Skip to main content
Log in

Health Consequences of Familial Negative Weight Talk Across the Spectrum of Gender Diversity

  • REVIEW
  • Published:
Current Nutrition Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To synthesize differences in familial negative weight talk and health-related correlates across gender identities and to highlight gaps relevant to the unique experiences and health correlates of boys and transgender and gender diverse youth.

Recent Findings

Most of the studies included in this review observed no difference by gender in familial negative weight talk health correlates. Gender biases in existing measures, however, may have contributed to underreporting of health correlates in boys. Moreover, transgender and gender diverse youth are severely underrepresented in this research.

Summary

Future research should consistently examine effect modification across gender identities and include measures that are specific to the weight-based concerns and experiences of boys and transgender and gender diverse youth.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Pearl RL, Puhl RM. Weight bias internalization and health: a systematic review. Obes Rev. 2018;19(8):1141–63. https://doi.org/10.1111/obr.12701.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. •• Puhl RM, Lessard LM. Weight stigma in youth: prevalence, consequences, and considerations for clinical practice. Curr Obes Rep. 2020;9(4):402–11. https://doi.org/10.1007/s13679-020-00408-8. Recent review of prevalence, sources, and health, social, and academic correlates of weight stigma among youth with overweight or obesity. This review delineates considerations for clinical care (e.g., acknowledging the presence of weight stigma in healthcare; using supportive and compassionate communication that respects adolescents' preferences for language related to weight).

  3. Palad CJ, Yarlagadda S, Stanford FC. Weight stigma and its impact on paediatric care. Curr Opin Endocrinol Diabetes Obes. 2019;26(1):19–24. https://doi.org/10.1097/med.0000000000000453.

    Article  PubMed  PubMed Central  Google Scholar 

  4. • Dahill LM, Touyz S, Morrison N, Hay P. Parental appearance teasing in adolescence and associations with eating problems: a systematic review. BMC public health. 2021;21(1):1–13. Recent systematic review of adolescents' experiences of parental weight- and appearance-related teasing and associated eating problems. This review highlights evidence of direct associations, as well as indirect associations (e.g., via negative self-evaluation), between parental teasing and disordered eating risk.

  5. • Yourell JL, Doty JL, Beauplan Y, Cardel MI. Weight-talk between parents and adolescents: a systematic review of relationships with health-related and psychosocial outcomes. Adolescent Research Review. 2021;6(4):409–24. https://doi.org/10.1007/s40894-021-00149-2. Recent systematic review of parental weight talk and negative health outcomes among youth ages 11–18. This review highlights preliminary findings that health-based conversations may be more productive and less harmful than weight-focused conversations.

  6. Ashley F. ‘Trans’ is my gender modality: a modest terminological proposal. Trans bodies, trans selves. 2021;2.

  7. Zhang Q, Goodman M, Adams N, Corneil T, Hashemi L, Kreukels B, et al. Epidemiological considerations in transgender health: a systematic review with focus on higher quality data. International Journal of Transgender Health. 2020;21(2):125–37.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Glossary of terms. https://www.hrc.org/resources/glossary-of-terms. Accessed 2023.

  9. Coelho JS, Suen J, Clark BA, Marshall SK, Geller J, Lam P-Y. Eating disorder diagnoses and symptom presentation in transgender youth: a scoping review. Curr Psychiatry Rep. 2019;21:1–10.

    Article  Google Scholar 

  10. Roberts SR, Salk RH, Thoma BC, Romito M, Levine MD, Choukas-Bradley S. Disparities in disordered eating between gender minority and cisgender adolescents. Int J Eat Disord. 2021;54(7):1135–46.

    Article  PubMed  Google Scholar 

  11. Strübel J, Sabik NJ, Tylka TL. Body image and depressive symptoms among transgender and cisgender adults: examining a model integrating the tripartite influence model and objectification theory. Body Image. 2020;35:53–62.

    Article  PubMed  Google Scholar 

  12. Brooks VR. Minority stress and lesbian women. Free Press; 1981.

  13. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lindley L, Galupo MP. Gender dysphoria and minority stress: support for inclusion of gender dysphoria as a proximal stressor. Psychol Sex Orientat Gend Divers. 2020;7(3):265.

    Article  Google Scholar 

  15. Eisenberg ME, Gower AL, McMorris BJ, Rider GN, Shea G, Coleman E. Risk and protective factors in the lives of transgender/gender nonconforming adolescents. J Adolesc Health. 2017;61(4):521–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Austin A, Holzworth J, Papciak R. Beyond diagnosis:“Gender dysphoria feels like a living hell, a nightmare one cannot ever wake up from.” Psychol Sex Orientat Gend Divers. 2022;9(1):12.

