Children's views of obesity, body size and weight: systematic review of UK qualitative evidence

Clinical Snapshot

Key Findings

• P Value: Not applicable (qualitative synthesis)

• Effect Size: Not applicable (qualitative synthesis)

• Primary Outcome: Children hold consistently negative views of overweight and obesity

• Nnt Or Sensitivity: High consistency across 34 studies with thematic saturation achieved

• Confidence Interval: Not applicable (qualitative synthesis)

Clinical Application

Findings directly applicable to clinical practice, health promotion, and anti-stigma interventions Highly relevant to Australian paediatric practice, school health programs, and RACGP childhood obesity guidelines. Findings support need for weight-neutral approaches in child health promotion consistent with emerging Australian clinical practice guidelines Children aged 4-12 years in developed healthcare systems with similar cultural contexts

Abstract

BACKGROUND: Understanding views about body size and weight is key to addressing both obesity and weight stigma. The views of younger children are not well understood and may differ in important ways from those of adults and young people. This review aimed to fill this gap. METHODS: Systematic review of qualitative evidence. We searched 19 database sources in February 2025 and included qualitative studies from the UK published since 2008 reporting data on children's (4-12 years) views of obesity, body size, body shape or weight. We assessed study quality using the Critical Appraisal Skills Programme checklist and conducted a thematic synthesis of the data. RESULTS: We included 34 studies. Study quality overall was fairly high. Children reported a range of perceived impacts of body weight, including health impacts, limitations on activities, bullying and teasing, which generated negative perceptions of overweight and fear of fatness. Ideas about body shape may be influenced by family members and by media or social media content. Children identified diet and physical activity as the main influences on body weight. There may be differences in views between girls and boys at older ages, although both are concerned about weight. We found very little data on differences relating to ethnicity or socioeconomic status. Children with overweight or obesity reported a pervasive experience of negative attitudes and bullying, which could be a barrier to participating in activities. CONCLUSION: Children, including very young children, generally hold very negative views of overweight and obesity. Overweight is seen to be linked with unhealthiness, limited agency and with being bullied. These links may influence how children understand messages about weight and health. PROSPERO REGISTRATION NUMBER: CRD42025650306.

References

1. 1.Lorenc, T., Burchett, H., Mendizabal-Espinosa, R., Stansfield, C., Sutcliffe, K., & Sowden, A. (2026). Children's views of obesity, body size and weight: systematic review of UK qualitative evidence. Journal of Epidemiology and Community Health. https://doi.org/10.1136/jech-2025-225045