Sex and Gender Differences in Weight Bias Internalization: A Systematic Review and Meta-Analysis

Weight bias internalization (WBI) refers to individuals adopting negative stereotypes and self-derogatory beliefs about their weight. Despite substantial research on sex and gender differences in WBI, findings are mixed. To elucidate these differences, this systematic review with meta-analysis summarized and synthesized existing findings in this area and explored potential moderators contributing to the heterogeneity in previous studies. We conducted a literature search across five databases (PubMed, PsycINFO, Web of Science, ProQuest Dissertations, and Scopus) for studies published up to June 2024. A total of 100 studies were identified. Using random-effects models, we conducted four meta-analyses (i.e., biological males vs. biological females, cisgender boys and men vs. cisgender girls and women, cisgender boys and men vs. gender-diverse people, and cisgender girls and women vs. gender-diverse people). Results showed significant sex and gender differences in WBI, with biological females exhibiting higher WBI than biological males, cisgender girls and women having higher WBI than cisgender boys and men, and gender-diverse people having higher WBI than cisgender people. Geographic region and WBI measures were significant moderators in the meta-analyses for biological males versus biological females and cisgender boys and men versus cisgender girls and women. Also, the percentage of participants with overweight/obesity was a significant moderator in the meta-analysis for cisgender boys and men versus cisgender girls and women. These findings enhance our understanding of sex and gender differences in WBI, offering important theoretical and practical implications for future research and intervention.