Weight self-stigma and associated factors among primary school students in Linhai, China: a cross-sectional study

This study assessed weight self-stigma (WSS) levels and associated factors among primary school students. A cross-sectional survey was conducted in five Linhai primary schools (May–July 2023). Among 2678 students (76.6% response rate), WSS was measured using the weight self-stigma questionnaire (WSSQ), with high/low groups divided by median score. Totally, 2619 (97.8%) valid questionnaires was included in the analysis. Mean WSSQ score was 21.5 ± 9.2, varying significantly by weight status: underweight (19.8 ± 8.3), normal (19.9 ± 8.3), overweight (25.5 ± 9.1), obesity (23.6 ± 10.7) ( p < 0.001). Logistic regression showed higher odds of high WSS for overweight ( OR = 3.00, 95% CI : 2.36–3.80), obesity ( OR = 1.68, 95% CI : 1.35, 2.09), rural schooling ( OR = 1.22, 95% CI : 1.01, 1.48), lower family socioeconomic status ( OR = 1.30, 95% CI : 1.04, 1.61), insufficient sleep (7–8 h vs. 10 h: OR = 1.51, 95% CI : 1.17–1.97; 9 h vs. 10 h: OR = 1.23, 95% CI : 1.03–1.47), and older age (10 yrs. vs. 7–9 yrs.: OR = 1.37, 95% CI : 1.03–1.82). High WSS levels were prevalent among primary school students with overweight/obesity. Insufficient sleep, lower family socioeconomic status, rural schooling, and older age emerged as associated factors. • School children with overweight or obesity usually experience weight self-stigma. • Weight self-stigma levels are higher in students with older age than the younger. • Intervention for reducing weight self-stigma can enhance weight management outcomes.