Introduction: Being stigmatized because of one’s weight can pose physical, mental, and social challenges. While weight stigma and its consequences are established throughout Europe, North America, and Australasia, less is known about weight stigma in other regions. The objective of this study was to identify the extent and focus of weight stigma research in Latin America, Asia, the Middle East, and Africa. Methods: A scoping review of weight stigma research in Latin America, Asia, the Middle East, and Africa was conducted. SCOPUS and PsychINFO databases were searched, and weight stigma experts were contacted to identify relevant literature. Sources were classified based on country/region, population, setting, and category of weight stigma researched. Results: A total of 130 sources were identified from 33 countries and territories. Results indicate that weight stigma has been investigated across populations and settings, mainly focusing on manifestations of weight stigma through experiences, practices, drivers, and personal outcomes of these manifestations. Conclusions: Weight stigma is a developing global health concern not restricted to Europe, North America, and Australasia. The extent and focus of weight stigma research in Latin America, Asia, the Middle East, and Africa vary between countries and regions leaving several research gaps that require further investigation.

Weight bias concerns the negative attitudes toward and beliefs about individuals due to their weight, while weight stigma is the social label attached to individuals who are the victims of prejudice because of their weight [1]. The prevalence and effects of weight bias and stigma toward people living with overweight or obesity – collectively referred to as weight stigma from here forward – have been well studied in Western societies [2, 3], with findings suggesting that weight stigma affects people within various contexts such as family, education, employment, and healthcare [3, 4]. Weight stigma can take a toll on individuals’ mental, physical, social, and financial well-being [3, 5]. In addition, this stigmatization can render public health efforts to address overweight and obesity ineffective or even nonexistent if public health professionals consider obesity an individual responsibility rather than a disease that has many physical, psychosocial, environmental, and commercial determinates [5]. Of note, despite growing global consensus that body mass index (BMI) should not be used to define and diagnose obesity [6‒8], we acknowledge that many researchers and practitioners continue this practice. Therefore, the term “obesity” will refer to individuals with a BMI of greater than or equal to 30 regardless of a clinical diagnosis.

As outlined in The Health and Discrimination Framework [9], stigmatization develops and is experienced not only through interpersonal interactions but also through organizations, communities, and public policy. These include the factors that promote stigmatization within individuals and societies, how stigma is manifested through experience and practice, and the outcomes of stigma both for people and organizations, thus impacting the overall health and social outcomes within a society.

While weight stigma research has been well conducted in Europe, North America, and Australasia, there is currently no broad understanding of the extent of weight stigma research in other parts of the world. The aim of this scoping review was to gain a preliminary understanding of the extent (how much) and focus (what, who, and where) of existing weight bias and stigma literature in areas within Latin America, Asia, the Middle East, and Africa.

A scoping review was conducted following the methodological framework outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) [10].

Eligibility Criteria

Eligibility criteria are detailed in online supplementary Table S1 (for all online suppl. material, see https://doi.org/10.1159/000536554). Criteria were selected to identify research conducted within Latin America, Asia, the Middle East, and Africa, as far back as the initial surge of weight stigma research around 2010 in Europe, North America, and Australasia, available in English, and directly assessed the topics of interest. The year of 2010 was determined based on preliminary searches of weight stigma research in PubMed and Scopus. For the purposes of this review, regions are defined based on the United Nations’ Sustainable Development Goals regional groupings [11]. See online supplementary Table S1 for details.

Information Sources

Literature searches were conducted in SCOPUS and PsycINFO databases. Weight stigma experts were contacted to identify additional sources absent from searches. Lastly, sources found through other means, such as searches done during an initial investigation into the topic, were also included.

Search Strategy

Search strategies were developed in conjunction with a reference librarian informed by reviews on similar topics (see online supplementary Tables S2 and S3 for search strategies) [12, 13].

Selection of Sources of Evidence

LE screened titles and abstracts, using the eligibility criteria discussed above. Relevant studies were exported to EndNote (Clarivate, London, UK) reference manager where duplicates were removed. In instances of uncertainty regarding eligibility, LE came to a consensus with OW regarding inclusion/exclusion. If unable to arrive at a consensus, uncertainties were resolved via discussions with all authors.