    Article  Google Scholar 

  17. Cooper K, Russell A, Mandy W, Butler C. The phenomenology of gender dysphoria in adults: a systematic review and meta-synthesis. Clin Psychol Rev. 2020;80: 101875.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Gillison FB, Lorenc AB, Sleddens EFC, Williams SL, Atkinson L. Can it be harmful for parents to talk to their child about their weight? A meta-analysis Prev Med. 2016;93:135–46. https://doi.org/10.1016/j.ypmed.2016.10.010.

    Article  PubMed  Google Scholar 

  19. Berge JM, Winkler MR, Larson N, Miller J, Haynos AF, Neumark-Sztainer D. Intergenerational transmission of parent encouragement to diet from adolescence into adulthood. Pediatrics. 2018;141(4). https://doi.org/10.1542/peds.2017-2955.

  20. Klinck M, Vannucci A, Fagle T, Ohannessian CM. Appearance-related teasing and substance use during early adolescence. Psychol Addict Behav. 2020;34(4):541–8. https://doi.org/10.1037/adb0000563.

    Article  PubMed  Google Scholar 

  21. Lessard LM, Puhl RM, Larson N, Simone M, Eisenberg ME, Neumark-Sztainer D. Parental contributors to the prevalence and long-term health risks of family weight teasing in adolescence. J Adolesc Health. 2021;69(1):74–81. https://doi.org/10.1016/j.jadohealth.2020.09.034.

    Article  PubMed  Google Scholar 

  22. Rodgers RF, Simone M, Franko DL, Eisenberg ME, Loth K, Neumark-Sztainer D. The longitudinal relationship between family and peer teasing in young adulthood and later unhealthy weight control behaviors: the mediating role of body image. Int J Eat Disord. 2021;54(5):831–40. https://doi.org/10.1002/eat.23492.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Rodgers RF, Wertheim EH, Damiano SR, Paxton SJ. Maternal influences on body image and eating concerns among 7- and 8-year-old boys and girls: cross-sectional and prospective relations. Int J Eat Disord. 2020;53(1):79–84. https://doi.org/10.1002/eat.23166.

    Article  PubMed  Google Scholar 

  24. Valois DD, Davis CG, Buchholz A, Obeid N, Henderson K, Flament M, et al. Effects of weight teasing and gender on body esteem in youth: a longitudinal analysis from the REAL study. Body Image. 2019;29:65–73. https://doi.org/10.1016/j.bodyim.2019.02.009.

    Article  PubMed  Google Scholar 

  25. Ra JS, Seu CK, Cho YH. Gender differences regarding parental teasing of Korean children’s weight and anti-fat attitudes. Journal of Korean Public Health Nursing. 2020;34(2):289–300. https://doi.org/10.5932/jkphn.2020.34.2.289.

    Article  Google Scholar 

  26. Trofholz AC, Tate A, Telke S, Loth KA, Buchanan GJ, Berge JM. Associations between weight talk and biopsychosocial outcomes in children from racially/ethnically diverse households. J Child Fam Stud. 2022. https://doi.org/10.1007/s10826-022-02351-9.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Oliveira S, Pires C, Ferreira C. Does the recall of caregiver eating messages exacerbate the pathogenic impact of shame on eating and weight-related difficulties? Eat Weight Disord. 2020;25(2):471–80. https://doi.org/10.1007/s40519-018-0625-8.

    Article  PubMed  Google Scholar 

  28. Lydecker JA, Riley KE, Grilo CM. Associations of parents’ self, child, and other “fat talk” with child eating behaviors and weight. Int J Eat Disord. 2018;51(6):527–34. https://doi.org/10.1002/eat.22858.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Berge JM, Trofholz A, Danner C, Brandenburg D, Pusalavidyasagar S, Loth K. Weight- and health-focused conversations in racially/ethnically diverse households with and without a child with overweight/obesity. Stigma and Health. 2020:No Pagination Specified-No Pagination Specified. https://doi.org/10.1037/sah0000268.

  30. Lawrence SE, Puhl RM, Watson RJ, Schwartz MB, Lessard LM, Foster GD. Family‐based weight stigma and psychosocial health: a multinational comparison. Obesity. 2023.

