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

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.