weight loss and amenorrhea were positively associated with referrals, while depressed mood and fear of weight gain showed negative associations. No significant link was found between the care pathway and clinical severity at the time of referral.
Conclusion: Referral to SEDC is associated with the type of healthcare provider initially consulted and the presence of specific symptoms, particularly weight loss and amenorrhea. These findings highlight the importance of enhancing awareness among frontline healthcare providers to promote earlier recognition and referral of ED cases.
6. Murray, S. B., Friedlich, C. E., & Kesheshian, T. (2025). The impact of incorporating an eating disorder screening tool and an eating disorder diagnostic workshop in outpatient general psychiatry settings in publicly insured populations: A case series. Eating Disorders: The Journal of Treatment & Prevention. Advance online publication. https://doi.org/10.1080/10640266.2025.2459972
Full text available for download at: https://tinyurl.com/uvnum74u
ABSTRACT. With an elevated prevalence of disordered eating in low-income settings, efforts to optimize the detection of eating disorders (EDs) in such settings are necessary. A significant barrier relates to the scarcity of training for clinicians not working in specialized ED settings. This manuscript assessed the impact of an ED screening tool and an ED assessment workshop upon the detection of EDs in publicly insured psychiatry settings. Leveraging a case series design to assess 165 consecutive adult patients in outpatient psychiatry settings, we indexed the prevalence of ED diagnoses rendered by psychiatrists when assessing patients (i) without prior knowledge of ED symptoms, (ii) after being made aware of patient scores from an ED screening measure, and (iii) after undergoing an ED assessment workshop, and being made aware of patient screening scores.
While 27% of the sample reported clinically significant ED symptoms on the screening measure, ED diagnoses were only rendered in 2% of the sample when psychiatrists were not made aware of ED symptoms prior to assessment. In contrast, incorporating a screening tool altered the rates of ED diagnoses, with 18% of the sample receiving an ED diagnosis. Moreover, the combinatorial introduction of both the ED screening measure and an ED assessment workshop further altered diagnostic practice—with this resulting in ED diagnoses in 27% of the sample. The findings suggest that ED screening and training workshops can have significant impacts on diagnostic accuracy and, with little cost, can provide patients with diagnoses that would otherwise go undetected.
ORTHOREXIA NERVOSA
7. Brytek-Matera, A., & Donini, L. M. (2025). The need for research on orthorexia nervosa: Looking back, looking forward. Eating and Weight Disorders, 30, 48. https://doi.org/10.1007/s40519-025-01743-2
Full text available for download at: https://tinyurl.com/4vvxyx4w
ABSTRACT. One of the sustainable development goals (SDGs) of the United Nations is to enhance scientific research and substantially increase the number of public and private research and development spending (SDG Target 9.5). What types of research should be carried out in the field of orthorexia nervosa (ON)? Fundamental, applied, comparative, exploratory, laboratory, longitudinal or mixed research? How can we utilize our previous misinterpretations to develop a more accurate understanding of ON? Do we need more research in this field? These and other questions encourage us to publicly debate on ON, which is why we would like to express our position on this issue.
Level of evidence: Level V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.
8. Albery, I. P., Smith, R., Frings, D., & Spada, M. (2025). Patterns of implicit and explicit identity as a vegan or vegetarian in predicting healthy orthorexia and orthorexia nervosa. Eating and Weight Disorders, 30, 27. https://doi.org/10.1007/s40519-025-01734-3
Full text available for download at: https://tinyurl.com/t8pufyrp
ABSTRACT. Orthorexia nervosa (OrNe) is an eating disorder characterised by a pathological interest and preoccupation with healthy foods and a healthy diet. Evidence suggests that tendencies towards OrNe may be prevalent across diet groups, and this is particularly the case in vegans and vegetarians. Our previous work has identified that alongside individual differences in obsessive compulsiveness and perfectionism, cognitive biases (attentional preference for healthy-related cues) are associated with OrNe, whereas explicit identity (as a vegan/vegetarian) is only associated with a healthy orthorexia form.
No work has assessed whether one’s known identity (explicit identity) or that form of identity which is based on fast acting cognitive associations (implicit identity) further differentiate healthy orthorexia from OrNe tendencies in addition to compulsiveness and perfectionism. One hundred and forty-four self-identified vegans (n = 45), vegetarians (n = 50) and meat-eaters (omnivores) (n = 49) (66 females, 74 males, 4 non-binary; M age = 35.09) completed measures of current hunger status, obsessive compulsivity, perfectionism, the Teruel Orthorexia Scale, perceived identity centrality as a vegan/vegetarian (explicit identity) and a “self as vegan/vegetarian” implicit association test (implicit identity).
Results showed increased orthorexia tendencies in both vegans and vegetarians compared to meat eaters (omnivores) but only in terms of healthy orthorexia. In addition, no differences were shown for OrNe suggesting the diet type is not influential in pathological orthorexia. Explicit identity and current hunger status were both shown to be associated with healthy orthorexia and not OrNe. Implicit identity as a vegan/vegetarian was unrelated to both dimensions, while compulsiveness and perfectionism predicted OrNe. Despite individuals implicitly associating the self with being a vegan/vegetarian, this identity does not serve as a maker of orthorexia nervosa.