  31. Lawrence SE, Lessard LM, Puhl RM, Foster GD, Cardel MI. “Look beyond the weight and accept me”: adolescent perspectives on parental weight communication. Body Image. 2023;45:11–9.

    Article  PubMed  Google Scholar 

  32. • Puhl RM, Lessard LM, Foster GD, Cardel MI. A comprehensive examination of the nature, frequency, and context of parental weight communication: perspectives of parents and adolescents. Nutrients. 2022;14(8). https://doi.org/10.3390/nu14081562. Recent study of forms, prevalence, contexts, and preferences related to parent-adolescent weight communication using two samples of parents and adolescents in the USA. Study indicates that both positive and negative weight comments by parents were common, especially from mothers; about half of adolescents wanted parents to avoid talking about weight entirely.

  33. Chen D-R, Sun G, Levin B. Gender-specific responses to multifaceted factors associated with disordered eating among adolescents of 7th to 9th grade. J Eat Disord. 2022;10(1). https://doi.org/10.1186/s40337-021-00524-3.

  34. Didericksen KW, Berge JM, Hannan PJ, Harris SM, MacLehose RF, Neumark-Sztainer D. Mother-father-adolescent triadic concordance and discordance on home environment factors and adolescent disordered eating behaviors. Fam Syst Health. 2018;36(3):338–46. https://doi.org/10.1037/fsh0000325.

    Article  PubMed  PubMed Central  Google Scholar 

  35. •• Eisenberg ME, Puhl R, Areba EM, Neumark-Sztainer D. Family weight teasing, ethnicity and acculturation: associations with well-being among Latinx, Hmong, and Somali Adolescents. J Psychosom Res. 2019;122:88–93. https://doi.org/10.1016/j.jpsychores.2019.04.007. This study uses data from the 2017 LGBTQ National Teen Survey and is one of only a few studies to date to examine correlates of family weight teasing among a sample of sexually and/or gender minoritized adolescents. Family weight teasing was associated with indicators of poor psychosocial well-being, even when adolescents perceived their parents to have LGBTQ-accepting attitudes.

  36. Eisenberg ME, Puhl R, Watson RJ. Family weight teasing, LGBTQ attitudes, and well-being among LGBTQ adolescents. Fam Community Health. 2020;43(1):17–25. https://doi.org/10.1097/fch.0000000000000239.

    Article  PubMed  Google Scholar 

  37. Murray SB, Nagata JM, Griffiths S, Calzo JP, Brown TA, Mitchison D, et al. The enigma of male eating disorders: a critical review and synthesis. Clin Psychol Rev. 2017;57:1–11.

    Article  PubMed  Google Scholar 

  38. Dahill LM, Morrison NMV, Mannan H, Mitchison D, Touyz S, Bussey K, et al. Exploring associations between positive and negative valanced parental comments about adolescents’ bodies and eating and eating problems: a community study. J Eat Disord. 2022;10(1):43. https://doi.org/10.1186/s40337-022-00561-6.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Himmelstein MS, Puhl RM. Weight-based victimization from friends and family: implications for how adolescents cope with weight stigma. Pediatr Obes. 2019;14(1). https://doi.org/10.1111/ijpo.12453.

  40. Magson NR, Rapee RM. Sources of weight stigma and adolescent mental health: from whom is it the most harmful? Stigma and Health. 2022;7(2):152–60. https://doi.org/10.1037/sah0000380.

    Article  Google Scholar 

  41. Webb HJ, Kerin JL, Zimmer-Gembeck MJ. Increases in emotional eating during early adolescence and associations with appearance teasing by parents and peers, rejection, victimization, depression, and social anxiety. The Journal of Early Adolescence. 2021;41(5):754–77.

    Article  Google Scholar 

  42. Zipfel S, Schmidt U, Giel KE. The hidden burden of eating disorders during the COVID-19 pandemic. The Lancet Psychiatry. 2022;9(1):9–11.

    Article  PubMed  Google Scholar 

  43. Radhakrishnan L. Pediatric emergency department visits associated with mental health conditions before and during the COVID-19 pandemic—United States, January 2019–January 2022. MMWR Morb Mortal Wkly Rep. 2022;71.

  44. Ward ZJ, Rodriguez P, Wright DR, Austin SB, Long MW. Estimation of eating disorders prevalence by age and associations with mortality in a simulated nationally representative US cohort. JAMA network open. 2019;2(10):e1912925-e.