Data Extraction

Data were extracted into Microsoft Excel by LE. OW aided in this process when there were ambiguities in how to interpret data. OW checked 13 (10%) randomly selected sources and charted results in full to confirm consistency. Updating to the form and refining of the extracted data were done in an iterative manner as seen fit by the reviewers.

Data Synthesis

Data were synthesized into tables created for the overall results and each region and stratified by the population studied, setting, and the main study category. University students were highlighted as a subgroup as they are often used in research and possibly overrepresented [14].

A total of 182 unique sources were assessed for eligibility after initial screenings and hand sorting with an additional 22 added from other means for a total of 204. Of the 204, 130 met inclusion criteria. The PRISMA-ScR [15] flowchart is reported in online supplementary Figure S4, and condensed versions of extracted data tables can be found in online supplementary Tables S7–S13. Sources were found in 33 countries and territories spanning all regions of the inclusion criteria. Most sources (n = 67) have been published from 2018 and later, with more than 20 published in both 2019 and 2020.

Framework

The data extracted, results, and discussion of this review were inspired by the Health and Discrimination Framework [9]. This framework outlines how discrimination (stigma) not only manifests in society but also what contributes to it and what the outcomes of it are. Weight stigma manifestations through stigmatizing practices and experiences were the primary focus of this review. Factors that contribute to weight stigma – including personal drivers and societal facilitators – and outcomes of weight stigma – including personal and organizational outcomes – were not the primary focus of this review but were noted if evident in the sources. See online supplementary Figure S5 for an adapted visual representation of the framework.

Weight Stigma Research Categories

Seven categories of weight stigma research were identified: stigma practices; bullying, teasing, and victimization; stigmatizing encounters; internalization of weight bias; questionnaire development; addressing weight stigma; and stigmatizing images and texts. Descriptions, examples, and the prevalence of these weight stigma research categories are detailed in Table 1. The first four listed include forms of weight stigma manifestations as based on the Health and Discrimination Framework [9]. The remaining three are other forms of weight stigma research identified during the review.

Table 1.

Weight stigma research categories

Weight stigma research categoryn (%)Details
1. Manifestations of weight stigma 
 1.1 Stigma practices 42 (32.3) Focused on the attitudes, beliefs, phobias, stereotypes, and prejudices that participants hold against people with obesity. For example, an Israeli study found that physical therapy professionals and students exhibited negative attitudes toward people with obesity [12
 1.2 Bullying, teasing, and victimization 30 (23.1) Included bullying, teasing, and victimization toward children and adolescents, although some consider adult perceptions of these behaviors toward youth. For example, a Brazilian study found that being teased by family members increased the risk of unhealthy weight control behaviors [13
 1.3 Stigmatizing encounters 25 (19.2) Assessed the manifestation of weight stigma through stigmatizing experiences, mainly in adults. For example, Indian women with overweight or obesity experienced stigmatization, discrimination, body dissatisfaction, and other day-to-day problems and that these worsened with increased BMI [14
 1.4 Internalization of weight bias 10 (7.6) Focused on stigma toward oneself. For example, Hong Kong youth with overweight had higher levels of internalized weight bias and lower health-related quality of life than those without overweight [15
2. Other weight stigma research 
 2.1 Questionnaire development 11 (8.5) Included sources developing or adapting questionnaires to measure the manifestations of weight stigma, for example, validation of the Turkish version of the weight self-stigma questionnaire [16
 2.2 Addressing weight stigma 6 (4.6) Included ways of addressing weight stigma, and evaluations of policies and laws. For example, two studies from China investigated if mindfulness could help reduce the impact of weight stigma on mental health [17, 18
 2.3 Stigmatizing images and text 6 (4.6) Included media representations of people with obesity and/or their effects on weight stigma, for example, examining the content of a newspaper from São Paulo, Brazil showing prejudices against people with obesity, especially women [19
Weight stigma research categoryn (%)Details
1. Manifestations of weight stigma 
 1.1 Stigma practices 42 (32.3) Focused on the attitudes, beliefs, phobias, stereotypes, and prejudices that participants hold against people with obesity. For example, an Israeli study found that physical therapy professionals and students exhibited negative attitudes toward people with obesity [12
 1.2 Bullying, teasing, and victimization 30 (23.1) Included bullying, teasing, and victimization toward children and adolescents, although some consider adult perceptions of these behaviors toward youth. For example, a Brazilian study found that being teased by family members increased the risk of unhealthy weight control behaviors [13
 1.3 Stigmatizing encounters 25 (19.2) Assessed the manifestation of weight stigma through stigmatizing experiences, mainly in adults. For example, Indian women with overweight or obesity experienced stigmatization, discrimination, body dissatisfaction, and other day-to-day problems and that these worsened with increased BMI [14
 1.4 Internalization of weight bias 10 (7.6) Focused on stigma toward oneself. For example, Hong Kong youth with overweight had higher levels of internalized weight bias and lower health-related quality of life than those without overweight [15
2. Other weight stigma research 
 2.1 Questionnaire development 11 (8.5) Included sources developing or adapting questionnaires to measure the manifestations of weight stigma, for example, validation of the Turkish version of the weight self-stigma questionnaire [16
 2.2 Addressing weight stigma 6 (4.6) Included ways of addressing weight stigma, and evaluations of policies and laws. For example, two studies from China investigated if mindfulness could help reduce the impact of weight stigma on mental health [17, 18
 2.3 Stigmatizing images and text 6 (4.6) Included media representations of people with obesity and/or their effects on weight stigma, for example, examining the content of a newspaper from São Paulo, Brazil showing prejudices against people with obesity, especially women [19

