Author ORCID Identifier

Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Suzanne Mazzeo

Second Advisor

Robin Everhart

Third Advisor

Scott Vrana

Fourth Advisor

Jessica LaRose

Fifth Advisor

David Coogan


Weight bias internalization (WBI; i.e., self-directed weight stigma or the degree to which individuals apply negative weight-based stereotypes to themselves), is problematic because it is associated with increased stress, emotional eating, healthcare avoidance, and exercise avoidance. Thus, WBI exacerbates health disparities and there is an urgent need to create treatments that address this concern. The current study examined the preliminary effectiveness of a previously developed online body gratitude journaling intervention (i.e., Expand Your Horizon) compared to an active control writing condition in emerging adult women with WBI. Racially/ethnically diverse women (N=100; n=49) or Expand Your Horizon (n=50). Both conditions completed three writing tasks over the course of a week. Assessments occurred at baseline, post-test (one-week), and follow-up (two-weeks). Results indicated women in both conditions experienced decreases in WBI at follow-up. Moreover, women in both conditions experienced significant decreases in body image issues, mental health concerns, and disordered eating symptomatology. However, women in the Expand Your Horizon condition experienced greater decreases in healthcare related stress compared to the active control condition. In contrast, women in the active control condition experienced greater increases in cognitive acceptance of physical activity compared to women in the Expand Your Horizon condition. Furthermore, WBI mediated treatment outcomes, which suggests that it is an important target for body image and mental health interventions. In sum, both writing interventions appear to be accessible, affordable, and effective treatments for women with WBI. Avenues for future research include testing this intervention in more diverse populations with a longer follow-up.


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