Talking About Weight with Children: Associations with Parental Stigma, Bias, Attitudes, and Child Weight Status

Parental weight stigma and bias can shape how parents talk about weight and health with their children, yet their interplay in Romania is unexplored. We examined how parents' experienced stigma, internalized bias, and explicit antifat attitudes relate to weight- and health-focused conversations with 5-17-year-olds, and whether these links vary by child weight status.

In a cross-sectional survey of 414 Romanian parents, we assessed stigma (teasing/unfair treatment), internalized bias (WBIS-M), antifat attitudes (AFA, UMBFAT), and frequency of health (healthy eating/PA) versus weight-focused talks and comments. BMI-derived child weight status was classified via WHO percentiles. Multivariate regressions and mediation analyses tested predictors and indirect effects.

Nearly 80% of parents discussed weight at least sometimes; higher child BMI percentile and parental internalized bias independently predicted more weight conversations (β = 0.44 and β = 0.25, both p < 0.001). Internalized bias mediated the effect of experienced stigma on weight talk (indirect effect = 0.105, 95% CI [0.047, 0.172]). Explicit antifat attitudes drove comments about others' weight (β = 0.17, p = 0.002). Health-focused talks were unrelated to stigma or bias but were more frequent among parents with higher education, better self-rated health, and lower BMI.

Parents' internalized weight bias-shaped by stigma-fuels weight-focused conversations, especially when children have higher BMI, while antifat attitudes underlie negative comments about others. Interventions should reduce parental internalized bias and train supportive, health-centered communication to curb weight stigma transmission.