Source Characteristics

The characteristics (i.e., populations, settings, category of weight stigma research) of sources are detailed in Table 2.

Table 2.

Source characteristics by population, setting, and category of weight stigma researched (n = 130)

PopulationSettingSPBTVSEIWBQDAWSSITTotal
Children/adolescents Education 15 18 
Family 
Multiple 
Other 21 
Total subcategory 28 46 
Adults (of which university students) Healthcare 18 27 
Education 
Work/finance 
Other 15 36 
Total subcategory 36 (16) 19 (5) 3 (2) 9 (5) 3 (2) 72 (30) 
Both adults and children/adolescents (of which university students) Education 
Work/finance 
Other 
Total subcategory 4 (1) 6 (1) 
No participants Healthcare 
Work/finance 
Other 
Total subcategory 
 Total 42 30 25 10 11 130 (31) 
PopulationSettingSPBTVSEIWBQDAWSSITTotal
Children/adolescents Education 15 18 
Family 
Multiple 
Other 21 
Total subcategory 28 46 
Adults (of which university students) Healthcare 18 27 
Education 
Work/finance 
Other 15 36 
Total subcategory 36 (16) 19 (5) 3 (2) 9 (5) 3 (2) 72 (30) 
Both adults and children/adolescents (of which university students) Education 
Work/finance 
Other 
Total subcategory 4 (1) 6 (1) 
No participants Healthcare 
Work/finance 
Other 
Total subcategory 
 Total 42 30 25 10 11 130 (31) 

Numbers in parentheses indicate the number of which sources included university students.

See online suppl. Tables S7–S13 for details on population, setting, and which category of weight stigma was researched in each of the sources.

SP, stigmatizing practices; BTV, bullying/teasing/victimization; SE, stigmatizing encounters; IWB, internalized weight bias; QD, questionnaire development; AWS, addressing weight stigma; SIT, stigmatizing images and texts.

Study Design

Over 80% (n = 106) of sources employed quantitative methods, and 102 of these were cross-sectional. An additional 20 (15.4%) sources used qualitative methods, which included cross-sectional interviews, content analyses, case studies, and a prospective cohort study. Three sources (2.3%) used cross-sectional mixed methods, and there was one (0.8%) legal commentary.

