# The impact of weight and race on perceptions of anorexia nervosa: a replication and extension of Varnado-Sullivan et al. (2020)

## TL;DR

This study explores how weight and race influence perceptions of anorexia nervosa, finding that weight has a stronger impact than race on stigma and treatment perceptions.

## Contribution

The study replicates and extends prior work by examining weight and race interactions in anorexia nervosa stigma and mental health literacy.

## Key findings

- Vignette weight significantly predicted mental health stigma, weight stigma, and mental health literacy.
- Race did not significantly predict stigma or mental health literacy, but there was a significant Race x Weight interaction for weight stigma.
- Weight-based bias was observed for individuals with eating disorders, with some race-weight interactions.

## Abstract

This study examined how weight and race impact mental health stigma, weight stigma, perceived need for treatment, and perceived severity of anorexia nervosa We experimentally manipulated weight and race, replicating and extending Varnado-Sullivan et al. (Eat Weight Disord 25:601–608, 2020).

336 participants were recruited from Prolific. Participants self-reported pre-existing exposure to and attitudes regarding mental illness. Participants were randomly assigned to read an anorexia nervosa vignette that manipulated race (White or Black) and weight (“underweight” or “obese”). Participants self-reported attitudes about the woman in the vignette (mental health stigma), weight stigma, and perceived need for treatment and severity of the condition (mental health literacy). We hypothesized that greater mental health stigma, weight stigma, and lower mental health literacy would be present for Black and higher-weight vignettes, controlling for covariates.

Analyses found that only vignette weight significantly predicted mental health stigma, mental health literacy, and weight stigma; vignette race did not significantly predict mental health stigma, mental health literacy, or weight stigma. A significant Race x Weight interaction predicted weight stigma and two mental health stigma items.

Replicating and extending Varnado-Sullivan et al. (Varnado-Sullivan et al. in Eat Weight Disord 25:601–608, 2020), we found weight-based bias for those with eating disorders, with some interactions between weight and race on weight stigma.

The online version contains supplementary material available at 10.1007/s40519-025-01748-x.