Understanding Childhood Obesity

Childhood Obesity Stigma

Children should never suffer from the negative beliefs of others for any reason – including their weight status. However, negative attitudes towards people of all ages who suffer from obesity exist. Even toward children.

Childhood obesity rates are rising. More children will face the negative effects of weight bias and stigma. Being a child living with the health effects of obesity can be hard enough. Being treated unfairly can only make their lives harder.

Misunderstanding the Causes of Childhood Obesity Can Lead to Stigma

There are many causes of childhood obesity. It is a complicated disease. It is not simply a result of a poor diet and lack of exercise. Most importantly, children are never to blame for their weight status. Not everyone understands childhood obesity.  A lack of understanding can lead to negative attitudes and beliefs, also known as stigma and bias.

How do Children Experience Weight Stigma?

Children and teens who are overweight and suffer from obesity are exposed to many forms of weight stigma, including:

Verbal Teasing by Peers

  • Name calling
  • Negative remarks
  • Being made fun of

Social Exclusion by Peers

  • Social media/cyber bullying
  • Being ignored
  • Being excluded from peer activities
  • Being a target of rumors

Physical Bullying by Peers

  • Hitting
  • Kicking
  • Pushing
  • Shoving

Different Expectations from Adults

  • Their parents and parents of their peers
  • Coaches
  • Teachers

Sources of Weight Stigma Toward Children

While other children are the main source of stigma toward children living with obesity; teachers, coaches, parents and healthcare providers can play a role as well.

Peers

  • Peers are the greatest source of stigma for children and teens living with obesity
  • Negative attitudes toward children with obesity appear in children as early as preschool
  • Bias increases as children grow-up
  • 1/3 of overweight girls and 1/4 of overweight boys report being teased by peers at school

Teachers and Coaches

  • Some teachers see children living with obesity as more emotional, less likely to succeed and have family problems
  • Some teachers expect less from students with childhood obesity
  • Some physical education teachers believe students who are overweight have lower reasoning, physical and cooperation abilities

Their Parents and Family

  • Parental stigma is very common
  • 47 percent of girls and 34 percent of boys with childhood obesity have been teased by family members
  • Parents are the source for the most negative stigma faced by children with obesity

Healthcare Providers

  • Not all family medicine and pediatric healthcare providers know how to talk about weight
  • A yearly well-visit may not provide enough time to discuss weight in-depth

How Does Weight Stigma Affect Children?

Children with excess weight suffer a great deal from weight stigma. They become more likely to have low self-esteem, depression, anxiety and a poor body image. Studies have found that children living with obesity who face negative attitudes from peers have higher rates of suicidal thoughts and behaviors than others.

Facing weight stigma can cause health problems. They include unhealthy eating behaviors, binge eating or trying unhealthy weight-loss options. Weight bias can also affect a child’s heart health. One study found teens who were unfairly treated due to their physical appearance had higher blood pressure, even after considering their current body weight, gender, activity level, posture and mood.

Overall, the added effects of weight bias greatly reduce a child’s quality of life. From declines in physical and psychosocial health to emotional and social well-being and school functioning. All areas of a child’s life are affected by weight bias.

 

What Can Parents Do to Help?

Parents should take the lead in reducing stigma and improving the lives of children who are overweight or suffering from obesity. They can:

1.)     Become aware of their personal attitudes about weight

Parental attitudes about weight are often unintentionally communicated to children. Here are some things to think about when it comes to your own attitudes about weight:

  • Do I make assumptions about a person’s character, ability or lifestyle based on their weight?
  • What are my views about the causes of obesity?
  • Do I believe common stereotypes about people with obesity to be true?

2.)     Use sensitive and appropriate language about weight

Children are very aware about what you say and how you feel. It is important to avoid making negative comments about your own or another person’s weight in front of your child. It is also important to talk with your child about what words they feel comfortable using when discussing weight.

3.)     Watch for signs that your child is subject to weight stigma

It is key that parents are mindful of the signs your child is the subject of weight stigma. Look for changes in behavior or eating. Talk with your child if you think they are having problems. Offer to help and provide support.

4.)     Increase awareness of weight stigma at your child’s school

Parents can be the best source of change in schools. Talk with your child’s teacher or principal about promoting awareness of weight stigma. You have the right to express your concerns about this issue and ask what the school can do to help.

5.)     Find role models to boost confidence and self-esteem

It is important children and teens see role models who are not thin. Talk with your child about the fact that weight does not limit success.

6.)     Discuss heath rather than size

Focusing on weight-loss and size can add to weight stigma, even if meant to be supportive. Talk about making choices to live a healthy life. Keep talks positive and do not let the issue become all you talk about.

 

Many thanks to Rebecca Puhl, PhD, Deputy Director for the Rudd Center for Food Policy & Obesity for her contributions to this piece.

References:
1. Brownell KD, Puhl RM, Schwartz MB, Rudd L. Weight bias: Nature, extent, and remedies. NY: Guilford Press, 2005.
2. Eisenberg ME, Neumark-Sztainer D, & Story M. Associations of weight-based teasing and emotional well-being among adolescents. Archives of Pediatric & Adolescent Medicine. 2003; 157: 733-738.
3. Puhl R, Latner J. (in press). Obesity, Stigma, and the Health of the Nation’s Children. Psychological Bulletin.
4. Puhl R, Brownell KD. Bias, discrimination, and obesity. Obesity Research. 2001;9:788-805.
5. Puhl R, Brownell KD. Confronting and coping with weight stigma: An investigation of overweight and obesity individuals. Obesity. 2006; 14:1802-1815.
6. Storch EA, Milsom VA, DeBraganza N, Lewin AB, Geffken GR, & Silverstein JH. Peer victimization, psychosocial adjustment, and physical activity in overweight and at-risk-for-overweight youth. Journal of Pediatric Psychology, Advance Access, April 6, 2006; doi: doi:10.1093/jpepsy/jsj113.

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