Abstract
Introduction
Weight stigma, or weight-based teasing or discrimination, has been experienced in physical activity settings by as many as 73% of youth with overweight or obesity and commonly results in decreased fitness regardless of weight status and decreased lifetime participation in physical activity. Despite its well-documented high prevalence and negative effects, it is unknown whether interventions aiming to increase physical activity among youth with obesity consider the barrier of experienced or anticipated weight stigma. To guide researchers and public health officials in designing effective physical activity interventions, this scoping review describes existing physical activity interventions and highlights the extent, if any, that they consider weight stigma in their design or implementation.
Main Body
The protocol for this scoping review was prospectively registered on the Open Science Framework and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for scoping reviews (PRISMA-ScR). Reference librarians conducted a literature search to capture published physical activity interventions targeting youth ages 11 to 18 with obesity in the United States since 2013. The databases searched were APA PsychInfo, CINAHL, Cochrane Libraries, PubMed, and Web of Science, resulting in 3,283 references. Using Covidence software, two reviewers blindly screened titles/abstracts and then completed a full text screen of the 301 publications that passed the initial screening process, discussing discrepancies until a consensus was reached. Reviewers identified 50 publications (describing a total of 40 interventions) that fit the inclusion criteria and were included in data extraction. One reviewer extracted data from the articles and a second reviewer confirmed the extractions to ensure accuracy. In addition to evaluating whether and how the interventions considered weight stigma, other elements that were extracted included details regarding the components of the intervention (e.g., content, setting, mode of delivery, targeted level of intervention, length), targeted outcomes (e.g., weight loss, fitness, self-efficacy), and sample characteristics (e.g., distribution of body mass index, age, gender, race/ethnicity).
Conclusion
Findings from this review showcases the various approaches that have been taken to encourage physical activity among youth with obesity, identifying the common characteristics of recent interventions to inform future intervention development. Findings demonstrate that very few of the interventions considered weight stigma in their design and/or implementation, highlighting an important gap that warrants attention in future studies.