The association between parent-child weight-communication and indicators of children’s wellbeing: a meta-analysis

Abstract

Background: Many parents express concern that raising the issue of weight may risk harming their child’s physical self-perceptions and wellbeing. Such concerns can deter families from engaging with obesity prevention services. This systematic review aimed to investigate the evidence behind these concerns by analysing the association between parent-child weight-talk and child wellbeing. Methods: A systematic search of eight databases identified four intervention studies and 38 associative studies involving five to 18 year old children. Meta-analysis was only possible for the associative studies, for which weight-talk was categorized into four communication types (encouraging weight loss, encouraging healthy behaviours without reference to weight loss, criticising a child’s weight, and neutral/impersonal weight-talk), and effect size estimates for associations with wellbeing indicators (self-perceptions, depression, dieting and dysfunctional eating) calculated through a random effects model. Findings: Data from associative studies indicated that encouraging children to lose weight and criticizing weight were associated with poorer physical self-perceptions and greater dieting and dysfunctional eating practices. Conversely, the two studies reporting on parental encouragement of healthy lifestyles without explicit reference to weight both reported positive wellbeing outcomes. Of the four intervention studies, only one isolated the effects of parent communication training on child wellbeing, in which direct discussion of body and weight satisfaction with girls’ improved physical self-perceptions. Discussion: The findings indicate that some forms of parent-child weight-talk are associated with poor wellbeing, but that this is not inevitable. Encouraging healthy behaviours without reference to weight-control, and positive parenting practices acknowledging and addressing weight-concern may avoid such effects.