Populations and Settings

Over half of sources (n = 72, 55.4%) had adult participants, of which 31 (43.1% of sources with adult participants, 23.8% of total) used university students. Just over a third had child/adolescent participants (n = 46, 35.4%), with the remainder including both adult and child/adolescent participants (n = 6, 4.6%) or no participants (n = 6, 4.6%), which included sources that analyzed images and texts as well as ways to address weight stigma. Other than nonspecific settings, the most common setting weight stigma research was conducted within each population were as follows: children/adolescents within education (n = 18, 13.8%), adults within healthcare (n = 27, 20.8%), both children/adolescents and adults within work/finances (n = 2, 1.5%), and sources without participants within healthcare (n = 2, 1.5%).

Manifestations of Weight Stigma

Sources measuring the manifestations of weight stigma including both stigma practices and stigma experiences were the most common (n = 107, 82.3%). Studies regarding experiences of stigma demonstrated that people with obesity experience bullying, harassment, discrimination, and stigmatization in many areas of society including school, healthcare, family, employment, and public spaces. This can lead to such outcomes as poorer healthcare, eating disturbances, sleep disturbances, decreased levels of employment and wages, and poorer well-being overall, among others. Studies investigating stigma practices often assessed the contributors to and existence of stigma against people with obesity, but few examined the effects these attitudes had. Within children/adolescents, the most common category of stigma researched was bullying, teasing, and victimization (n = 28). Stigma practice studies were the most common in adults (n = 36).

Other Categories of Weight Stigma Research

The remaining categories of weight stigma research concerned questionnaire development (n = 11, 8.5%), addressing weight stigma (n = 6, 4.6%), and stigmatizing images and texts (n = 6, 4.6%) did not directly measure manifestations of weight stigma, although all questionnaires were developed to measure either stigma practices or experiences. Adults were most often used in the development of questionnaires (n = 9 of 11, 81.8%). Sources looking to address weight stigma, or rather confront and improve weight stigma, examined ways to improve care for people with obesity and confronted weight stigma in healthcare policy and employment. Studies that examined stigmatizing images and texts mainly identified the existence of media that stigmatized people with overweight or obesity as well as the stigmatizing effects rendered by the promotion of thin ideals in media.

Drivers, Facilitators, and Outcomes

Drivers (on a personal level), facilitators (on a societal/cultural level), personal outcomes (such as the development of mental health conditions), and/or organizational outcomes (such as creation of policies) were assessed in 100 (76.9%) of the sources, most often in relation to manifestations of weight stigma. Most common were drivers (n = 51, 39.2%) and/or personal outcomes (n = 48, 36.9%). Facilitators were considered in 25 (19.2%) of the sources, and organizational outcomes were considered in four (3.1%).

Among others, drivers of weight stigma manifestations that were investigated included factors such as socioeconomic status, participants’ BMI, participants’ feelings about their own weight, exposure to people with obesity (such as having someone with obesity in the family), participants’ attitudes toward obesity itself, and attitudes of participants’ family members toward people with obesity. For example, a study [16] with healthcare students in Chile found that having a desire for thinness predicted antiobesity attitudes.

Facilitators of weight stigma manifestations included such factors as media exposure, the general attitude toward people with obesity in the given community, policies and laws, and traditional versus modern lifestyles. A study [17] from Iran found that social barriers, such as humiliation from the community members, created a hindrance to losing weight for children with overweight or obesity.

Personal outcomes focused on the effects of weight stigma on physical, mental, and social health including the development of depression, eating disturbances, reduced quality of life, sleeping disturbances, isolation, reduced income, and unhealthy weight-control behaviors. Internalized weight bias and being teased about weight were found to be a predictor of eating disorder symptomatology in female university students in a study [18] from the United Arab Emirates.

Lastly, organizational outcomes discussed ways to reduce weight stigma for people through changes in practices and policies within healthcare settings and the law. A legal commentary [19] from South Africa discussed the need to have legal protections against people with overweight or obesity. For further details on which studies included drivers, facilitators, and/or outcomes, see online supplementary Tables S7–S13.

