Experienced Weight Stigma Changes Following Bariatric Surgery: a Systematic Review and Meta-Analysis.

Abstract

Experiencing weight stigmatization is linked to maladaptive eating, poorer mental health, and increased risk of weight gain, potentially impacting metabolic bariatric surgery (MBS) outcomes. This meta-analysis aimed to synthesize patient experiences of weight stigmatization before and after MBS and to examine the association of presurgical weight stigma on postsurgical weight loss. This preregistered study followed PRISMA guidelines. Six databases were searched through March 2025; eligible studies included published articles and dissertations/theses available in English that quantitatively measured presurgical weight stigma among MBS samples and included relevant outcomes. Meta-analyses utilized random effects models with change scores converted to Hedge's g and associations between presurgical experienced weight stigma and post-MBS weight change converted to coefficient r. Forty-one studies were included, with 36 reporting on experienced weight stigma change pre- to post-MBS and 10 studies reporting on the relationship between pre-MBS experienced weight stigma and post-MBS weight loss. Results revealed weight stigmatization decreased substantially after MBS (6-12 months, g = 1.28; 13-24 months, g = 1.16; 25-36 months, g = 1.26). Presurgical weight stigma was not associated with weight loss post-surgery (r = 0.05). Findings are limited by minimal studies reporting on longer term relationships between baseline stigma, post-MBS weight loss, and additional health outcomes.