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Research examines
weight stigma toward children
(October
2007 Issue)
Overweight people are subjected to intense stigma in our culture,
often treated as lazy or stupid. It's the same on television, in
movies and even books (see Harry Potter's cruel, stupid…and overweight…cousin,
Dudley).
We are a culture that is fixated on weight. Just look at the magazines
lining the supermarket. From headlines on overly thin actresses
("Mary Kate on Death's Door!"), to articles on losing those extra
pounds ("Lose Weight Now - Without Effort!"), the message is the
same: "judge me not by what I do, but by how I look." But keep reading
that same cover and you'll next find a recipe for "Death by Chocolate
Cake" or "Easy Meals the Kids Will Love." It's a one-two punch -
be thin (but not too thin) but eat, eat, eat.
The more we seem to focus on losing weight, the higher our national
obesity rates climb. And children are the most unfortunate victims.
The Institute of Medicine has found that a third of American children
are either obese or at risk for obesity.
According to studies, these children experience prejudice for their
weight, primarily at school and in the home, two places that should
be safe havens for children.
New England Psychologist's Catherine Robertson-Souter spoke
with Rebecca M. Puhl, Ph.D., the director of research at the Rudd
Center for Food Policy and Obesity at Yale University, about the
issue and concern we should all have that a significant group of
children are not receiving fair treatment.
In collaboration with Janet Latner, Ph.D., Puhl authored a comprehensive
literature review addressing weight stigma toward children. Her
current projects include stigma reduction media tools for schools
and research examining weight bias in health care settings.
Puhl serves as co-chair of the Weight Bias Task Force of the North
American Association for the Study of Obesity, and is an editor
of the book "Weight Bias: Nature, Extent, and Remedies."
Q: Tell us about the literature review you recently completed.
A: No one had pulled together the research on obesity and stigma
in kids and we realized there was an important story to be told.
We hope this can set a research agenda of what needs to be examined,
to stimulate more research.
Weight bias in general is very prevalent and socially acceptable.
We want to increase the attention paid to stigma and help people,
especially caregivers, understand that kids are vulnerable to weight
bias.
Q: Is the problem getting worse?
A: I would say that yes, it is getting worse. What is interesting
is that we might expect that as the prevalence of obesity gets greater,
the stigma gets reduced but the opposite finding has occurred. Janet
Latner, the co-author of this study, did additional research with
kids that replicated a study from 40 years ago and found that bias
has worsened, gotten more negative.
Q: Why?
A: I think that several things contribute. The portrayal of
obese individuals in the media, where they are stereotyped and ridiculed,
reinforces how we see obesity. Then, if we think of how much media
both children and adults consume, that's one reason that the stigma
has increased.
Another problem is the belief of personal responsibility for body
weight. It is common for people to perceive obesity as a lack of
willpower or a lack of self-discipline.
And unlike other forms of more widely-recognized stigma like age,
race and gender, there are no legal statutes to protect the obese.
Through all of this, we are sending the message to our children
that this is an acceptable form of bias.
Q: How do you change it?
A: To change this form of bias, we need major shifts in societal
attitude, changes in media portrayals and we have to have a better
understanding of what causes obesity.
For instance, in employment, where companies are starting to penalize
people with a high BMI (Body Mass Index), we have to realize that
having a high BMI doesn't mean necessarily that this person is plagued
with health problems just as being thin doesn't mean they are healthy.
We need to take the focus off the numbers on the scale.
Q: How do you change it for kids?
A: We need school systems to treat weight bias with the legitimacy
they give other forms of bias. We need to have zero tolerance.
School is the most common venue where weight bias occurs, from
other kids and, as increasing research shows, from teachers. There
was a study that interviewed teachers and found they had lower expectations
from obese and overweight children - and that means these kids are
treated differently. Also, kids are aware of negative attitudes.
They report receiving negative comments about their athletic abilities
in another study. This leads them to not participate in physical
activities, which adds to their weight problem.
Phys-ed teachers need to be aware how body conscious PE classes
are for kids, not just for overweight kids but for all kids. This
is an environment where students get most teased and the teachers
need to structure classes in ways to allow all kids to be successful.
Q: How do you answer people who counter that everyone is responsible
for his own weight and so the bias is actually just a fair assessment?
A: When we think about causes of obesity, you have to remember that
this is a result of a complex interaction of environmental, genetic
and behavioral factors. Behavior is only one piece. They say that
our genes load the gun and our environment pulls the trigger. Unhealthy
foods are cheap, accessible and they taste great and children are
heavily targeted by advertising. Kids see at least 10,000 ads for
unhealthy foods each year. They get mixed messages: they are told
that it's bad to be fat but at the same time bombarded with messages
in the media that they have to eat a lot.
Individual choice does weigh into it, but our bodies are really
programmed to gain weight easily. They are adaptive from when food
was scarce. Now that food is overabundant, our bodies are not programmed
to get rid of fat cells - that is why it is very easy to put it
on and very hard to take it off once you have.
I get the question from people that maybe the stigma is good as
it would motivate people to lose weight. But instead, it contributes
to additional weight gain. For example, kids who are teased about
their weight can often respond by eating more or participating in
less physical activity. Self blame and negative emotions are not
effective.
Q: Does the stigma actually make it harder for kids to get healthier?
A: Kids who are teased about their weight sometimes cope by engaging
in binge eating and avoidance of physical activity. It can become
a negative and dangerous cycle. The more kids are stigmatized, the
more likely they are to blame themselves. They internalize the negative
attitude.
Kids who are teased are vulnerable to a range of negative attitudes
including depression and suicidal behavior. Studies that showed
that overweight kids who are teased about their weight are two to
three times more times likely to attempt suicide even than other
kids who are overweight and not teased.
Q: What can schools and parents do?
A: School and home environments need to promote healthy lifestyle
behaviors for children. It is important for all kids, no matter
what body size they are.
Schools need to treat this with the legitimacy that they treat
other forms of bias and intervene when there is a problem.
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