Aims
To systematically synthesise evidence on whether obesity disproportionately impacts gender inequality and socio-economic disempowerment among women with obesity compared to men with obesity in high-income countries.
Method
A systematic search of Embase, MEDLINE, Web of Science, and Google Scholar for relevant studies. Risk of bias was assessed using the JBI critical appraisal tools.
Results
We identified 17 observational studies published between 2004 and 2021 from an initial 3,495 citations. Studies primarily used a Body Mass Index (BMI) of ≥30 kg/m² to define obesity and consistently identified disproportionate socio-economic disadvantages for women with obesity compared to those without obesity. These women often earned a lower monthly income (e.g., monthly salary in Finland, €1,464.0 vs. €1,641.5), faced higher unemployment rates (e.g., in Finland, OR=2.266, p<0.01), and had lower personal incomes (e.g., annual income in Canada for 2002: $33,424 vs. $34,686). They also reported greater perceived workplace discrimination (e.g. in the US, 14.5% of women with BMI ≥35kg/m² vs. 1.1% with BMI 19 to 24.9kg/m², p<0.05). Additionally, women with obesity earned lower hourly wages (e.g., in Germany, -0.198 log points, p < 0.01, vs. -0.007 log points) and received smaller bonus payments (e.g., South Korea, OR = 0.501, p < 0.01 vs. 1.305) compared to their male counterparts with obesity. For men with obesity, the findings were less consistent; some studies indicated lower wages (e.g., in Sweden), while others found no significant effect on employment or even higher wages in some cases (e.g., Iceland). Men with obesity reported discrimination, but less consistently across outcomes compared to women.
Conclusion
Obesity is reported to be a significant driver of gender inequality and socio-economic disadvantages, with a more pervasive and detrimental impact on women compared to men with obesity in high-income countries. This emphasises the need for gender-sensitive interventions to address weight-related socio-economic disparities.