# A weight stigma-informed model to improve energy intake assessment

> **NIH NIH R21** · VIRGINIA POLYTECHNIC INST AND ST UNIV · 2022 · $246,492

## Abstract

1 PROJECT SUMMARY
 2 Underreporting of energy intake among people with overweight and obesity is widely acknowledged
 3 as a problem in nutrition research. As a majority (74%) of U.S. adults experience overweight/obesity,
 4 and as most of adults with overweight/obesity report experiencing weight stigma in the form of teasing,
 5 bullying, discrimination, rejection, or other unfair treatment that indicates social devaluation due to
 6 body weight, it is imperative that dietary assessment methods are improved to address factors specific
 7 to weight status, such as stigma, that may influence reporting accuracy. Weight stigma is associated
 8 with many negative psychosocial and health consequences, including impeding weight management
 9 efforts and contributing to disordered eating behaviors. For participants with a history of weight stigma,
10 underreporting of energy intake may be a coping mechanism for mitigating the anticipated negative
11 effects of weight stigma. To date, the impact of weight stigma on energy intake underreporting among
12 people with overweight/obesity is unknown. The overall objective of this R21 proposal is to establish
13 proof-of-concept for the relationship between weight stigma and energy intake underreporting for
14 adults with overweight/obesity. Adults (n=68; ≥18 yrs) with overweight/obesity (BMI ≥25 kg/m2) will
15 complete a crossover investigation to determine associations between weight stigma (anticipated,
16 perceived, and internalized weight stigma) and energy intake underreporting, determined by
17 comparing reported energy intake from interviewer-administered 24-hr dietary recalls to objectively
18 measured total energy expenditure from a 10-day doubly-labeled water period (DLW). Participants will
19 be randomized into 1 of 2 dietary recall sequence periods, both with 10-days of DLW, separated by a
20 20-day washout: Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) first,
21 followed by interviewer-administered dietary recalls during the second period, or vice versa.
22 Participants will complete validated assessments of weight stigma, dieting history, social desirability,
23 body size dissatisfaction, and binge eating prior to randomization. This research may help to inform
24 obesity treatment protocols by increasing recognition of negative impacts of weight stigma on health
25 and addressing self-reported dietary intake limitations in adults experiencing overweight/obesity. This
26 research could have public health impact by informing U.S. dietary surveillance methods and
27 guidelines by providing a model that is responsive to the impact of weight stigma on dietary
28 assessment accuracy. This approach may provide an improved self-reported energy intake approach
29 that will allow for future correction of underreporting in adults with overweight/obesity.

## Key facts

- **NIH application ID:** 10589552
- **Project number:** 1R21NR020405-01A1
- **Recipient organization:** VIRGINIA POLYTECHNIC INST AND ST UNIV
- **Principal Investigator:** Valisa Hedrick
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $246,492
- **Award type:** 1
- **Project period:** 2022-09-22 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10589552

## Citation

> US National Institutes of Health, RePORTER application 10589552, A weight stigma-informed model to improve energy intake assessment (1R21NR020405-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10589552. Licensed CC0.

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