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Although family emotional climate has been shown to influence health outcomes, few studies have tested if various aspects of family emotional climate either buffer or exacerbate chronic disease onset related to size discrimination. Using a subsample of the MIDUS 1 and 2 projects, we conducted a longitudinal analysis to test the relationship between perceived size discrimination, family support, and family strain and likelihood of various adverse outcomes as well as interaction effects between both family support and family strain with size discrimination. Size discrimination was found to be significantly related to increased chances of diabetes and chronic sleep problems 10 years later when controlling for BMI, basic demographics, and baseline outcome variable levels. Findings surrounding family support and family strain varied by outcome variable. Interaction effects had no significant results within the models. Implications for family therapists are discussed.<\/jats:p>","DOI":"10.1111\/jmft.70178","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:40:18Z","timestamp":1791200418000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body Size Discrimination, Family Emotional Climate, and Chronic Health Incidence in Middle Age: A Longitudinal Study"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3074-8258","authenticated-orcid":false,"given":"Maggie L.","family":"Smith","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0096-577X","authenticated-orcid":false,"given":"Sarah B.","family":"Woods","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0217771"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-023-01561-1"},{"issue":"3","key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1002\/jclp.20749","article-title":"The Role of Weight Stigmatization in Cumulative Risk for Binge Eating","volume":"67","author":"Almeida L.","year":"2011","journal-title":"Journal of Clinical Psychology"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bodyim.2021.10.006"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.24252"},{"issue":"1","key":"e_1_2_7_7_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjdrc-2025-004928","article-title":"Introduction and Methodology: Standards of Care in Overweight and Obesity\u20142025","volume":"13","author":"Bannuru R. 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