A systematic review of ecological momentary assessment studies on weight stigma and a call for a large-scale collaboration

Background: Weight stigma is associated with poor mental health correlates in cross-sectional research. Researchers are increasingly using Ecological Momentary Assessment (EMA) methods, collecting comprehensive within-person data to understand the temporal nature of weight stigma and its biopsychosocial correlates. Aim: To systematically review EMA studies on the effect of weight stigma on biopsychosocial correlates and integrate the findings. Method: PsycINFO, CINAHL, Embase, Medline Complete, and Web of Science were searched and studies were doubled screened (H.B. and X.P.G.). Results: Twelve studies (N = 615) met our inclusion criteria. For both between- and within-subject effects, experienced and internalized weight stigmas were associated with negative correlates/outcomes (e.g., higher disordered eating and lower positive mood). However, studies differed in the correlate measures assessed, EMA methods used, and participant instructions provided. Given these inconsistencies, comparison across studies was difficult, and findings could not be reliably integrated. Conclusions: Consistent with previous research, studies from this review suggest weight stigma leads to adverse outcomes. EMA has the potential to overcome many of the limitations present in cross-sectional research on weight stigma and provide more ecologically valid and reliable results. We argue for a collaborative data-sharing consortium with standardized EMA methodologies, so researchers worldwide can contribute to and make use of a large, collective dataset on weight stigma and health correlates (see osf.io/s5ru6/).