  45. Densham K, Webb HJ, Zimmer-Gembeck MJ, Nesdale D, Downey G. Early adolescents’ body dysmorphic symptoms as compensatory responses to parental appearance messages and appearance-based rejection sensitivity. Body Image. 2017;23:162–70. https://doi.org/10.1016/j.bodyim.2017.09.005.

    Article  PubMed  Google Scholar 

  46. Wardle J. Eating style: a validation study of the Dutch Eating Behaviour Questionnaire in normal subjects and women with eating disorders. J Psychosom Res. 1987;31(2):161–9.

    Article  CAS  PubMed  Google Scholar 

  47. Liu H-Y, Chang C-C, Gill DL, Wu S-C, Lu FJ. Male weight trainers’ body dissatisfaction and exercise dependence: mediating role of muscularity drive. Psychol Rep. 2019;122(6):2137–54.

    Article  PubMed  Google Scholar 

  48. Thornborrow T, Onwuegbusi T, Mohamed S, Boothroyd LG, Tovée MJ. Muscles and the media: a natural experiment across cultures in men’s body image. Front Psychol. 2020:495.

  49. Bommersbach TJ, McKean AJ, Olfson M, Rhee TG. National trends in mental health–related emergency department visits among youth, 2011–2020. JAMA. 2023;329(17):1469–77. https://doi.org/10.1001/jama.2023.4809.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Tomiyama AJ. Stress and obesity. Annu Rev Psychol. 2019;70:703–18.

    Article  PubMed  Google Scholar 

  51. Hemmingsson E, Nowicka P, Ulijaszek S, Sørensen TI. The social origins of obesity within and across generations. Obes Rev. 2023;24(1): e13514.

    Article  PubMed  Google Scholar 

  52. Romano KA, Lipson SK, Beccia AL, Quatromoni PA, Gordon AR, Murgueitio J. Changes in the prevalence and sociodemographic correlates of eating disorder symptoms from 2013 to 2020 among a large national sample of US young adults: a repeated cross-sectional study. Int J Eat Disord. 2022;55(6):776–89.

    Article  PubMed  PubMed Central  Google Scholar 

  53. •• Nagata JM, Ganson KT, Murray SB. Eating disorders in adolescent boys and young men: an update. Curr Opin Pediatr. 2020;32(4):476. Recent review of eating disorders in adolescent boys and young men. This review highlights common body image concerns among men, manifestations of disordered eating in boys and men, and the need for gender-tailored eating disorder treatment approaches.

  54. Gorrell S, Murray SB. Eating disorders in males. Child and Adolescent Psychiatric Clinics. 2019;28(4):641–51.

    Article  Google Scholar 

  55. Frederick DA, Garcia JR, Gesselman AN, Mark KP, Hatfield E, Bohrnstedt G. The Happy American Body 2.0: Predictors of affective body satisfaction in two US national internet panel surveys. Body image. 2020;32:70–84.

  56. McLean SA, Rodgers RF, Slater A, Jarman HK, Gordon CS, Paxton SJ. Clinically significant body dissatisfaction: prevalence and association with depressive symptoms in adolescent boys and girls. Eur Child Adolesc Psychiatry. 2022;31(12):1921–32.

    Article  PubMed  Google Scholar 

  57. Baker JH, Higgins Neyland M, Thornton LM, Runfola CD, Larsson H, Lichtenstein P, et al. Body dissatisfaction in adolescent boys. Dev Psychol. 2019;55(7):1566.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Andersen AE. Males with eating disorders. New Dir Ment Health Serv. 1986;1986(31):39–46.

    Article  Google Scholar 

  59. Rand-Giovannetti D, Cicero DC, Mond JM, Latner JD. Psychometric properties of the Eating Disorder Examination-Questionnaire (EDE-Q): A confirmatory factor analysis and assessment of measurement invariance by sex. Assessment. 2020;27(1):164–77.

    Article  PubMed  Google Scholar 

  60. Mitchell L, Murray SB, Cobley S, Hackett D, Gifford J, Capling L, et al. Muscle dysmorphia symptomatology and associated psychological features in bodybuilders and non-bodybuilder resistance trainers: a systematic review and meta-analysis. Sports Med. 2017;47:233–59.

    Article  PubMed  Google Scholar 

  61. Klimek P, Murray SB, Brown T, Gonzales M IV, Blashill AJ. Thinness and muscularity internalization: associations with disordered eating and muscle dysmorphia in men. Int J Eat Disord. 2018;51(4):352–7.

