Abstract
BACKGROUND: Weight stigma is an important public health concern due to its association with increased stress and adverse health outcomes, including poor metabolic health and weight gain. This study aimed to investigate the frequency and emotional impact of perceived weight stigma (PWS) during adolescence and its association with weight changes into young adulthood, with a focus on sex differences. We hypothesised that a high frequency of PWS during adolescence correlates with an increased emotional impact of PWS, that there are variations in PWS between sexes, and that PWS is associated with increased weight gain for both sexes. METHODS: A total of 2,466 young adults from Denmark were recruited for this cohort study. Participants recalled PWS from ages 15-20 via self-reported questionnaires at the ages 32/38. Self-reported weight and height were collected at age 21 and again at 32/38, allowing for calculation of BMI changes during follow-up (n = 1,772). For analysis, weight change was operationalised as a binary outcome: large BMI increases (above the 80th percentile) vs. all other. Logistic regression was used to examine the sex-specific frequency and emotional impact of PWS alongside BMI increases. RESULTS: Females reported significantly higher frequencies of PWS than males (0.5; 95% CI [0.27, 0.73]; p < 0.001). While females generally experienced higher emotional impact, males who reported high levels of emotional impact from stigma exhibited comparable risks of large BMI increases ((a)OR: females: 2.9; [1.9; 4.3], males: 2.4 [1.4; 4.3]). Contrary to our hypothesis, only modest correlations were found between the frequency of PWS and emotional impact (r = 0.31-0.61). CONCLUSIONS: The study confirms that weight stigma during adolescence is associated with significant weight increases in young adulthood in both sexes. Although females report more frequent and emotionally impactful experiences, males showed similar adverse BMI increases. These findings underscore the importance of considering sex-specific patterns in future research on long-term consequences of weight stigma.