Weight stigma is a consequence of discriminatory practices against individuals and negative beliefs towards other individuals based on their weight and appearance (e.g., that they are lazy, lack power, and are selfish) [1, 2]. Moreover, weight stigma has been identified as a social identity threat for individuals who are higher weight. Weight stigma increases the risk for many negative health consequences (e.g., emotional distress, cognitive deficits, eating disturbances) and is a barrier to health and well-being [1]. In addition to individuals who are higher weight, weight stigma has a negative impact on individuals across the weight spectrum [3]. Individuals’ misperceiving their actual weight status (i.e., higher weight, and underweight) is a potential risk factor among participants with average weight status that can increase psychological distress and the perception of weight stigma [3,4,5].

According to weight stigma evidence, its rapid spread is significant among individuals with higher weight [6,7,8]. Recent research found that almost 60% of participants (with higher weight) in Western countries (e.g., Australia, Canada, France, France, United States and United Kingdom) have experienced weight stigma [9]. Likewise, weight stigma is prevalent across Asia (especially, in China) [10]. The findings in China have shown that about 30% – 60% of the participants with higher weight have reported exposure to weight stigma and increased risk of experienced weight stigma [10, 11]. Moreover, a previous systematic review reported that there is increasing weight stigma research in Asia and that additional studies are needed to understand the extent of weight stigma [12].

Weight stigma includes negative stereotypical attitudes (e.g., beliefs that those who are higher weight are lazy, unattractive, etc.), and it might result in prejudice (e.g., negative attitudes towards those who are higher weight) and acts of discrimination (e.g., unfair treatment or social rejection) [6, 7]. Weight stigma is reported across several distinct settings and sources, including interpersonal sources (i.e., friends/peers, parents, significant others, and strangers) and non-interpersonal sources (i.e., television, movies, print media, and online media) [13]. Moreover, the effects of weight stigma might differ based on the sources of weight stigma [13]. Therefore, further research on contextual factors (i.e., interpersonal and non-interpersonal) is needed to understand weight stigma’s major sources and outcomes.

Scholars have operationally defined stigma as a social phenomenon that must include: (i) labelling, (ii) negative stereotyping, (iii) linguistic separation, and (iv) power asymmetry [14]. Stigma (with weight stigma being a common type) can be conceptualized into public stigma or personal stigma [7]. Public stigma is defined as the response of the public to those in specified groups (i.e., mental health illness) while personal stigma is defined as those in specified groups experiencing prejudice directly [7]. Moreover, personal stigma may also be described as having three essential features: (i) self-stigma (a reaction that accepts and endorses stereotypes within the self), (ii) perceived stigma (awareness of diminishing stereotypes, prejudice, and discrimination about the self), and (iii) experienced stigma (receiving prejudice and discrimination from other individuals), and these types of stigma may be observed through the three aforementioned components (i.e., stereotypes, prejudice, and discrimination) [7, 13, 15, 16].

However, distinguishing these different types of stigma may be impeded by their similar characteristics, particularly in distinguishing between perceived stigma and experienced stigma [13, 15, 17]. Stigmatizing attitudes among the public can influence both perceived stigma and experienced stigma; individuals may perceive concomitant negative beliefs, stigmatizing attitudes, and discriminatory behavior from the general population [18, 19]. Indeed, public stigma (i.e., others’ negative stereotypes) may be even more powerful than personal stigma [20]. Moreover, individuals (irrespective of whether they are higher weight or not) may observe weight stigma from the general public, and those who are higher weight may observe weight stigma and have experienced weight stigma.

Individuals who are higher weight experience weight stigma and discrimination in many different settings: in the workplace (e.g., from employers, co-workers), in healthcare settings (e.g., from doctors, nurses), in school and education environment (e.g., from friends, teachers), in personal relationships (i.e., parents, children), and in the media [2, 13]. Based on the Cyclic Obesity/Weight-Based Stigma (COBWEBS) model, weight stigma is characterized as social devaluation and denigration toward individuals who associate with higher weight through their experiences and practices [21]. Moreover, weight stigma can be defined as a potential stressor among individuals with higher weight [21, 22]. When individuals (who perceive themselves as being of higher weight) have stress about self-weight, stress could increase their negative behavior, emotionally and physiologically (e.g., increased cortisol secretion, increased food intake, and increased weight gain) [21]. Those who have experienced weight stigma face social problems (i.e., social isolation) and poor psychological health (e.g., reduced self-esteem, body image distress, disordered eating behaviors), which can contribute to poor physical health (e.g., lack of motivation to exercise, high blood pressure) [6, 16, 22]. Additionally, weight stigma can lead to short-term and long-term negative physical and psychological health outcomes [3, 13, 19, 22,23,24,25,26].

