Weight bias among children and parents during very early childhood: A scoping review of the literature.

OBJECTIVE: Exposure to and endorsement of weight bias attitudes are risk factors for poor mental health and weight-related outcomes among children and youth. Better understanding early-emerging weight bias, and how parents of young children may influence development of weight bias, may help reduce its occurrence. Although early childhood (under 5 years) is a developmental period characterized by increasing social-cognitive abilities to categorize others based on external features such as weight, little is known about the emergence or socialization of very early weight bias. The aim of this review was therefore to investigate weight bias and its correlates among very young children and parents of very young children as potential socialization agents. METHODS: A comprehensive search strategy was used to search electronic databases for studies that examined weight bias attitudes among children and parents. The review included studies that assessed weight bias in children and/or parents of children ages 1-3 years old (some including 3-5 year-olds), and that were published in English between 2011 and 2021. RESULTS: Thirteen of the 1748 identified studies met inclusion criteria. Only two studies used a longitudinal design. Seven of eight studies of children used behavioral tasks to assess child weight bias; among the 10 studies including parents, 4 used interviews and 6 used questionnaires to assess parent weight bias. Children were found to display anti-fat and pro-thin bias, with bias more prevalent among older children. Positive associations between parent and child weight bias were found in four studies. CONCLUSIONS: Child weight bias emerges prior to age 3 years and shows some association with parent weight bias. Future research should employ longitudinal designs to characterize influences on emerging weight bias among very young children.

A systematic search and qualitative review of reporting bias of lifestyle interventions in randomized controlled trials of diabetes prevention and management.

BACKGROUND: Scholars have documented presumptions regarding the relationships between diet, exercise, weight, and type 2 diabetes. However, it is unclear to what extent researchers contribute to these presumptions, and how often these relationships are thoroughly delineated within the context of randomized controlled trials (RCTs). Thus, the aim was to conduct a systematic search and qualitative, thematic analysis of RCTs focusing on lifestyle interventions for diabetes prevention or management, to examine how researchers discuss body weight in 1) the rationale and design of their RCTs; and 2) their presentation and interpretation of their findings. METHODS: We completed an electronic search for records published between 2007 and November 2016. Selection criteria included: RCTs with a follow-up period of ≥12 months; adult participants with type 2 diabetes/pre-diabetes; lifestyle interventions classified as dietary, exercise, and/or behavioural; primary outcomes of incident diabetes and complications, mortality, cardiovascular disease, and quality of life; and secondary outcomes of glycemic control and blood pressure. Nineteen articles were identified for inclusion and subject to thematic content analysis. RESULTS: Obesity and weight loss figured prominently in the rationale and outcomes of the majority of the articles, despite intentional exclusion of "weight loss" and "obesity" as search terms. There was ambiguity over whether weight loss was classified as inclusive to the intervention, an outcome, or a measure of adherence. Results revealed that authors frequently engaged in "spin reporting" by pooling data from intervention and control groups to test the relationship between weight lost and outcomes and in their presentation of results. CONCLUSIONS: Researchers need to be aware of their biases and assumptions regarding body weight in designing, analyzing, and interpreting lifestyle interventions for diabetes prevention and management.