Source Location

The distribution of sources is depicted in Figure 1. Brazil, China, and Turkey had the most sources with over 10 each. Six to 10 sources were found from Mexico, Hong Kong, Iran, Taiwan, and in the multicountry studies. Two to five studies were found in Israel, Pakistan, India, South Africa, South Korea, Chile, Jamaica, Malaysia, the United Arabs Emirates, Columbia, Guatemala, Paraguay, and Peru. Lastly, Brunei, Dominica, Ecuador, Ghana, Japan, Nepal, Nigeria, Puerto Rico, Samoa, Saudi Arabia, the Seychelles, Singapore, and Uganda all had one study. For specific information on which countries are within each region and the number of sources found per region and country, see online supplementary Tables S7–S13.

Fig. 1.

Distribution of identified sources.

Fig. 1.

Distribution of identified sources.

Close modal

Latin America and the Caribbean (n = 45, 34.62%)

The stratification of sources mirrored those within the overall results, spanning all populations, settings, and study categories. Drivers, facilitators, and/or outcomes of weight stigma were assessed in 34 (75.6%) of the region’s sources.

Eastern and South-Eastern Asia (n = 34, 26.15%)

Sources from this region spanned all categories of weight stigma and 27 (79.4%) included drivers, facilitators, and/or outcomes. However, the populations and settings lacked some diversity. Notably, 26 (76.5%) of studies included children/adolescents and/or university students, including 19 of the 20 sources that evaluated personal outcomes of experiencing stigma.

North Africa and Western Asia (n = 20, 15.38%)

All but one study included adult participants (n = 19, 95%), with university students making up more than half (n = 10, 52.6%) of these. Studies focusing on stigma practices in adults within healthcare were the most common (n = 8, 40%). Drivers, facilitators, and/or outcomes were examined in 80% (n = 16) of the sources.

Central and Southern Asia (n = 16, 12.31%)

Populations studied included both children/adolescents and adults. Half (n = 5, 50%) of studies that included adults had university students as participants. Specific study settings included education (n = 3, 18.8%) and healthcare (n = 3, 18.8%). All study categories were represented except stigmatizing images and texts, and 75% (n = 12) included drivers, facilitators, or outcomes.

Sub-Saharan Africa (n = 8, 6.15%)

Experiences of weight stigma were examined in 75% (n = 6) of the sources. Notably, 50% (n = 4) of the sources examined weight stigma in employment/finances. Drivers, facilitators, or outcomes were examined in 62.5% (n = 5) of the sources.

Oceania (n = 1, 0.77%)

One study (0.8%) from Oceania out of Samoa was found. It examined stigmatizing practices within the healthcare system and addressed both the facilitators and personal outcomes of weight stigma.

Multicountry (n = 6, 4.62%)

Studies were considered multicountry if they contained three or more studies within the inclusion criteria and were in different regions. Three examined stigma practices in adult populations. The remaining sources included a study on bullying, teasing and victimization in children/adolescents, weight stigma in employment, and weight stigma found in images in texts. Of note, 83.3% (n = 5) of the sources examined facilitators of weight stigma. See online supplementary Tables S7–S13 for specific information on sources found in each region.

This scoping review aimed to identify and map the extent and focus of existing weight bias and stigma literature within Latin American, Asia, the Middle East, and Africa. We identified 130 weight stigma research articles and papers spanning 33 countries and territories, representing every region within the inclusion criteria, with an increase in the volume of published research since 2018. The extent of research varied between countries and regions, with most sources coming from Latin America and the Caribbean and Eastern and South-Eastern Asia with Brazil and China being the top two countries in which sources were found. This is a growing field of research in Latin America, Asia, the Middle East, and Africa. However, the uneven distribution of research indicates that further work is needed to address gaps in the global knowledge regarding weight stigma.

Study populations were of all ages including children, adolescents, and adults, and weight stigma was researched in multiple settings including healthcare, education, and work/finances. The focus of weight stigma research in these regions is comparable to that in Europe, North America, and Australasia. Weight bias and stigma research mainly focused on the manifestations of weight stigma as well as those factors that contribute to and the effects of these manifestations. The main categories of weight stigma research included seven foci: (i) stigmatizing practices; (ii) bullying/teasing/victimization; (iii) stigmatizing encounters; (iv) internalized weight bias, (v) questionnaire development; (vi) addressing weight stigma; and (vii) stigmatizing images and texts.

