Weight Conversations in Romantic Relationships: What Do They Sound Like and How Do Partners Respond?

Abstract

Introduction

The limited research examining weight conversations (i.e., conversations about weight, body shape, or size) in adult romantic relationships has shown associations between engaging in these conversations and disordered eating behaviors, overweight/obesity and psychosocial problems in adults. Given the potential harmful consequences of these conversations it is important to gather more rich qualitative data to understand how weight talk is experienced in romantic relationships and how romantic partners respond to these conversations.

Methods

Adults (n=118; mean age 35 years) from a cross-sectional study were interviewed in their homes. The majority of adults (90% female; mean age =35yrs.) were from minority (64% African American) and low-income (<$25,000/year) households. Qualitative data was analyzed using inductive content analysis.

Results

Sixty five percent of participants reported that weight conversations were occurring in their romantic relationships. Qualitative themes included: (1) weight conversations were direct and focused on physical characteristics, (2) weight conversations included joking or sarcastic remarks, (3) weight conversations focused on “we” and being healthy, (4) weight conversations occurred after watching TV or movies, as a result of insecurities in one’s self, as length of the relationship increased, or as partners age, and (5) partners responded to weight conversations by feeling insecure or by engaging in reciprocal weight conversations with their romantic partner.

Discussion

Weight conversations were prevalent in romantic relationships, with some conversations experienced as negative and some positive. Qualitative themes from the current study should be confirmed in quantitative studies to inform future intervention research targeting weight conversations in romantic relationships.

Introduction

Previous research focusing on weight conversations (i.e., conversations about weight, body shape, or size) in romantic relationships is limited. Findings from these few prior studies have shown significant associations between romantic partner weight conversations and adult unhealthy weight control behaviors including fasting, skipping meals, binging, purging, using diuretics, smoking as a way to reduce food intake and chronic dieting (Eisenberg et al., 2012; Eisenberg et al., 2013). While there is some evidence indicating that weight conversations in romantic relationships can be harmful, it is unknown whether weight conversations can motivate adults to engage in positive behaviors such as, eating healthier and being more physically active. Thus, it is important to examine whether adults experience weight conversations positively or negatively within romantic relationships.

Family Systems Theory (Bertalanffy, 1952; von Bertalanffy, 1968; Whitchurch & Constantine, 1993) guides the study design, research questions and analysis of the current study. Family Systems Theory purports that within a romantic relationship multiple interactions occur simultaneously, with each partner shaping and being shaped by the other partner’s behavior. For example, in relation to weight conversations, one partner may make a negative comment about the other partner’s body or eating behavior (e.g., overeating, or taking second helpings of food). This comment may make the other partner feel bad or mad, which in turn may increase their intake of unhealthful foods or engaging in unhealthy weight control behaviors (e.g., meal skipping). The increase in these unhealthful behaviors may result in weight gain over time. On the other hand, one partner may start a discussion with the other partner about the importance of being healthy. This comment may make the other partner more willing to engage in physical activity, which in turn may increase the likelihood that both partners will be physically active together. Therefore, according to Family Systems Theory, weight conversations are experienced within a relational context that can influence each partner’s health behaviors such as, weight gain/loss, disordered eating behaviors, and emotional health.

Overall, there is limited data regarding how weight conversations are experienced in romantic relationships and how partners respond to these types of conversations. Thus, qualitative research using diverse samples is needed to understand more about how weight conversations operate in romantic relationships. The main research questions in the current study include: (1) What do weight conversations sound like within romantic relationships?, (2) When do weight conversations occur in romantic relationships?, and (3) How do romantic partners respond to weight conversations when they occur?

Methods

Sample and Study Design

The Family Meals, LIVE! study is a two-year, cross-sectional study, designed to identify key risk and protective factors for childhood obesity in the home environment (Berge, Rowley, et al., 2014; Berge, Trofholz, Fong, Blue, & Neumark-Sztainer, 2015). The study collected both quantitative and qualitative data on families to gain a more in-depth examination of the home environment in relation to risk and protective factors for obesity (Berge, Rowley, et al., 2014). For the current study, the qualitative interviews conducted with parents in their homes were utilized for analyses (Berge, Rowley, et al., 2014). All participating family members provided consent or were assented into the study. All study protocols were approved by the University of Minnesota’s Institutional Review Board.

