SynthesisBMJ open2018
Income and obesity: what is the direction of the relationship? A systematic review and meta-analysis.
Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 121 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
121 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Acute Care Surgery Models Worldwide: A Systematic Review.World journal of surgery · 2020Pooled it
- The association between serum zinc level and overweight/obesity: a meta-analysis.European journal of nutrition · 2019Pooled it
- Cost-effectiveness of goal-directed and outcome-based financial incentives for weight loss in low-income populations: the FIReWoRk randomized clinical trial.International journal of obesity (2005) · 2024Trial
- UK cost-effectiveness analysis of endoscopic sleeve gastroplasty versus lifestyle modification alone for adults with class II obesity.International journal of obesity (2005) · 2023Trial
- Effect of MED-02 Containing Two Probiotic Strains,Nutrients · 2022Trial
- Wealth and weight revisited: A Bayesian model averaging approach to the Obesity Kuznets Curve.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Obesity and Dental Caries: A State-of-the-Art Review of Shared Risk Factors, Biological Mechanisms and Current Evidence.Medical sciences (Basel, Switzerland) · 2026Review
- Does Weight Loss Translate to Workplace Gains? Results of an Employment Questionnaire in Adults With Prediabetes and Overweight or Obesity.Diabetes, obesity & metabolism · 2026Article
- Changes in nutrition-related health outcomes following a minimum wage increase.SSM - population health · 2026Article
- Associations between dietary intake of flavonoids and adiposity: cross-sectional findings from the Fenland Study, the United Kingdom.International journal of obesity (2005) · 2026Article
- Income Persistence and the Risk of Hepatocellular Carcinoma in Individuals with Type 2 Diabetes.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Associations Between Social Risks and Obesity in High-risk Veterans.Journal of general internal medicine · 2026Article
- Income and risk of type 2 diabetes incidence varied associations according to obesity status: a nationwide study.BMC public health · 2026Article
- BMI Was Maintained Among Women with Low Incomes in Indiana Who Participated in Food Assistance and/or Federal Nutrition Education Over 1 Year.Current developments in nutrition · 2026Article
- The transition from preclinical to clinical obesity: the importance of a borderline stage.Clinical science (London, England : 1979) · 2026Review
- Ultra-processed food consumption and body mass index from adolescence to early adulthood: multi-trajectory analysis using data from the 1993 Pelotas (Brazil) birth cohort.Cadernos de saude publica · 2026Article
- European Code Against Cancer, 5th edition - diet, excess body weight, physical activity, sedentary behavior, breastfeeding, and cancer.Molecular oncology · 2026Review
- Prevalence and determinants of obesity among women aged 15-49 years in the Ashanti region, Ghana: Analysis of the 2022 Ghana demographic and health survey.SAGE open medicine · 2026Article
- Being overindebted and overweight in Switzerland - A largely unexplored association in an understudied population.PloS one · 2026Article
- Income-related inequalities in the association of obesity and periodontal disease: a register-based cross-sectional analysis in the Tokyo metropolitan districts.Clinical oral investigations · 2025Article
61 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIt was repeatedly shown that lower income is associated with higher risks for subsequent obesity. However, the perspective of a potential reverse causality is often neglected, in which obesity is considered a cause for lower income, when obese people drift into lower-income jobs due to labour-market discrimination and public stigmatisation. This review was performed to explore the direction of the relation between income and obesity by specifically assessing the importance of social causation and reverse causality.
designSystematic review and meta-analysis.
methodsA systematic literature search was conducted in January 2017. The databases Medline, PsycINFO, Sociological Abstracts, International Bibliography of Social Sciences and Sociological Index were screened to identify prospective cohort studies with quantitative data on the relation between income and obesity. Meta-analytic methods were applied using random-effect models, and the quality of studies assessed with the Newcastle-Ottawa Scale.
resultsIn total, 21 studies were eligible for meta-analysis. All included studies originated from either the USA (n=16), the UK (n=3) or Canada (n=2). From these, 14 studies on causation and 7 studies on reverse causality were found. Meta-analyses revealed that lower income is associated with subsequent obesity (OR 1.27, 95% CI 1.10 to 1.47; risk ratio 1.52, 95% CI 1.08 to 2.13), though the statistical significance vanished once adjusted for publication bias. Studies on reverse causality indicated a more consistent relation between obesity and subsequent income, even after taking publication bias into account (standardised mean difference -0.15, 95% CI -0.30 to 0.01). Sensitivity analyses implied that the association is influenced by obesity measurement, gender, length of observation and study quality.
conclusionsFindings suggest that there is more consistent evidence for reverse causality. Therefore, there is a need to examine reverse causality processes in more detail to understand the relation between income and obesity. PROSPERO REGISTRATION NUMBER: 42016041296.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.