How weight stigma impacts obesity in childhood—and how MEND trains frontline professionals to deal with it

The prevalence of obesity among American youth is an ongoing concern. National survey data show that obesity in children aged 2–19 years reached 18.5% in 2016. Public health programs, policies and interventions, such as the MEND program, have made it easier for children and families to improve their eating and physical activity behaviors. Yet, many of these efforts do not adequately address the consequences of weight stigma in youth and how that impedes progress in reaching weight-related health goals.

The American Academy of Pediatrics (AAP) and The Obesity Society issued a policy statement in 2017 on stigma experienced by children and adolescents with obesity and how it can affect the social, psychological and physical well-being of these youth.

According to the AAP statement, weight stigma is the devaluation of a person because they have overweight or obesity. It often includes stereotypes that people with obesity are lazy or lacking in willpower. In children, weight stigma can lead to teasing or social isolation, which can impair their quality of life. Students, parents and teachers have reported that weight-based bullying is the most common form of bullying at school. Research shows that youth who are bullied about their weight are more vulnerable to depression, low self-esteem and poor body image.

Some well-meaning people, including family members, may believe that weight shaming and blaming will motivate children to change their eating and activity habits. Instead, it is likely to do just the opposite. Weight stigma can lead to unhealthy eating behaviors, decreased physical activity, social isolation, and excess weight gain over time.

Parents and healthcare professionals can help reduce stigma in children with overweight or obesity. Here are some tips taken from the MEND program:

  • Recognize that there are many causes of obesity in childhood. These include genetic, environmental and socioeconomic factors, plus cultural practices, family traditions and personal choices.
  • Use neutral, non-stigmatizing language. When speaking to children about their weight, try “your weight” or “above a healthy weight for your height” instead of using “fat” or “obese.” Also, choose people-first language that puts the person before the medical condition. For example, use “a child with obesity” instead of “an obese child.”
  • Focus on health rather than size. Emphasizing a child’s size and need for weight loss may not be appropriate and can lead to weight stigma. Instead, focus on making food and activity choices that will help children have energy and be healthy.
  • Let children know that they are worth more than their weight. If children are bullied because of their weight, they may believe that what they look like is more important than who they are. Instead, praise them for their good qualities, such as their personality, intelligence, talents or helpfulness. Support and acknowledge their efforts and successes in making positive lifestyle changes.

Healthy Weight Partnership realizes that talking about weight is a sensitive issue for children and parents. The MEND program offers guidance to parents on how to talk to children about their weight in a positive and helpful way.