Parents/adults and their children (n=120) from four primary care clinics serving primarily diverse and low-income families in Minneapolis/St. Paul participated in Family Meals, LIVE! in 2012–2013. Adults were mostly women (91%) and were approximately 35 years old (SD = 7; range = 25–65 years). The racial/ethnic backgrounds were as follows: 62% African American, 19% White, 4% American Indian, 4% Asian, and 11% mixed or other race/ethnicity. Over 50% of adults were from very low socioeconomic status households (< $25,000). The majority of adults had finished high school but had not attended college, and about 50% of adults were working full- or part-time.

Procedures

Families participated in two home visits, two weeks apart (Berge, Rowley, et al., 2014). In the second visit, a qualitative interview was conducted with the primary caregiver/adult. The interview guide was created based on a literature review and pilot data from focus groups. Weight conversations in romantic relationships were a main focus of the interviews. Interview questions included: (1) How do you talk about weight, body shape, or size with your romantic partner/significant other?; (2) When do these types of conversations occur?; and (3) How do you respond when your romantic partner/significant other talks with you about your weight, body shape, or size?

Adults were interviewed by research staff who were trained in using standardized qualitative interview protocols (Crabtree & Miller, 1999). Interviewers were required to reach certification levels in qualitative interviewing skills before conducting participant interviews (see previous section) (Crabtree & Miller, 1999).

Analysis

Tape-recorded interviews (n=118; two adults did not complete the qualitative interview) were transcribed verbatim (Elo & Kyngas, 2008). All parent transcripts were analyzed and coded to ensure saturation of themes occurred. During the coding process, the first 20 transcripts were coded by two coders and then consensed. Once the coders reached 95% inter-rater reliability, every fifth interview was double coded and consensed (Miles & Huberman, 1994). During consensus, both coders discussed questions in-person regarding quotes or placement of quotes in theme categories until 100% agreement was reached. NVivo 10 qualitative analysis software was used to organize and code the data (NVivo 10, QSR International Pty. Ltd, Melbourne, Australia, 2000).

Transcripts were coded using inductive content analysis, which allows themes to naturally emerge from the data (Elo & Kyngas, 2008). First, constant comparison, line-by-line coding was conducted to identify broad theme categories. The broad themes were then broken into sub-themes to organize participant responses across all content areas discussed by participants. Major overarching themes were then identified across content areas and sub-categories were collapsed where appropriate. Participants could endorse multiple themes, thus themes are not mutually exclusive. All names in quotes have been changed to protect participant confidentiality.

Results

Research Questions #1: What Do Weight Conversations Sound Like Within Romantic Relationships?

Sixty five percent of participants gave examples of weight conversations that were occurring in their romantic relationships (Table 1). About 30% of participants expressed that they did not engage in weight conversations per se, but instead focused on health and a shared “we” approach to becoming healthy with their romantic partner. A few participants (5%) said that they did not engage in any weight conversations of any kind with their romantic partner. Of the participants that endorsed weight conversations in their relationships, 50% indicated that weight conversations were direct and focused on physical characteristics and 40% of participants stated that weight conversations were typically experienced as joking and sarcasm. All themes are discussed below.

Table 1.

