Kibitzers and Weight Concern—to comment, or not to comment?

Most individuals, if not all, have found themselves in a situation where they felt they simply had to say something. Afterall, to notice an individual’s weight with concern and not say something would be a complete negligence of all moral obligation. This is the mindset we often hold in order to justify the idea of delivering unsolicited weight advice to others. Interestingly, research has begun to investigate the impact of this common conviction and has found it may do more harm than good. Five studies in particular focused on the long-term health impacts of weight teasing when directed toward children and adolescents.

A longitudinal study with a duration of 15 years and including 1774 participants, aimed to determine if there were differences in regard to the severity of health outcomes depending on the source of the weight teasing¹. Upon the completion of the follow-up, it was found that, for females, a variety of weight-centered health issues were more likely to emerge later in life when family was the source of the teasing. Another study looked for a link between the presence of weight stigma in the lives of adolescents and their risk for developing an eating disorder later in life. This study did in fact, find a connection between the development of eating disorders in those who were exposed to both weight stigma and/or weight bias internalization².

Ahorsu, et al, dove deeper in an attempt to uncover a correlation between weight-related self-stigma and binge eating disorder. Yet, with 1,497 participants and a prospective study design, the results were not sufficient in supporting the research question. However, the researchers were able to conclude that while there was little evidence to show a definitive link between self-stigma and binge eating, it is highly plausible that weight-related self-stigma plays a role in the development of other psychological issues³. A particularly interesting study by Rowlinson, et al, took a unique approach by assessing the presence of weight bias/discrimination in children ages 4 – 6 years. The methods included the presentation of a story book which included a variety of characters (i.e. a physically disabled character and a fat character) among other able-bodied, straight-sized characters. Shockingly, the majority of young children in this study rated the fat character as less likely to win a race and more likely to have fewer friends. This study hints at the prevalence of significant externalized weight bias in young children⁴. The final study assessed the method of support preferred by youth who were experiencing forms of weight discrimination or victimization. Results revealed that more than half of the 361 participants reported via survey that they preferred peer support over parental support⁵.

What, then, should parents and practitioners do?

Bias begins in the home. Therefore, it is the responsibility of parents to:

1. Work on identifying their own bias.
2. Refrain from making weight-centered remarks toward or around their children, whether well-intended or not.
3. Gently correct their children if they repeat weight discriminating comments overheard at school or on television. Explain why it is not appropriate to comment on another individual’s body, whether well-intended or not.

In regard to the role of practitioners, healthcare providers should:

1. Consider reflecting on their primary concern when a child of a high or low weight visits their clinic. If the approach revolves around the thought, “this child will be teased if they don’t get into shape”, perhaps it may prove to be more beneficial if the discussion-focus includes ensuring the child has a solid peer group and family support system.

2. Provide parents with the educational resources needed to understand the long-term health impacts of weight discrimination, rather than the health impacts of weight alone.

Sources

1. Puhl RM, Wall MM, Chen C, Bryn Austin S, Eisenberg ME, Neumark-Sztainer D. Experiences of weight teasing in adolescence and weight-related outcomes in adulthood: A 15-year longitudinal study. Prev. Med. 2017;100:173-179. doi:10.1016/j.ypmed.2017.04.023
2. Chen H, Ye Y, Guo J. Impact of weight stigma on preadolescents’ and adolescents’ disordered eating behaviors: Testing two mediation models. J Soc Behav Pers: an international journal. 2020;48(10):1-15. doi:10.2224/sbp.9392
3. Ahorsu DK, Lin CY, Imani V, et al. A prospective study on the link between weight‐ related self‐stigma and binge eating: Role of food addiction and psychological distress. Int J Eat Disord. 2020;53(3):442-450. doi:10.1002/eat.23219
4. Harrison S, Rowlinson M, Hill AJ. “No fat friend of mine”: Young children’s responses to overweight and disability. Body Image. 2016;18:65-73. doi:10.1016/j.bodyim.2016.05.002
5. Puhl RM, Peterson JL, Luedicke J. Strategies to address weight-based victimization: youths’ preferred support interventions from classmates, teachers, and parents. J. Youth Adolesc. 2012;42(3):315-327. doi:10.1007/s10964-012-9849-5