Can it be harmful for parents to talk to their child about their weight? A meta-analysis

Abstract

Many parents express concern that raising the issue of weight risks harming their child's physical self-perceptions and wellbeing. Such concerns can deter families from engaging with weight management services. This systematic review aimed to investigate the evidence behind these concerns by analysing the association between parent-child weight-talk and child wellbeing. A systematic search of eight databases identified four intervention studies and 38 associative studies. Meta-analysis was only possible for the associative studies; to facilitate more meaningful comparisons, weight-talk was categorized into four communication types and effect size estimates for the association between these and wellbeing indicators were calculated through a random effects model. Encouraging children to lose weight and criticizing weight were associated with poorer physical self-perceptions and greater dieting and dysfunctional eating (effect sizes: 0.20 to 0.47). Conversely, parental encouragement of healthy lifestyles without explicit reference to weight was associated with better wellbeing, but this was only measured in two studies. Of the four intervention studies, only one isolated the effects of parents' communication on wellbeing outcomes, reporting a positive effect. There was no effect of age on the strength of associations, but dysfunctional eating was more strongly associated with parent communication for girls than boys. The findings indicate that some forms of parent-child weight-talk are associated with poor wellbeing, but suggest that this is not inevitable. Encouraging healthy behaviours without reference to weight-control, and positive parental involvement in acknowledging and addressing weight-concern may avoid such outcomes. More longitudinal research is needed to analyse the direction of these effects.

The role of weight stigma in parental weight talk

“…While it is beyond the scope of our study to identify reasons for differences in weight talk between fathers and mothers, one potential explanation for this finding could be different perspectives of parents and children. Previous studies typically assess parental weight talk from the perspective of the child, as opposed to the parent, but studies that have compared reports of parents with those of their children have pointed to potential differences in frequency of weight talk . Furthermore, it may be that parental sex affects not just the frequency of weight talk, but the topics of these conversations and the sex of the child they engage with.…”

“…Frequency of parental comments about their own weight is associated with adolescent use of extreme weight control behaviours . In contrast, parental conversations with children that focus on healthy eating or being physically active, without talking about body weight, have no evidence for associations with negative health ramifications and may instead help prevent disordered eating behaviours …”

“…What parents say to their children about body weight can play an important role in children's body esteem and physical well‐being . “Parental weight talk” is a general term that has been used to describe weight‐related communication by parents with their children, such as parental encouragement of their child to lose or maintain weight (child‐centred weight conversations), encouragement to exercise/eat healthy without reference to weight (child‐centred health conversations), impersonal/indirect weight comments about oneself or others (parental weight comments), and weight criticism/teasing of their children …”

Teen, Parent, and Clinician Expectations About Obesity and Related Conditions During the Annual Well-Child Visit

“…35 At the family level, parental encouragement or criticism of a child's weight was associated with dysfunctional eating and dieting, and poorer physical self-perception and well-being. 36 However, parental receipt of weight information about their child did not yield negative effects on self-esteem or teasing. 37 In our study, while parents expressed concerns that the emotional impact of obesity be discussed by their child's provider, there was no mention of negative experiences with obesity screening; rather, this was considered expected.…”

Family members' experiences with adult participation in weight management programs: Triadic perspectives from patients, partners and children

“…Much less is known about the role that children play in their parents' or caregivers' weight loss attempts. 16 There is some research to indicate that parental weight loss efforts has negative consequences for children, such as the development of disordered eating behaviours, 17,18 as well as child weight loss efforts influencing parental weight. [19][20][21] Specifically, parental discussion about weight status, their own or their adolescent's, may increase the risk of developing eating disorders.…”