Weight Conversation Qualitative Analysis Themes

Weight Conversation Themes by Research Question	N (%) Endorsed
Research Question #1: What Do Weight Conversations Sound Like Within Romantic Relationships?
Weight Conversations	77 (65)
Weight Conversations are Direct and Focus on Physical Characteristics	59 (50)
Weight Conversations Use Joking or Sarcasm	47 (40)
No Weight Conversations	41 (35)
Weight Conversations Focus on “We” and Being Healthy	35 (30)
Weight Conversations Do Not Occur	6 (5)
Research Question #2: When Do Weight Conversations Occur?
Watching TV or a Movie	77 (65)
Prompted by One’s Own Body Insecurity	47 (40)
Length of Romantic Relationship	42 (36)
Age and Stage of Life	31 (26)
Research Questions #3: How Do Romantic Partners Respond to Weight Conversations When They Occur?
Feelings of Insecurity	65 (55)
Engage in Reciprocal Weight Talk or Teasing	50 (42)

Weight Conversations Are Direct and Focused on Physical Characteristics

Many participants said that the weight conversations they experienced in their romantic relationships were very direct (Table 1). For example, one woman (African American, 30 years) said of her romantic partner, “Yeah, he talks about my weight…he just says I’m big or heavy.” Another woman (African American, 28 years) said,

I just say pretty much, ‘Hey, you are looking kind of heavy there.’ You know, I think you need to cut back on ‘such and such’ and he says the same to me.

One man (African American, 27 years) said of his romantic partner,

…she [romantic partner] says, ‘it looks like you’re getting a little bigger, or your pants look tight’. We also use ‘big boned or voluptuous’ instead of calling each other fat or something like that.

In addition, many participants said that their romantic partner engaged in weight conversations by focusing on specific physical characteristics where they had “extra weight” or where they “needed to lose weight”. One woman said of her romantic partner, “He says I have a little extra weight in my stomach.” One man (African American, 33 years) said,

She [romantic partner] says, ‘you look like you gained some weight. Did you gain some weight in your belly? How much do you weigh now?’ and I might say, ‘your hips are getting bigger, have you gained weight?’

Weight Conversations Include Joking or Sarcasm

Many participants stated that weight conversations occurred through “joking” or “sarcasm” about each other’s weight, body shape, or size (Table 1). One woman (American Indian, 25 years) stated,

We’ve got a joking kind of relationship about it [weight]…if my husband makes a comment about the cookies being gone, and he knows that I ate them, he calls me ‘fatty’…it’s a joke.

Another woman (African American, 28 years) said,

Most of our conversations between my spouse and I about weight are 9 times out of 10 on a joking level….my husband and I will go back and forth jabbing at each other and acknowledging each other as ‘fatso’…and we laugh about it.

Another woman (White, 31 years) related,

The subject [weight] comes up often because ou know, he sees me without clothes on and so I have a sort of insecurity there…it [weight conversations] is mostly in a joking matter…but, it bothers me a little.

Weight Conversations Focused on “We” and Being Healthy

Some participants said that they did not engage in weight conversations in their romantic relationship, but rather discussed how to be “healthy” and how to be healthy as a couple using “we” language (Table 1). For example, one woman (White, 30 years) stated,

We talk about what the negative effects of not making certain dietary changes are and how not getting enough exercise is unhealthy…we try to encourage and motivate each other…I ask him to help motivate me to exercise and sometimes to do it with me.

Another woman (Hispanic, 23 years) said,

We talk about wanting to be healthy…belonging to the gym together. Both him and I work out together now. We’re trying to eat less…we’re always very positive, never ‘you’re fat’ or you know whatever.

An African American women (25 years) stated,

We just talk about like the things that are going on in our family right now with our parents and how we want to prevent it, like his parents have diabetes, my mom has diabetes, and I’m like we need to watch out how we eat and start exercising. We need to be healthy.

Weight Conversations Do Not Occur

Some participants indicated that that they did not engage in weight conversations in their romantic relationships (Table 1). One man (White, 27 years) stated, “I would not approach my significant other about her weight because I’m sure she sees exactly what everybody else sees.” One woman (White, 33 years) stated, “That’s a sacred area. We don’t like to talk about that.” An African American women (29 years) said, “he doesn’t talk to me about my weight, so I wouldn’t do it to him”. Another woman (White, 31 years) said,

I don’t address his weight because he’s [romantic partner] like, he’s happy with himself so I just really, I avoid that topic altogether…he doesn’t really ever bring it up with me either.

