Bidirectional relationships between weight stigma and pediatric obesity: A systematic review and meta‐analysis

Abstract

Summary This study for the first time quantified concurrent and bidirectional relationships between weight stigma and weight status in children, with age and gender as moderators. A literature search was conducted in PubMed, Web of Science, and PsycINFO for studies examined associations between weight stigma and weight status among children aged 6–18 years. Twenty‐five studies (20 cross‐sectional studies and five longitudinal studies) from six countries with 101,036 participants were included in review, and 18 were included in meta‐analysis. Weight and height were self‐reported in nine studies, otherwise objectively measured. With data from 17 cross‐sectional studies and baseline portions of four longitudinal studies, meta‐analysis showed weight stigma and overweight/obesity were associated (pooled OR = 3.12, 95% CI: 2.71, 3.60), they were also associated across age and gender. Body mass index (BMI) was associated with greater weight stigma (pooled r = 0.38, 95% CI: 0.32, 0.43). Age modified such association. Weight stigma predicted increased BMI from three longitudinal studies (pooled β = 1.12, 95% CI: 0.78, 1.45); another two longitudinal studies reported BMI predicted greater weight stigma. Data were inadequate for age‐ or gender‐stratified analyses. Findings supported positive concurrent and bidirectional relationships between weight stigma and weight status. Timely obesity and weight stigma interventions to protect children well‐being are needed.

Complexity and Stigma of Pediatric Obesity

“…58 A recent meta-analysis found a significant association between weight stigma and overweight/ obesity, with a higher risk of overweight and obesity among young children compared with adolescents and among boys compared with girls. 59 Furthermore, this meta-analysis demonstrated that weight stigma and increased BMI were predictive of each other in longitudinal studies.…”

A meta-analysis of weight stigma and health behaviors.

“…To understand the magnitude of this relationship, it is worth considering the finding in juxtaposition with other meta-analytical evidence on weight stigma. For example, previous meta-analyses showed that weight stigma was positively associated with depression ( r = .41; Alimoradi et al, 2020) and body weight ( r = .38; Ma et al, 2021). This study, thus, demonstrated that the effects of weight stigma on unhealthy behaviors were on par with those on mental outcomes and weight status.…”

“…The relationship was stable, regardless of age, gender, coping strategies, and social support. Ma et al (2021) analyzed 18 studies on the relationship between weight stigma and weight status in children aged between 6 and 18. Weight stigma was found to predict about two times the increased risk of having higher body weight, especially among younger children and boys.…”

National childhood obesity‐related intervention systems and intervention programs in China in 1949 to 2020: A narrative review

“…These may have resulted in many changes in children’s energy intake and energy expenditure behaviors and contributed to a shift toward a positive energy balance (4,5). In parallel, the prevalence of overweight and obesity in Chinese children increased from 0.1% in 1985 to 19.4% in 2014 (6,7). Children with overweight or obesity face not only an increased risk of serious medical complications but also weight‐based stigma (8,9).…”