Weight stigma and your child: what parents need to know

Weight stigma and your child: what parents need to know

Do you have a child who is living in a larger body? Are you worried about your “fat” kid?

You should be, but not because of their adipose tissue. The reason you should be worried is because weight stigma can have a significant impact on your child’s lifelong health. In fact, weight stigma is worse than weight itself!

Popular media and healthcare providers scream about the dangers of fat cells. But the real danger is weight stigma and weight discrimination.

What is weight stigma?

Weight stigma is discrimination or stereotyping based on a person’s weight. It reflects internalized societal attitudes towards body size and impacts how we treat each other. Understanding weight stigma will help your child avoid body hate, disordered eating, and eating disorders.

Many people to believe that fat people are lazy, eat unhealthy food all the time, and are less intelligent. (HINT: this is not true) Many people believe that fat people are not worthy of respect. This leads to discrimination that has a lifelong impact on health.

The media and weight stigma

Media and entertainment outlets frequently portray strongly biased views of people who live in larger bodies. Media and entertainment outlets depict fat people in dehumanizing and stigmatizing images. These include newspapers, magazines, books, movies, documentaries, videos, photographs, social media accounts, and more.

The media shows fat people eating fattening foods, sitting, and wearing tight, ill-fitting clothing. It shows thin people eating colorful salads, exercising, and looking stylish.

The media portrays fat people as lazy, weak-willed, self-indulgent, and a drain on the nation’s resources. Don’t buy it!

Healthcare and weight stigma

The second leading source of weight stigma are people in the medical and healthcare professions. This creates a significant barrier to healthcare for anyone who lives in a larger body. No visit to the doctor, regardless of the purpose, begins without an attempt to weigh the body.

Anyone in the “overweight” and above categories is lectured about their weight. This is regardless of why they came for a visit. It is also based only on weight, not health behaviors. Many receive lectures about weight reduction, despite the fact that there is no proven, safe, and effective method for reducing weight.

Weight stigma in healthcare often results in delayed diagnosis and treatment for many people who have serious medical conditions. Doctors often tell fat patients to move more and eat less. Regardless of a patient’s symptoms, doctors frequently focus on weight loss.

What happens to fat kids?

Our kids grow up in an ecosystem that is full of weight stigma. As early as preschool, children prefer very thin to overweight figures in drawings and stories [1]. By elementary school, obese children report unsatisfactory peer relations, including social rejection [2].

Children who are living in larger bodies are at increased risk for being targets of weight-related teasing [3], and they also experience more non-weight-related teasing and bullying [4], and other forms of victimization such as physical aggression [5].

As early as the first grade, fat kids are treated differently by their peers. They more likely to be treated poorly and be disliked. They often struggle with loneliness and friendships. Severely obese children are more likely to be rejected, made fun of, teased, picked on, and disliked [6].

Weight stigma leads to poor health and eating disorders

The “War on Obesity” has failed to reduce the national weight. It has, however, succeeded in increasing fat stigma, which many researchers say is more health-damaging than fat itself. Weight teasing and bullying in adolescence leads to higher BMIs 15 years later.

This means that the “War on Obesity” is actually causing people to gain weight. People who are exposed to weight stigma are also more likely to exhibit eating disorder behaviors including extreme dieting and self-induced vomiting [7].

In cultures with fat stigma, we see more young women who express dissatisfaction or disgust with their bodies, which is an essential precursor (and continuing accompaniment) of eating disorders. [8]. 

There is a strong relationship between the “obesity epidemic” and the proliferation of eating disorders. “If fat bodies were accepted and not hated in our culture, fat people would not embark on restrictive eating or disordered eating in order to lose weight, and the majority would not develop eating disorders.” [9]

You may think the solution is to put your child on a diet. But diets have serious consequences. Instead, parents should help them manage the impact and reduce their exposure to weight stigma.

What you can do at home

How you treat your child at home can be an important balm against the weight stigma they will experience in the world. A safe, secure home environment free of fat stigma can prevent a lot of the trauma of weight stigma.

Here are a few basic rules to implement at home. Enforce these rules across all family members and anyone who enters your home without exception. Your child needs to truly believe that your home is a safe place, free from weight stigma and judgment.

No diets

Nobody in the home should even go on a restrictive diet with the purpose of losing weight.

Stop food policing

A wide variety of food should be available to everyone in the home without restriction or monitoring.

Don’t fat shame

Don’t allow anyone to tease or criticize another person’s body. This applies to anyone in the family, outside of the family, a celebrity, a stranger, etc.

Avoid glorifying body-types

Everyone should learn to avoid making comments about “perfect bodies” and glorifying any particular body type. Don’t praise people for weight loss, discuss methods to achieve weight loss or a “perfect butt,” “washboard abs,” etc.

