Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: A systematic review.

AIM: To summarize the associations between weight stigma and physiological and psychological health for individuals who are overweight or obese. BACKGROUND: Weight stigma can be defined as individuals experiencing verbal or physical abuse secondary to being overweight or obese. Weight stigma has negative consequences for both physiological and psychological health. DESIGN: A quantitative systematic review. DATA SOURCES: PubMed, PsycINFO, CINAHL and MEDLINE from 1 January 2008 - 30 July 2016. REVIEW METHODS: A systematic review was conducted using the Cochrane Collaboration guidelines, the PRISMA statement guidelines and the quality assessment from the National Heart, Lung and Blood Institute. Inclusion criteria consisted of quantitative studies that examined the associations between weight stigma and physiological and psychological health outcomes in adults who were overweight or obese. Exclusion criteria consisted of qualitative studies, literature reviews, expert opinions, editorials and reports on weight stigma without health outcomes or with behavioural outcomes and intervention studies that reduced weight stigma. A quality appraisal of the selected studies was conducted. RESULTS: A total of 33 studies met the eligibility criteria. Weight stigma was positively associated with obesity, diabetes risk, cortisol level, oxidative stress level, C-reactive protein level, eating disturbances, depression, anxiety, body image dissatisfaction and negatively associated with self-esteem among overweight and obese adults. CONCLUSION: Weight stigma is associated with adverse physiological and psychological outcomes. This conclusion highlights the need to increase public and professional awareness about the issue of weight stigma and the importance of the further development of assessment and prevention strategies of weight stigma.