Analysis of Blame, Guilt, and Shame Related to Body and Body Weight and Their Relationship with the Context of Psychological Functioning Among the Pediatric Population with Overweight and Obesity: A Systematic Review.

There is scientific evidence showing that body- and/or body weight-related blaming, guilting, and shaming continue to be both promoted and tolerated in many societal contexts, including schools and healthcare settings. A deeply ingrained belief still prevails among many individuals that inducing these negative emotions can serve as a motivator for children and adolescents to engage in obesity treatment. Therefore, the aim of this systematic review is to examine these emotions (blame, guilt, shame) in relation to body weight and their impact on psychological functioning within the pediatric population affected by overweight and obesity. Articles were searched up using PubMed and Web of Science in June 2023 and March 2025. The search was conducted without limiting the years of publication. The inclusion criteria included the following: (1) pediatric samples, (2) full text available, and (3) original research articles. Articles were excluded if they were editorials, letters, replies from authors, review articles, and articles without a full text. The initial search returned 199 results. A total of 16 articles were included in the study. Analysis of the collected records revealed associations between body- or weight-related blame, guilt, and shame and various aspects of psychological functioning in the pediatric population such as (a) interpersonal context (e.g., social stigma, bullying, teasing history, social connectedness, weight-related language used by parents in conversations with children and adolescents; (b) intrapsychic context-relationship with eating and food (e.g., binge eating, dietary restraint, emotional eating, and the risk of developing eating disorders); (c) intrapsychic context-self-perception (e.g., self-esteem, feelings of worthlessness, self-compassion, self-efficacy, perceived control); (d) intrapsychic context-emotional functioning (e.g., emotional distress, anxiety, depression, emotion regulation strategies); and (e) intrapsychic context-additional psychological factors (e.g., mindfulness, quality of life, willingness to seek help, and motivation for both help-seeking and sustaining successful lifestyle changes). Understanding the dynamics of body- and/or weight-related blame, guilt, and shame among children and adolescents with overweight and obesity is essential for developing effective support systems that enhance their well-being and psychological resilience in both the prevention and treatment of obesity. Further research is needed to explore the relationships between body- and weight-related blame, guilt, and shame and psychological functioning in pediatric populations with overweight and obesity, including the dynamics of child-parent-healthcare provider interactions, the context of parenting skills and attitudes that support the child during obesity treatment, the long-term consequences of body- and weight-related blame, guilt, and shame, the relationship between healthcare providers' tendencies to engage in body- and weight-related shaming or blaming and their communication skills and mental well-being (e.g., levels of professional burnout, emotion regulation skills, and personality traits), as well as the influence of social media on body- and weight-related shame, guilt, and blame.