The findings in this review illustrate that weight stigma is a global health issue. While this does not indicate that all communities stigmatize people with overweight or obesity, one cannot assume that it does not exist. For example, we found stigma against people with overweight or obesity within the multicountry studies and those out of Nigeria [20], Ghana [21], Guatemala [22, 23], Dominica [24], and Jamaica [25‒27], where one may not expect to find stigma toward people with overweight or obesity based on traditional body norms. Even as far back as 2011, researchers Dhillon and Dhawan [28] saw that the influences of Western body size ideals were reaching India, provoking stigmatization against people with overweight or obesity. These findings present an opportunity for public health officials to be proactive in preventing and addressing and the stigmatization of people with overweight or obesity. For example, policies protecting both children and adults from being discriminated against based on weight – from those who are considered underweight to those with overweight or obesity – could be adopted regardless of current prevalence of weight stigma.

Many of the review sources indicate bullying among young people in educational settings and stigma within healthcare settings as two of the main areas to include interventions. Within schools and universities, anti-bullying policies as well as educating and training teachers and administrators about weight-based bullying and teasing could be a first step in addressing this issue. This is also something that needs to be done in Western countries where, as an example, only three states in the USA had weight listed as a risk factor for being bullied in their anti-bullying laws as of 2017 [29]. The impact of weight stigma in children and adolescents is also something that healthcare systems should be aware of, given the health outcomes faced by many young people who are stigmatized based on their weight.

Healthcare outcomes due to weight stigma, such as healthcare utilization or unfair treatment of people with overweight or obesity, were rarely examined in the sources in this review. However, the review did provide much evidence of weight bias attitudes and beliefs among healthcare professionals. Based on existing research throughout Western countries, negative attitudes among healthcare professionals could be influencing the quality of and access to healthcare for people with overweight or obesity [12, 30]. Therefore, efforts to reduce weight bias, among healthcare professionals, could have an impact on healthcare delivery and patient health outcomes [3, 12, 31, 32].

Interventions to address weight stigma look different depending on the setting and the types of resources that are available in respective healthcare systems. For example, societies that have established weight stigma among healthcare professionals would likely need to adopt tactics to address the unfair treatment of patients with overweight or obesity. These tactics can include educating healthcare professionals about both the genetic and social determinates of health and weight as well as the impacts of weight stigma, as suggested by Talumaa et al. [32]. In addition, focusing on patient health outcomes rather than weight has been shown to improve the experience of weight stigma within healthcare [32]. In contrast, societies where people with overweight or obesity have traditionally been celebrated and perhaps seen as a sign of good health would need to establish ways to address the disease of obesity as a health concern without creating shame or stigma about body size. It would also be helpful for healthcare systems within and across borders to work together in addressing weight stigma.

In addition, media or stigmatizing images and texts as facilitators of weight stigma should be addressed. Changing the narrative toward people with overweight or obesity could make a difference in how they are treated, as has been seen in other stigmatized diseases such as HIV/AIDS or substance misuse [33]. For example, schools and healthcare organizations could use of nonstigmatizing, body inclusive images to avoid further perpetuation of weight stigma. Governments and public health agencies could reframe obesity to avoid personal blame and stigmatizing language and images while including positive images of people of all shapes in sizes in their communication strategies.

Finally, there is a need for interventions to prevent and reduce weight stigma at organizational levels through laws and policies protecting people with overweight or obesity from stigmatization and discrimination [34]. Specific policies around this in employment could also be adopted [35]. For example, certain societies or occupations expect that applicants include a picture with their resume. This can lead to weight stigmatization when applicants with overweight or obesity are less likely to be hired for the job, as exemplified from studies from Mexico [36] and Europe [37]. By omitting pictures or other means that create opportunities for people to be judged on their weight rather than their competencies, equality in employment could start to improve.

  • Systematic Review of Current Evidence. To further understand weight stigma throughout Latin America, Asia, the Middle East, and Africa, a systematic review of the available literature should be done. This systematic review should include an updated literature search to include more recent research.

