Weight-related teasing and bullying are widely reported by adolescents and their parents, according to findings reported in a poster presentation at the 39th Annual Meeting of The Obesity Society (TOS) at ObesityWeek® 2021.
“Weight stigma is an important concept for health care providers to consider when delivering care to persons with overweight or obesity,” explained lead author Karyn Roberts, PhD, RN, CHSE, who is clinical assistant professor at the University of Wisconsin-Milwaukee College of Nursing. This stigma has been linked to adverse health behaviors, psychological problems, decreased health-related quality of life, and weight gain. Adolescents aged 12 to 19 years have the highest rates of severe obesity (11.7%), Dr. Roberts explained.
To better understand the experiences of weight stigma in this population, the researchers examined 31 transcripts from interviews with 12 adolescents with severe obesity (7 boys, 5 girls) attending a pediatric weight management program located in a large metropolitan children’s hospital and 19 of their parents (17 mothers). The children and parents identified as primarily White and Latino.
Repeated Episodes of Teasing and Bullying Reported
“Both parents and adolescents described episodes of teasing and bullying about the adolescent’s weight occurring over time, repeatedly, and in a variety of settings and from a variety of sources,” Dr Roberts said. Interactions with health care providers outside of the weight management program were often perceived as negative when the adolescent’s health concerns were ignored and health care providers just assumed those symptoms and concerns were related solely to their weight.
“The interesting thing about this secondary analysis was that in my interviews I did not ask any questions about stigma, teasing, and bullying; the intent was really to just ask about their experiences daily in following the recommendations of the clinic,” Dr Roberts said in a Q&A session. When asked what led them to the weight management program, “over and over again the kids and parents talked about these experiences’ sharing some very difficult experiences with peers, family, and health care workers,” she said.
Both adolescents and their parents reported feeling blamed by others and themselves for the adolescent’s weight. This study was also published in the Journal of Advanced Nursing.
Study limitations included possibly losing content or context from Spanish translation and inclusion of only adolescents who were seeking obesity treatment.
“This secondary analysis adds to the sparse literature documenting the experiences of weight stigma from adolescents with severe obesity and their parents,” Dr Roberts explained. “It is important to understand these experiences as they offer context to provide more empathetic health care, which is free of weight stigma, and allow holistic health to be the focus of care regardless of a patient’s weight status.”
Mitigating Obesity Stigma
These data can also inform education and health policies, Dr Roberts concluded. Strategies to mitigate this stigma include helping families understand that weight loss is a multifactorial and complex issue that is not as simple as energy in and out, and that the “shame and blame” mentality will backfire and does not motivate children to adopt healthier behaviors, she said.
“Educating families on implicit weight biases in a nonjudgmental way that acknowledges we all have them is something to consider,” Dr Roberts explained. She added that peer support networks may be advantageous for teenagers with obesity.
Support for public policy prohibiting weight discrimination is growing in the United States as reported in a separate study at the meeting.
Dr Robert’s study was funded by Sigma Theta Tau International Small Grants.
Roberts KJ, Polfuss M, Marston EC, Davis RL. Experiences of weight stigma in adolescents with severe obesity and their families. Poster presented at: ObesityWeek® 2021; Nov. 1-4, 2021.
Roberts KJ, Polfuss ML, Marston EC, Davis RL. Experiences of weight stigma in adolescents with severe obesity and their families. J Adv Nurs. 2021;77(10):4184-4194. doi:10.1111/jan.15012