Gender inequality and socio-economic disadvantages associated with obesity in women compared to men: a rapid review and meta-analysis of observational studies from high-income countries

Objective: To assess whether obesity-related socio-economic disadvantages in wages, employment, and workplace discrimination equally affect women compared to men in high-income countries. Method: We searched databases and Google Scholar from inception to March 2025. Data on wages, employment, and perceived discrimination were pooled using random-effects meta-analysis where possible. Primary effect measures were obesity-versus-comparison ratios for continuous outcomes (wage ratio, WR) and odds ratios (OR) for dichotomous outcomes, each with 95% confidence intervals (CI), stratified by women versus men. Heterogeneity was assessed using the I² statistic and τ². Results: From 3495 screened citations, 17 studies (2004–2021) were included. Pooled effect estimates suggested greater socio-economic disadvantages among women with obesity, although subgroup differences were not statistically significant (p > 0.05). Meta-analysis revealed a significant wage penalty overall (WR = 0.95, 95% CI: 0.91–0.99; I² = 93.0%, τ² = 0.003), which appeared larger for women (WR = 0.91, 95% CI: 0.82–1.01) than men (WR = 0.96, 95% CI: 0.95–0.98). The association between obesity and employment was nonsignificant overall (OR = 0.94, 95% CI: 0.86–1.02), with a larger effect estimate for women (OR = 0.86, 95% CI: 0.69–1.06) than men (OR = 0.96, 95% CI: 0.87–1.05). Individuals with obesity were over four times more likely to report workplace discrimination (OR = 4.62, 95% CI: 1.04–20.53), with a higher, but not statistically significant, estimate for women (OR = 5.65, 95% CI: 0.57–55.89) than men (OR = 4.37, 95% CI: 0.24–79.14). Narrative synthesis confirmed consistent wage and employment penalties for women with obesity across countries. Conclusion: In high-income countries, obesity is associated with socio-economic disadvantages. A consistent pattern of stronger associations was observed for women, though statistical evidence for sex differences remains inconclusive.