A systematic review of social connections as determinants of obesity: Longitudinal evidence limited to marital transitions.

Background: Social relationships impact health and may affect proximal determinants such as obesity. Our review examined empirical evidence of the impact of changes in social relationships on risk of obesity in aging adults, with attention to gender.

Methods: We systematically searched Medline, EMBASE, Scopus, CINAHL, and ProQuest Dissertations and reference lists of relevant reviews and papers published up to November 2022. Longitudinal studies examining changes in marital status, living arrangement, social participation, and social networks and anthropometric changes or incident obesity were deemed eligible. Relevant data were extracted and synthesized narratively.

Results: We identified 41,910 eligible titles, resulting in 252 full texts and 7 included studies. All studies were conducted in the United States and assessed marital transitions only; 3 studies included both women and men. Overall, compared with people who remain non-married, entering marriage leads to a significant increase in body mass index (BMI) for both genders. Conversely, transitioning out of marriage through widowhood or divorce leads to a decrease in weight (kg/lbs), waist circumference, and BMI for both genders. All seven studies were deemed to be of medium quality.

Conclusions: Our review revealed a paucity of prospective evidence on social connections as determinants of obesity among aging adults. There is limited evidence that marital transitions are associated with changes in anthropometric measurements in aging individuals, but no evidence on the effects of changes in living arrangements, social participation, and social networks on anthropometric measurements. More research attention to the social determinants of obesity is warranted.