The impact of excess body weight on employment outcomes: A systematic review of the evidence

Viktorija Kesaite; Jane Greve

doi:10.1016/j.ehb.2024.101398

The impact of excess body weight on employment outcomes: A systematic review of the evidence

Econ Hum Biol. 2024 Apr 30:54:101398. doi: 10.1016/j.ehb.2024.101398. Online ahead of print.

Authors

Viktorija Kesaite¹, Jane Greve²

Affiliations

¹ MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Box 285 Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge CB2 0QQ, United Kingdom. Electronic address: Viktorija.Kesaite@mrc-epid.cam.ac.uk.
² VIVE - The Danish Center for Social Science Research, Herluf Trolles Gade 11, Copenhagen K 1052, Denmark.

PMID: 38718448
DOI: 10.1016/j.ehb.2024.101398

Abstract

Background: Excess body weight has been recognised as an important factor in influencing labour market outcomes. Several hypotheses explain the causal effect of excess body weight on employment outcomes, including productivity, labour supply, and discrimination. In this review, we provide a systematic synthesis of the evidence on the causal impact of excess body weight on labour market outcomes worldwide.

Methods: We searched Econ Lit, and Web of Science databases for relevant studies published from 1st Jan 2010-20 th Jan 2023. Studies were included if they were either longitudinal analysis, pooled cross-sectional or cross-sectional studies if they used instrumental variable methodology based on Mendelian Randomisation. Only studies with measures of body weight and employment outcomes were included.

Results: The number of potentially relevant studies constituted 4321 hits. A total of 59 studies met the inclusion criteria and were qualitatively reviewed by the authors. Most of the included studies were conducted in the USA (N=18), followed by the UK (N=9), Germany (N=6), Finland (N=4), and non-EU countries (N=22). Evidence from the included studies suggests that the effect of excess weight differs by gender, ethnicity, country, and time period. White women with excess weight in the USA, the UK, Germany, Canada, and in the EU (multi-country analyses) are less likely to be employed, and when employed they face lower wages compared to normal weight counterparts. For men there is no effect of excess weight on employment outcomes or the magnitude of the effect is much smaller or even positive in some cases.

Conclusions: This review has shown that despite ample research on the relationship between excess weight and employment status and wages, robust causal evidence of the effects of excess weight on employment outcomes remains scarce and relies significantly on strong statistical and theoretical assumptions. Further research into these relationships outside of USA and Western Europe context is needed.

Keywords: Employment outcomes; Excess body weight; Systematic review.