Research Question #2: When Do Weight Conversations Occur?

Of the participants that indicated weight conversations were occurring in their romantic relationships, the following themes were identified related to when weight conversations occurred. Weight conversations often occurred while watching TV or a movie (65%); as a result of one partner’s own insecurity about their weight, body shape, or size (40%); in regards to the length of the relationship (36%); and (4) in response to the age and developmental stage of participants (26%) (Table 1).

Watching TV or a Movie

Many participants indicated that weight conversations occurred in response to watching a TV show or a movie (Table 1). For example, one woman (African American, 35 year) stated,

It [weight conversations] usually happens when we are watching TV. He points out that I used to be thinner, like the women on TV, and that I should lose some weight…to get back to how I used to look.

Another man (Hmong, 36 years) said,

It usually comes up when we just watched a movie together and one of the characters is really fit or hot and my girlfriend will sort of say that I’ve let myself go…and need to get fit.

Prompted by One’s Own Body Insecurity

Some participants identified that weight conversations were prompted by their own feelings of insecurity about their bodies (Table 1). Insecurity was noted by participants’ desire to lose weight, exercise more, and dislike with the way they look. One woman (African American, 39 years) stated,

With my fiancé I always tell him that I want to lose weight and that I’m going to lose it. By me having some kids, it just blew me up and made me fat. So, now I talk to him about losing weight and working out and he’s always wanted to do the same…so he works out with me.

Another woman (Hispanic, 30 years) said,

I’m like, ‘I gained a lot of weight…I don’t like how I look…I’m fat and I’m going to start losing weight, so you got to work out with me.” And he’s like, ‘I don’t care if you get big. I love you.’ And I was like, ‘good answer.’

One woman (American Indian, 33 years) stated,

Well, weight is a hard issue…I bring it up like, ‘this is me before and this is me now.’ I’m always telling him I don’t like how I look and that I need to lose weight.

Length of Romantic Relationship

Some participants said that they engaged in more weight conversations as the length of their romantic relationship increased (Table 1). For example, one man (American Indian, 34 years) said, “When we hit our 5^th anniversary it was like now everything is fair game to talk about…weight, being fat…or too skinny.” One woman (White, 33 years) stated,

Yeah, you know, in the beginning of my relationship with Tim, definitely, he knew he could not…do not talk about my weight…he knows it’s a touchy subject for me…but the longer we are together, the more I talk about my weight, or dissatisfaction with my weight with him…he brings up my weight too.

Age and Stage of Life

Some participants indicated that weight conversations were more likely to happen as they aged (Table 1). One woman (White, 40 years) said, “You know, it really comes up now more because my husband and I both turned 40 this year, so we’re both trying to lose weight.” Another woman (African American, 38 years) stated,

I think as we get older we’ve been talking about weight more and looking at you know incorporating more exercise into our schedule. I have put on more weight and I know I don’t look like I used to…so things don’t fit anymore suddenly, and I’m like, ‘I’m getting fat’

Research Question #3: How do Romantic Partners Respond to Weight Conversations When They Occur?

Participants stated that in response to weight conversations occurring in their romantic relationship they felt insecure (55%) or they engaged in reciprocal weight conversations (42%) with their partner (Table 1).

Feelings of Insecurity

Many participants said that they felt insecure as a result of their romantic partner engaging in weight conversations (Table 1). For example, one woman (African American, 35 years) said, “I’m probably self-conscious about it [weight], you know, because a lot of the jokes have kind of surfaced my insecurities, you know?” One man (African American, 39 years) said,

I just try to a laugh it off when she calls me ‘fatso’ or tells me I have a ‘beer belly’…but deep down it does hurt my feelings…I wonder if she still thinks I’m hot, you know, next to other guys or my friends.

Engage in Reciprocal Weight Conversations

Some participants said that when their romantic partner engaged in weight conversations they responded by doing the same thing back (Table 1). One woman (African American, 30 years) said, “we talk about each other’s weight a lot and sometimes it runs into teasing like, you’re a fat pig”. Another woman (Hispanic, 32 years) said,

Normally, how it goes is that one person will tease the other and then that person will then go back and tease that other person. So, if I call my husband “Fatso” he will then come and grab my belly.