  • More Research Overall. If and how weight stigma is enacted across societies cannot be known unless research is undertaken. There are many intricacies regarding how weight stigma develops, manifests, and affects people depending on who and where they are given the extent of diversity within and between communities, countries, and regions. It is particularly important that this is reflected in research in areas where weight stigma may not be as evident as others.

  • Participant Samples and Settings. Representing a comprehensive view of weight stigma across demographics and settings is necessary. Studies including specific age groups within various settings such as healthcare, education, and employment were commonly researched. It may be prudent to expand this research into other settings such as government agencies since they can impact laws and policies to protect people with overweight or obesity from discrimination. In addition, a recent study [38] comparing six Western countries found that over 75% of participants from all countries had experienced weight stigma from family members. Given this finding, research on weight stigma in the home should also be included to see if this is true in other parts of the world.

  • Study Design. It is necessary to employ a variety of study methods to understand weight stigma more broadly, particularly in areas where weight stigma seems to be emerging. Longitudinal studies are necessary to determine the long-term impacts of weight stigma on individuals and society; changes in weight stigma over time including the drivers, facilitators, manifestations, and outcomes of those changes; and the effects of policy or legal changes related to weight stigma. In addition, qualitative and mixed methods designs would help researchers understand the experiences and perspectives of people stigmatized due to having overweight or obesity.

  • International Studies. Examining weight stigma across societies will be important, especially in the consideration of the drivers and facilitators of weight stigma. By having these larger international studies, areas and populations can be illuminated as potential sources of weight stigma that may not otherwise be identified. While this review found a total of 11 sources (six in the multicountry group and five others) that included more than one country, representing 8.5% of the total, only 1% of weight stigma research worldwide includes international studies, making these types of investigations a priority for researchers in the Western regions as well [34].

This scoping review provides the first comprehensive overview of the existing weight bias literature from areas within Latin America, Asia, the Middle East, and Africa. Because this review was limited to sources available in English, further research that includes sources in other languages is warranted to map where weight stigma is being researched more broadly. While the existence of drivers, facilitators, and outcomes of weight stigma in research was assessed in this review, a further review regarding the specific contributors and effects of weight stigma in different countries and regions is warranted. For example, many of the studies included the drivers and facilitators of weight stigma. A review could be conducted regarding what those are and if they differ between countries and/or regions.

Our findings indicate that weight bias and stigma exist globally and to ignore this issue risks perpetuating health and social inequalities. There is a growing body of research into weight stigma throughout Latin America, Asia, the Middle East, and Africa, which arguably suggests an increasing awareness of weight stigma and its negative impacts. Given the vast research gaps, it would be beneficial to employ collective efforts, driven by local experts and researchers, in addressing this global health concern. This will also help to create an understanding of weight stigma that transcends borders and can be applicable to societies around the world and allow for a cohesive front in addressing weight stigma.

We would also like to thank the staff at the Biomedical Library at the University of Gothenburg for their assistance with the search methods for this study.

An ethics statement is not applicable because this study is based exclusively on the published literature.

Ms. Eggerichs, Dr. Wilson, and Dr. Chaplin have nothing to disclose. Dr. Ramos Salas reports research consulting fees from Obesity Canada during this study. She also reports consulting fees from the European Association for the Study of Obesity and the World Health Organization, as well as grants from the Canadian Institutes of Health Research, Social Sciences and Humanities Research Council, and Novo Nordisk outside of the submitted work. Dr. Ramos Salas is the CEO of K&X Ramos AB – a research consulting agency in Sweden and a co-founder of Replica Communications – a global research and communications agency.

This study was not supported by any sponsor or funder.

X.R.S. conceived of the presented idea. L.E. carried out the data collection, sorting, and analysis with support of O.W. L.E. wrote the manuscript with support of O.W., X.R.S., and J.E.C. X.R.S. and J.E.C. supervised the project.

All data generated or analyzed during this study are included in this article and its supplementary material files. Further inquiries can be directed to the corresponding author. An abstract [39] of this study was published at the 2022 European Congress on Obesity in a poster session.

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