AAP and the Obesity Society Address the Social and Emotional Impact of Weight Stigma on Children and Teens

According to national agencies, for children who have overweight or obesity, stigma and discrimination can add to their health problems and harm their quality of life, making them feel isolated, embarrassed and sad.

According to research, weight alone can be a predictor of victimization and bullying.

In the new jointly written policy statement, the American Academy of Pediatrics and the Obesity Society offer guidance for pediatricians and health care professionals to reduce weight stigmatization and discrimination and to educate others about the negative consequences of such actions. The policy was published online this month and will be published in the December 2017 issue of Pediatrics.

“Treating obesity is complex and challenging,” said Stephen J. Point, MD, MPH, FAAP, and lead author of the policy and founding chair of the AAP Section on Obesity Executive Committee. “Sometimes we can forget the burden that weight stigma places on children and families struggling with obesity.”

Weight stigma among youth is most often experienced as victimization, teasing, and bullying. In the school setting, weight-based bullying is among the most frequent forms of peer harassment reported by students, according to the report.

Officials note, 71 percent of those seeking weight loss treatment say they have been bullied about their weight in the past year and more than one third indicated that the bullying has gone on for more than five years.

“Youth face weight teasing and victimization at school from peers, but sometimes also at home from parents,” said co-author Rebecca Puhl, Ph.D., deputy director for the Rudd Center for Food Policy and Obesity and fellow with the Obesity Society. “The issue needs to be on the radar for pediatric health professionals, who may be among the few allies who can offer support and help prevent youth from further harm from these experiences.”

Weight stigma increases feelings of isolation and sadness, which can lead to avoiding activities, binge eating, and additional weight gain noted officials.

“Words are powerful and can encourage or do harm, and so when working with families trying to make healthy changes, I remind myself: be nice, be patient,” Dr. Pont added. “If we are aware and avoid words or actions that could be felt as stigmatizing by other patients, then we will be more successful.”

Both AAP and the Obesity Society say they encourage health care professionals to model non-biased behaviors and language. AAP recommends using “people first” language, such as “children with obesity” instead of “obese child.” They explain empathetic and empowering counseling techniques are also encouraged, such as motivational interviewing, and addressing weight stigma and bullying in clinic visits.

The report suggests health care professionals can advocate for training and education about weight stigma in medical schools, residency programs, and continuing medical education programs. Officials say they can also empower families to be advocates to address weight stigma in the home environment and school setting.

“Treating children and teens who have obesity means more than just changing nutrition and physical activity habits. It’s also about addressing the social and emotional impact that excess weight can have on their quality of life,” noted Dr. Pont. “Through these new recommendations, we hope to encourage more effective and empathetic approaches in how we address and care for children and families with obesity.”

Michaela Madison Reporting

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