WEIGHT STIGMA, Part 1 of 3
9. Austen, E., Hunger, J. M., Bonell, S., & Griffiths, S. (2025). Gaps in measurement: Highlighting anti‐fat bias as an underrepresented construct in the Modified Weight Bias Internalization Scale. Social and Personality Psychology Compass, 19, e70057. https://doi.org/10.1111/spc3.70057
Full text available for download at: https://tinyurl.com/mwd5xtnf
ABSTRACT. Increasing cross‐sectional literature highlights a strong overlap of internalised weight bias (i.e., weight‐based self‐devaluation) with constructs like body dissatisfaction. The highest overlap is in studies that use the Modified Weight Bias Internalization Scale (WBIS‐M). We argue that anti‐fat bias (e.g., negative judgements of fat people) is a core feature of internalised weight bias definitions not represented in the WBIS‐M, making its items less distinct from body dissatisfaction.
To investigate, we examined the longitudinal relationships of anti‐fat bias with internalised weight bias among 3025 sexual minority men using random intercept cross‐lagged panel models. We contend that, if the WBIS‐M adequately captures anti‐fat bias, these constructs should be strongly associated across time.
To the contrary, we found medium cross‐lagged (longitudinal) relationships of these constructs over time (βs 0.07–0.08), and a small between‐person association of these constructs (β = 0.10). The limited strength o these effects suggests that the WBIS‐M does not adequately capture anti‐fat bias to the extent that existing definitions suggest it should. Researchers must be cognisant of what measures capture, and consider what scales most appropriately capture the components of weight stigma they want to assess.
10. Hudson, A., Batalha, L., & Ciarrochi, J. (2025). Higher-weight social identity as a risk and protective factor in the negative health consequences of weight stigma: A systematic review. International Journal of Obesity. Advance online publication. https://doi.org/10.1038/s41366-025-01755-z
Full text available for download at: https://tinyurl.com/yc2enf2e
ABSTRACT. Background: Weight stigma causes significant physical and psychological harm to its targets. Objective: This review aims to determine when identifying as a member of the higher-weight group exacerbates versus mitigates the adverse effects of weight stigma. Methods: Searches were conducted on 10 January, 2025, using PsycInfo, Medline, Scopus, Web of Science, Embase, and CINAHL. Evidence was synthesised in terms of exacerbating versus protective effects of higher-weight social identity (as moderator/mediator) in the relationship between weight stigma and 18 distinct health outcomes. This review is registered on PROSPERO (ID: CRD42023415639).
Results: Fourteen studies met the inclusion criteria. Studies employing weight status measures to assess higher-weight social identity identified actual and self-perceived higher-weight as risk factors for anticipated rejection, dietary control challenges, increased physiological stress and greater functional disability following stigmatisation. Conversely, studies measuring individual connection with the higher-weight group revealed that stronger identification had protective effects on self-esteem and distress, but only for specific individuals (e.g., those with low internalised weight bias). Limitations: Grey literature and unpublished studies were not reviewed
Conclusions: Initial evidence suggests that higher-weight social identity functions as both risk and protective factor in the relationship between weight stigma and well-being. Implications: Future research should explore the emotional and evaluative components of higher-weight social identity to enhance understanding of how and when group membership influences the adverse effects of weight stigma. This knowledge can inform targeted interventions designed to improve the well-being of higher-weight individuals.
11. Pacanowski, C. R., Vizthum, D., Katz, S. E., Skubisz, C. (2025). Weight bias among undergraduate women with health-related majors: A systematic review. Journal of Eating Disorders, 13, 108. https://doi.org/10.1186/s40337-025-01275-1
Full text available for download at: https://tinyurl.com/37vj965y
ABSTRACT. Background: Weight bias in healthcare has negative consequences for both patients and providers. While weight bias has been examined among healthcare professionals, understanding levels of bias during education may aid in understanding when bias is most salient and allow for targeted intervention to reduce bias. The objective of this systematic review was to describe the levels of explicit, internalized, and implicit weight bias among undergraduate women majoring in health-related fields.
Methods: This review was pre-registered with PROSPERO (CRD42023478263). A systematic literature search was conducted using PubMed, APA PsycINFO (Proquest), CINAHL Plus with Full Text, Web of Science, and Cochrane Library (CENTRAL). Search terms centered on weight bias and undergraduate students studying health-related topics. Original research studies available in English that presented data on weight bias outcomes and presented data in the publication or provided data after being contacted for undergraduate women in health-related majors were included. Study quality was assessed with the Joanna Briggs Institute critical appraisal tool. Mean scores for quantitative scales and themes from qualitative studies were extracted and summarized
Results: The search produced 681 results; 14 studies were found eligible representing 3,260 women from eight countries. Eight different quantitative scales were used across 12 studies to assess aspects of weight bias; one assessed implicit weight bias and one subscale assessed internalized weight bias. Two of the 14 studies used qualitative methods. Most studies reported low or moderate weight bias but most scale developers did not include cut points. Scales relating to controllability of obesity or blame had scores most indicative of weight bias.
Discussion: Undergraduate women in health-related majors have levels of explicit weight bias similar to levels that have been reported in healthcare professionals. There have been limited studies assessing internalized weight bias, implicit weight bias, and qualitative assessments in undergraduate women majoring in health-related fields.