Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
Gender Inequality and Socio-Economic Disadvantages Associated With Obesity in Women Compared to Men: A Rapid Review and Meta-Analysis of Observational Studies From High-Income Countries.
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Danso Nana Ama Asi, Fahey Paul P, Naidoo Navindhra, Wu Rebecca, Atlantis Evan
Аннотация
OBJECTIVE: To assess whether obesity-related socio-economic disadvantages in wages, employment, and workplace discrimination equally affect women compared to men in high-income countries.
METHOD: We searched databases and Google Scholar from inception to March 2025. Data on wages, employment, and perceived discrimination were pooled using random-effects meta-analysis where possible. Primary effect measures were obesity-versus-comparison ratios for continuous outcomes (wage ratio, WR) and odds ratios (OR) for dichotomous outcomes, each with 95% confidence intervals (CI), stratified by women versus men. Heterogeneity was assessed using the I2 statistic and τ2.
RESULTS: From 3495 screened citations, 17 studies (2004-2021) were included. Pooled effect estimates suggested greater socio-economic disadvantages among women with obesity, although subgroup differences were not statistically significant (p > 0.05). Meta-analysis revealed a significant wage penalty overall (WR = 0.95, 95% CI: 0.91-0.99; I2 = 93.0%, τ2 = 0.003), which appeared larger for women (WR = 0.91, 95% CI: 0.82-1.01) than men (WR = 0.96, 95% CI: 0.95-0.98). The association between obesity and employment was nonsignificant overall (OR = 0.94, 95% CI: 0.86-1.02), with a larger effect estimate for women (OR = 0.86, 95% CI: 0.69-1.06) than men (OR = 0.96, 95% CI: 0.87-1.05). Individuals with obesity were over four times more likely to report workplace discrimination (OR = 4.62, 95% CI: 1.04-20.53), with a higher, but not statistically significant, estimate for women (OR = 5.65, 95% CI: 0.57-55.89) than men (OR = 4.37, 95% CI: 0.24-79.14). Narrative synthesis confirmed consistent wage and employment penalties for women with obesity across countries.
CONCLUSION: In high-income countries, obesity is associated with socio-economic disadvantages. A consistent pattern of stronger associations was observed for women, though statistical evidence for sex differences remains inconclusive.
METHOD: We searched databases and Google Scholar from inception to March 2025. Data on wages, employment, and perceived discrimination were pooled using random-effects meta-analysis where possible. Primary effect measures were obesity-versus-comparison ratios for continuous outcomes (wage ratio, WR) and odds ratios (OR) for dichotomous outcomes, each with 95% confidence intervals (CI), stratified by women versus men. Heterogeneity was assessed using the I2 statistic and τ2.
RESULTS: From 3495 screened citations, 17 studies (2004-2021) were included. Pooled effect estimates suggested greater socio-economic disadvantages among women with obesity, although subgroup differences were not statistically significant (p > 0.05). Meta-analysis revealed a significant wage penalty overall (WR = 0.95, 95% CI: 0.91-0.99; I2 = 93.0%, τ2 = 0.003), which appeared larger for women (WR = 0.91, 95% CI: 0.82-1.01) than men (WR = 0.96, 95% CI: 0.95-0.98). The association between obesity and employment was nonsignificant overall (OR = 0.94, 95% CI: 0.86-1.02), with a larger effect estimate for women (OR = 0.86, 95% CI: 0.69-1.06) than men (OR = 0.96, 95% CI: 0.87-1.05). Individuals with obesity were over four times more likely to report workplace discrimination (OR = 4.62, 95% CI: 1.04-20.53), with a higher, but not statistically significant, estimate for women (OR = 5.65, 95% CI: 0.57-55.89) than men (OR = 4.37, 95% CI: 0.24-79.14). Narrative synthesis confirmed consistent wage and employment penalties for women with obesity across countries.
CONCLUSION: In high-income countries, obesity is associated with socio-economic disadvantages. A consistent pattern of stronger associations was observed for women, though statistical evidence for sex differences remains inconclusive.