In plain language
Weight stigma — being socially devalued because of body weight — causes real psychological and physical harm, from depression and anxiety to weight gain, and attempts to reduce society-wide bias have had limited success. This review asked a different question: when does identifying as a member of the higher-weight group make the harm of stigma worse, and when does that same group identity actually protect people? Two theoretical traditions make opposite predictions — the weight-based social identity threat model treats the identity as a risk factor, while the social cure framework suggests group belonging can be protective.
The authors systematically searched six databases (PsycInfo, Medline, Scopus, Web of Science, Embase, and CINAHL) in January 2025 and synthesised the evidence on higher-weight social identity as a moderator or mediator between weight stigma and 18 distinct health outcomes. Fourteen studies met the inclusion criteria, and the review was pre-registered on PROSPERO.
The answer turned out to be both. When studies measured identity simply as actual or self-perceived higher weight, that status functioned as a risk factor — amplifying anticipated rejection, dietary control problems, physiological stress, and functional disability after stigmatising experiences. But when studies measured a person's felt connection with the higher-weight group, stronger identification protected self-esteem and reduced distress — though only for certain people, such as those with low internalised weight bias. The findings point to the emotional and evaluative side of group identity as a promising target for interventions that help higher-weight people withstand stigma.
Key findings
- Fourteen studies met inclusion criteria, spanning seven measures of weight stigma, five ways of operationalising higher-weight social identity, and 18 distinct health outcomes.
- Actual and self-perceived higher weight acted as risk factors: they were associated with greater anticipated weight-based rejection, dietary control challenges, increased physiological stress (including cortisol reactivity), and greater functional disability following stigmatisation.
- In contrast, stronger felt connection and identification with the higher-weight group had protective effects on self-esteem and psychological distress.
- These protective effects were conditional, emerging only for specific individuals — for example, those with low internalised weight bias.
- The evidence supported both the weight-based social identity threat model (identity as risk) and the social cure framework (identity as protection), depending on how identity was measured, the outcome examined, and moderating factors.
- The four studies examining identity as a protective factor included 3,017 participants; results across the field were too heterogeneous for meta-analysis, highlighting the need for research into the emotional and evaluative components of higher-weight identity.
How to cite
APA
Hudson, A., Batalha, L., & Ciarrochi, J. (2025). Higher-weight social identity as a risk and protective factor in the negative health consequences of weight stigma: A systematic review. International Journal of Obesity, 49, 1209–1228. https://doi.org/10.1038/s41366-025-01755-z
BibTeX
@article{hudson2025higher,
author = {Hudson, Alice and Batalha, Luisa and Ciarrochi, Joseph},
title = {Higher-weight social identity as a risk and protective factor in the negative health consequences of weight stigma: a systematic review},
journal = {International Journal of Obesity},
year = {2025},
volume = {49},
pages = {1209--1228},
doi = {10.1038/s41366-025-01755-z}
}
Related work
- All publications by Joseph Ciarrochi (searchable, with free PDFs)
- Process-Based Therapy & Idionomic Analysis
Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.