One man (African American, 36 years) stated,

I give it [weight teasing] right back to her. She will say something about me not having a six pack anymore and I’ll say ‘you didn’t use to have a big butt either’.

Discussion

Results of the current study both support and extend previous findings in the literature about weight conversations in romantic relationships. First, results corroborate findings from previous studies by showing that weight conversations do occur in romantic relationships (Eisenberg et al., 2011, 2012; Eisenberg et al., 2013). The current study extends previous findings by showing that weight conversations in romantic relationships typically include direct conversations focusing on physical characteristics and include teasing and sarcasm. These findings suggest the need for assessment measures of weight conversations in romantic relationships. There are several brief inventories that measure weight-bias and stigmatization in adult populations (Puhl & Brownell, 2001) however, there are no assessments that assess weight conversations in romantic relationships. Future research should include the development of brief weight conversations assessments to be used for screening and for providing estimates of the incidence of weight conversations in adult romantic relationships.

Second, previous studies with children and adolescents have shown that engaging in conversations about “being healthy” is protective and engaging in conversations about weight, body shape, or size are risk factors for developing disordered eating behaviors and being overweight/obese (Berge, Maclehose, et al., 2013; Berge, MacLehose, et al., 2014). Similarly, the current study found that conversations focused on being healthy were occurring within romantic relationships. A next important step for future research is to examine via quantitative studies whether health-focused conversations in romantic partners is protective for weight and weight related behaviors.

Another new finding from the current study is that weight conversations occurred in response to several different factors, including: after watching a TV show or movie, in response to one’s own body insecurity, as the length of the romantic relationship increased, and as a byproduct of partners’ aging process. This new information regarding when weight conversations are occurring may guide future research and interventions as when to target weight conversations in romantic relationships. For example, relationships in long-term relationships and couples who are mid- to older-adults may be vulnerable populations for the occurrence of weight conversations and may benefit from interventions aiming to reduce weight conversations and increase health-focused conversations.

Additionally, findings related to how romantic partners respond to weight conversations indicated that romantic partners tend to feel insecure, which corroborates previous studies indicating that negative psychosocial outcomes occur as a result of experiencing weight conversations (Eisenberg et al., 2011, 2012; Eisenberg et al., 2013). Furthermore, individuals who are overweight/obese may already have experienced weight bias and stigmatization in their places of employment, healthcare, and in society (Puhl & Brownell, 2001; Puhl, 2008); the addition of weight conversations in romantic relationships may lead to even worse negative psychosocial outcomes. Additionally, the finding that romantic partners engaged in reciprocal weight conversations is a new finding that warrants more research. It would be important to investigate whether partners who experience reciprocal weight conversations are at higher risk of relationship dissatisfaction than other couples.

There were several strengths of this study. First, the large sample (n=118) was a strength for conducting a qualitative analysis. Additionally, the low-income and minority population was a strength of the study. There were also study limitations. One limitation includes the lack of couple data. Future research would benefit from interviewing both romantic partners to provide a more in-depth understanding regarding how weight conversations are experienced. Another limitation is the lack of detail on the duration and the quality of romantic relationships and associations with weight conversations. Furthermore, although the low-income and minority sample is a strength, it also reduces the generalizability of the findings to other racial/ethnic and socioeconomic groups. Our limited sample of males also prohibited assessing sex differences related to experiencing weight talk and teasing. Future research should assess sex differences between men and women’s experiences of weight talk and teasing within romantic relationships.

Conclusion

Results from the current study add insight regarding prior quantitative findings showing associations between weight conversations in romantic relationships and weight and weight-related behaviors in adults. These qualitative themes should be corroborated with quantitative data and considered when developing pilot interventions to reduce harmful weight conversations and increase health-focused weight conversations in romantic relationships. Future research is needed to identify whether these identified themes generalize to a larger population.