Weight-related stigma and psychological distress: A systematic review and meta-analysis

Zainab Alimoradi; Farzaneh Golboni; Mark D Griffiths; Anders Broström; Chung-Ying Lin; Amir H Pakpour

doi:10.1016/j.clnu.2019.10.016

Weight-related stigma and psychological distress: A systematic review and meta-analysis

Clin Nutr. 2020 Jul;39(7):2001-2013. doi: 10.1016/j.clnu.2019.10.016. Epub 2019 Oct 31.

Authors

Zainab Alimoradi¹, Farzaneh Golboni¹, Mark D Griffiths², Anders Broström³, Chung-Ying Lin⁴, Amir H Pakpour⁵

Affiliations

¹ Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
² International Gaming Research Unit, Psychology Department, Nottingham Trent University, United Kingdom.
³ Department of Nursing, School of Health and Welfare, Jönköping University, Sweden.
⁴ Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong. Electronic address: cylin36933@gmail.com.
⁵ Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran; Department of Nursing, School of Health and Welfare, Jönköping University, Sweden. Electronic address: Pakpour_Amir@yahoo.com.

PMID: 31732288
DOI: 10.1016/j.clnu.2019.10.016

Abstract

Background & aims: Individuals who are overweight or who have obesity are likely to perceive or experience unfriendly treatment (i.e., weight-related perceived stigma) from different sources such as work colleagues because of the stigma towards excess weight. People who are overweight may accept such stigma and devalue themselves (i.e., weight-related self-stigma).

Methods: A systematic review and meta-analysis was conducted to examine the relationship between weight stigma (including weight-related self-stigma and weight-related perceived stigma) and psychological distress (including depression and anxiety) using random-effects meta-analyses. Utilizing five academic databases (PubMed, Scopus, WOS, Embase and ProQuest) and keywords related to weight stigma and psychological distress, empirical studies focusing on the association between weight stigma and psychological distress were selected. The timeline for the searched papers was from the inception of each database to the end of August 2019.

Results: Eligible studies (N = 30; 25 on weight-related self-stigma and eight on weight-related perceived stigma) were analyzed with a total of 9345 participants experiencing weight-related self-stigma, and 15,496 experiencing weight-related perceived stigma. The pooled associations were moderate between weight-related self-stigma and psychological distress (corrected Fisher's Z = 0.40 for depression; 0.36 for anxiety) and between perceived stigma and depression (Fisher's Z = 0.44).

Conclusions: Results of the meta-analysis demonstrated that weight stigma is associated with psychological distress. The comprehensive search of the literature and rigorous methodology employed are the two major strengths in the present study. Because self-stigma and perceived stigma are different concepts, their associations with psychological distress should not be merged together.

Keywords: Obesity; Psychological distress; Systematic review; Weight-related stigma.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Adolescent
Adult
Aged
Anxiety / diagnosis
Anxiety / psychology
Body Image / psychology*
Depression / diagnosis
Depression / psychology
Female
Humans
Male
Middle Aged
Obesity / diagnosis
Obesity / physiopathology
Obesity / psychology*
Psychological Distress*
Self Concept*
Stereotyping*
Weight Gain*
Weight Prejudice*
Young Adult