Stigma, obesity and adolescent risk behaviors: current research and future directions

•Adolescents who are, or self-perceive as, overweight are vulnerable to risk-taking.•Weight stigma may contribute to this association through poor body image and stress.•Increased engagement in risk behaviors may be a stress-coping mechanism.•Social networks moderate the associations between weight stigma and risk behaviors.•Interventions to reduce weight-stigma may reduce engagement in risk behaviors.

Adolescents are particularly vulnerable to risk behaviors as, in this life stage, they are experiencing intense physical, psychological and social changes. Adolescents who are overweight/obese, but particularly those who perceive themselves as such, are more likely to engage in risk behaviors than those who are, or perceive, themselves of normal-weight. Weight stigma and discrimination may contribute to this association as they reinforce poor body image and create intense stress. Stress is associated with poor emotion regulation, more impulsive, contextually-determined, and less rational decision-making, leading to greater engagement in risk behaviors. However, pathways from weight stigma/discrimination to risk behavior may be moderated by adolescents’ social networks. This review provides a conceptual model and empirical evidence to illustrate the proposed pathways from weight stigma and discrimination to risk behaviors. Public health implications and future research directions are also discussed.