The significance of attachment quality for obesity: A meta-analytic review

Theoretical considerations and empirical results suggest that attachment quality is relevant to obesity. This study used meta-analytic methods to systematically examine the empirical, peer-reviewed evidence regarding the relationship between attachment quality and body mass index (BMI) in separate meta-analyses for children and adults. Relevant peer-reviewed literature published between 1990 and 2013 was obtained from PubMed, PsycINFO, and reference lists of included articles. Results of the meta-analysis for studies with adults indicated a small but statistically significant association between attachment quality and BMI (absolute value of weighted average r = .05, p = .03; 95% confidence interval, CI [.004 to .09]; number of independent studies [k] = 7; N = 2,135). Specifically, BMI was negatively associated with attachment security. Publication bias analyses did not demonstrate cause for concern about the results. Results of the meta-analysis for studies with children indicated a small association between attachment quality and BMI that fell just short of statistical significance (absolute value of weighted average r = .08, p = .06; 95% CI [−.004 to .16]; k = 5; N = 8,602). Several moderator variables were examined using the aggregated sample including both adults and children, but none of the analyses yielded statistically significant results. Possible explanations for an impact of attachment quality on obesity might involve the underdevelopment of emotion-regulation and heightened psychophysiological responsiveness, which point to avenues for future research.