Intersectionality in Weight Stigma Research: A Systematic Review of Empirical Evidence.

Abstract

BACKGROUND: Social stigma and discrimination based on body weight or size (weight stigma) contribute to inequities in healthcare access, yet research often treats weight stigma as a uniform exposure. Intersectionality has been invoked to address this limitation by situating weight stigma within intersecting systems of power and marginalization. However, how intersectionality is operationalized in empirical weight stigma research remains unclear. OBJECTIVE: To examine how intersectionality is theoretically conceptualized and analytically operationalized in empirical studies of weight stigma, and to synthesize main intersectional findings. METHODS: A PRISMA-guided systematic review was conducted using PubMed, Embase, PsycINFO, and Web of Science, with searches through December 12, 2024. Studies applying intersectionality in the context of weight stigma were included. Data were extracted on theoretical grounding, analytic strategies, measurement approaches, intersectional axes, outcomes, findings, and study quality. RESULTS: Twenty-one studies met the inclusion criteria (10 qualitative, 11 quantitative). Analytic approaches to intersectionality varied across studies. Four themes emerged: co-occurring stigma across identities, context-specific manifestations, group differences in weight stigma, and cumulative intersectional disadvantage. Across these themes, weight stigma co-occurred with other forms of marginalization and varied across intersecting social identities, contributing to differences in healthcare access and everyday social experiences, with heterogeneous patterns observed across populations. CONCLUSIONS: Findings indicate that weight stigma operates through co-occurring systems of marginalization and varies across intersecting social identities, with important implications for health equity. However, approaches to operationalizing intersectionality remain inconsistent, highlighting a need for greater alignment between theoretical frameworks and analytic strategies.