Weight stigma originates from many sources [27], the most common being family members, strangers, and the media. Various sources of weight stigma can contribute to different negative health effects [16, 28]. A previous study reported that being treated unfairly by family members was strongly associated with negative emotional affect (i.e., depression) [28]. However, weight-based discrimination by strangers had somewhat lower negative emotional affect [28]. Furthermore, media sources could increase weight-biased attitudes among individuals who perceive themseves as being higher weight such as body dissatisfaction and reduced self-esteem [29]. Therefore, research is needed to examine different sources of weight stigma, which might improve the development of effective interventions to decrease weight stigma.

Due to the high prevalence of weight stigma and its relation to adverse health outcomes [3, 19, 22, 24, 26, 30, 31], weight stigma researchers have developed numerous instruments related to weight stigma to understand the prevalence of weight stigma and to identify specific symptoms [31, 32]. In the extant literature, there are various instruments that assess weight stigma originating from external sources. These include the Stigmatizing Situations Inventory (SSI) [33] the Interpersonal Sources of Weight Stigma (ISWS) [8], the Physical Appearance Related Teasing Scale (PARTS) [34], the Treatment-based Experiences of Weight Stigma (STEWS) [35], and the Fat Microaggressions Scale [36]. Empirical evidence has also demonstrated that these instruments are widely recognized internationally as effective tools for evaluating external sources of stigmatization or discrimination against individuals who are higher weight [8, 33,34,35,36]. The SSI, ISWS and PARTS focus on interpersonal sources to assess individuals’ weight stigmatization and experiences of weight stigmatization [8, 33, 34]. The STEWS concerns individuals’ experiences of weight stigma in eating disorders from healthcare providers and peers [35]. The FMS assesses frequency of occurrence of experienced fat-microaggressions from both interpersonal and media sources among individuals with higher weight [36]. However, to the best of the authors’ knowledge, to date, there is no existing instrument assessing external sources of weight stigma from both interpersonal and non-interpersonal sources among individuals with various types of weight status (i.e., underweight, average weight, and higher weight). Moreover, there is no instrument that asks individuals to indicate how frequently they observe weight stigma in their daily lives and environments across interpersonal and non-interpersonal sources. Therefore, developing scales that could assess various ranges of contexts within which weight stigma occurs, and understanding how this stigma develops might contribute to reducing the impact of individuals’ weight-based stigmatizing experiences.

Previous findings have suggested the importance of contextual factors or sources of weight stigma in capturing the full extent of individuals’ experiences of weight stigmatization [16]. Sources of weight discrimination might predict the severity and health consequences of the stigma [16]. Pinpointing the specific source of weight stigma may facilitate its reduction by enabling the direct change of the specific source [30]. Therefore, a better assessment of sources of weight stigma might help bring about better understanding and prevention strategies.

Previous research has proposed that weight stigma could emanate from various sources, particularly media and interpersonal sources [8, 13, 28, 30, 37]. Therefore, it is important to develop an instrument to assess the frequency of exposure to weight stigma from various media and interpersonal sources. The Weight Stigma Exposure Inventory (WeSEI) was developed to address this literature gap by expanding the ISWS and FMS [8, 36]. More specifically, the ISWS asks participants to rate their frequency of exposure to weight stigma from interpersonal sources (i.e., family members, doctors, classmates, sales clerks at stores, friends, co-workers/colleagues, mother, spouse, servers at restaurants, nurses, general community, father, employers/supervisors, sister, dieticians/nutritionists, brother, teachers/processor, authority figures or police, mental health professionals, son, daughter, other) [8]. The FMS asks participants to rate their experiences of fat-microaggression from both interpersonal sources (i.e., healthcare providers and strangers) and non-interpersonal sources (i.e., social media, television shows, movies) among individuals with higher weight [36].

The WeSEI collapses these interpersonal sources to four important groups of people (i.e., parents and siblings, friends/peers, significant others, and strangers) and non-interpersonal sources of exposure (i.e., social media, traditional media, television series/movies) from the ISWS and FMS [8, 36]. Therefore, the purpose of the present study was to develop and validate the WeSEI to assess observed weight stigma across interpersonal and non-interpersonal sources.