No scales

There is no reason to keep a scale in the home. Throw it away.

Health at Every Size philosophy

Learn about and embody the HAES philosophy that any body can be healthy.

Please remember that your child’s siblings can be a major source of shame and ridicule for your larger child. You must maintain strict rules for sibling behavior. Make sure you never encourage (and actively discourage) any form of teasing about weight or body size.

What you can do at school

School is the place in which your child is most at risk of fat stigma. Approximately 43% of overweight or obese adolescents reported being teased by peers [10]. To help your child, you must advocate for them at the school and classroom level. Here are a few goals for your child’s school environment:

Language

Your child should not feel criticized or stigmatized by teachers. Health should not be linked to body weight.

Dress codes

Larger children should be held to the same dress code standards as smaller children. For example, short-shorts may reveal more “skin” on a larger child. But often the length of the shorts is identical in comparison to the child’s height. Standards should be evenly enforced.

Weighing

Children should not be weighed at school. There is no educational justification for weighing children at school. School weight-ins can be a shameful event for a child who is living in a larger body.

It may be tricky to advocate for your child’s safety at school, but it is essential. Want ideas? Read Linda Bacon’s guide for teachers and administrators. 

Also, help your child build friendships from an early age. Studies have found that just one friend in a class can buffer the negative effect of poor treatment by peers. [11]

What you can do at the doctor’s office

Weight stigma in the healthcare setting is pervasive and leads to lifetime health impacts. People who experience weight stigma attend fewer doctors’ visits, screenings, immunizations, and more. Help your child learn to navigate the health system while living in a larger body by doing the following:

Don’t weigh my child

Unless your child is going on medication or going into surgery, you don’t have to put them on the scale. Talk to your doctor in advance about avoiding the shame-inducing and unnecessary act of being weighed at every appointment. Ask whether being weighed is a medical necessity or simply part of their administrative process. Protect your child from being weighed unless medically necessary. And no, being “overweight” does not justify being weighed at every visit.

Don’t tell my child to lose weight

There is not a single proven weight intervention yet. While most people can lose weight short-term, intentional weight loss results in regain and even additional pounds two years later. Tell your doctor not to suggest weight loss – even the seemingly benign “move more/eat less,” which is entirely unhelpful.

Treat my child without bias

Weight bias is unconscious, which is why it’s so damaging in the healthcare setting. Bring it to the forefront by talking to your child’s doctor about weight bias. Ask the doctor to treat your child as if your child is living in an “average” sized body.

Here is a letter to a doctor who told me to “watch” my daughter’s weight.

You may feel intimidated and uncomfortable advocating for your child in this way, but you simply must. If your child’s doctor is not open to having these discussions with you, then you must find a different doctor. Period.

Fight the good fight

A child who is living in a larger body needs a parent who is aware of weight stigma. Parents should create safe spaces and reduce the risks of weight stigma for their child. With your attention and care, your child can avoid the worst socio-emotional impacts of weight stigma.


References

[1] Su & Aurelia, Preschool children’s perceptions of overweight peers, Journal of Early Childhood Research, 2011

[2] Gable, Krull, & Chang, Implications of Overweight Onset and Persistence for Social and Behavioral Development Between Kindergarten Entry and Third Grade, Applied Developmental Science, 2009

[3] Gray, Kahhan, & Janicke, Implications of Overweight Onset and Persistence for Social and Behavioral Development Between Kindergarten Entry and Third Grade, 2009

[4] Gunnarsdottir, Njardvik, et al., Teasing and social rejection among obese children enrolling in family-based behavioural treatment: Effects on psychological adjustment and academic competencies, International Journal of Obesity 2012

[5] Hayden-Wade et al., Prevalence, characteristics, and correlates of teasing experiences among overweight children vs. non-overweight peers, Obesity Research, 2005

[6] AW Harrist, TM Swindle, et al, The Social and Emotional Lives of Overweight, Obese, and Severely Obese Children, Child Development, 2016

[7] Puhl, et al., The Role of Stigma in Weight Loss Maintenance Among U.S. Adults, Annals of Behavioral Medicine, 2017

[8] Polivy and Herman, Causes of Eating Disorders, Annual Review of Psychology, 2002

[9] Watkins P., Hugmever A. D., Teaching about eating disorders from a Fat Studies perspective, Transformations, 2012

[10] Van den Berg, Neumark-Sztainer, et al, Racial/ethnic differences in weight-related teasing in adolescents, Obesity, 2008

[11] Reiter-Purtill, Ridel, et al, The benefits of reciprocated friendships for treatment-seeking obese youth, Journal of Pediatric Psychology, 2010

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