    Article  PubMed  Google Scholar 

  62. Veale D, Eshkevari E, Kanakam N, Ellison N, Costa A, Werner T. The Appearance Anxiety Inventory: validation of a process measure in the treatment of body dysmorphic disorder. Behav Cogn Psychother. 2014;42(5):605–16.

    Article  PubMed  Google Scholar 

  63. Schaefer MK, Salafia EHB. The connection of teasing by parents, siblings, and peers with girls’ body dissatisfaction and boys’ drive for muscularity: the role of social comparison as a mediator. Eat Behav. 2014;15(4):599–608.

    Article  PubMed  Google Scholar 

  64. Greenway CW, Price C. A qualitative study of the motivations for anabolic-androgenic steroid use: the role of muscle dysmorphia and self-esteem in long-term users. Performance enhancement & health. 2018;6(1):12–20.

    Article  Google Scholar 

  65. Williamson G, Osa ML, Budd E, Kelly NR. Weight-related teasing is associated with body concerns, disordered eating, and health diagnoses in racially and ethnically diverse young men. Body Image. 2021;38:37–48. https://doi.org/10.1016/j.bodyim.2021.03.010.

    Article  PubMed  Google Scholar 

  66. Garner DM, Olmsted MP, Bohr Y, Garfinkel PE. The eating attitudes test: psychometric features and clinical correlates. Psychol Med. 1982;12(4):871–8.

    Article  CAS  PubMed  Google Scholar 

  67. Cusack CE, Iampieri AO, Galupo MP. “I’m still not sure if the eating disorder is a result of gender dysphoria”: trans and nonbinary individuals’ descriptions of their eating and body concerns in relation to their gender. Psychology of Sexual Orientation and Gender Diversity. 2022.

  68. Romito M, Salk RH, Roberts SR, Thoma BC, Levine MD, Choukas-Bradley S. Exploring transgender adolescents’ body image concerns and disordered eating: semi-structured interviews with nine gender minority youth. Body Image. 2021;37:50–62.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Guss CE, Williams DN, Reisner SL, Austin SB, Katz-Wise SL. Disordered weight management behaviors, nonprescription steroid use, and weight perception in transgender youth. J Adolesc Health. 2017;60(1):17–22.

    Article  PubMed  Google Scholar 

  70. Testa RJ, Rider GN, Haug NA, Balsam KF. Gender confirming medical interventions and eating disorder symptoms among transgender individuals. Health Psychol. 2017;36(10):927.

    Article  PubMed  Google Scholar 

  71. Puhl RM, Himmelstein MS, Watson RJ. Weight-based victimization among sexual and gender minority adolescents: findings from a diverse national sample. Pediatr Obes. 2019;14(7): e12514. https://doi.org/10.1111/ijpo.12514.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Grammer AC, Byrne ME, Pearlman AT, Klein DA, Schvey NA. Overweight and obesity in sexual and gender minority adolescents: a systematic review. Obes Rev. 2019;20(10):1350–66.

    Article  PubMed  Google Scholar 

  73. Berge JM, MacLehose RF, Loth KA, Eisenberg ME, Fulkerson JA, Neumark-Sztainer D. Parent-adolescent conversations about eating, physical activity and weight: prevalence across sociodemographic characteristics and associations with adolescent weight and weight-related behaviors. J Behav Med. 2015;38(1):122–35. https://doi.org/10.1007/s10865-014-9584-3.

    Article  PubMed  Google Scholar 

  74. Puhl RM, Himmelstein MS, Watson RJ. Weight-based victimization among sexual and gender minority adolescents: implications for substance use and mental health. Health Psychol. 2019;38(8):727–37. https://doi.org/10.1037/hea0000758.

    Article  PubMed  PubMed Central  Google Scholar 

  75. Fraser G. Evaluating inclusive gender identity measures for use in quantitative psychological research. Psychology & Sexuality. 2018;9(4):343–57.

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Rebecca Puhl, Ph.D., for her feedback on this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Katherine M. Rancaño.

Ethics declarations

Conflict of Interest

Dr. Rancaño received funding from the National Institute of Diabetes And Digestive And Kidney Diseases of the National Institutes of Health (F31DK126399) and the Friedman School of Nutrition Science and Policy at Tufts University outside of the submitted work. No other disclosures were reported.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rancaño, K.M., Lawrence, S.E. Health Consequences of Familial Negative Weight Talk Across the Spectrum of Gender Diversity. Curr Nutr Rep 12, 581–593 (2023). https://doi.org/10.1007/s13668-023-00501-z

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13668-023-00501-z

Keywords

Navigation