Calling Children Fat Won't Protect Them From Obesity

Weight stigma in childhood associated with obesity in early adulthood

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Public anti-obesity efforts often promote weight stigmatization, such as using negative language or offensive stereotypes about obesity. But this view may have detrimental effects, especially in children.

A recent study found that girls labeled "too fat" by family members and peers at age 10 had increased odds of being obese at age 19.

The researchers discovered that this association was independent of body mass index (height to weight ratio) at age 10, suggesting that weight stigma in early life may have lasting consequences on weight gain.

"Discuss weight in a healthy way with your child."

This study was conducted by Jeffrey M. Hunger, MA, of the University of California, Santa Barbara, and A. Janet Tomiyama, PhD, of the University of California, Los Angeles.

The study included 1,213 black girls and 1,166 white girls who took part in the National Heart, Lung and Blood Institute Growth and Health Study from age 10 to age 19.

Each girl's parent or guardian provided information on their household income and education status at the beginning of the study when the girls were 10 years old.

The researchers took body measurements and recorded the date of each girl's first period.

The girls were asked if they had been "weight labeled" by any of the following people who may have "told you that you were too fat?":

  • Father
  • Mother
  • Brother
  • Sister
  • Best girlfriend
  • Boy you like best
  • Any other girl
  • Any other boy
  • Teacher

The girls were followed-up until age 19 when obesity status was assessed.

The findings showed that 1,188 (58 percent) of the girls had been labeled as fat at age 10. The black girls reported more weight labeling than the white girls, although the difference was small.

After adjusting for baseline body mass index, household income, parental education status, race and age at first period, the researchers determined that the girls who were labeled as too fat at age 10 had 66 percent increased odds of being obese at age 19.

When limited to family members only, weight labeling at age 10 was associated with 62 percent increased odds of obesity at age 19.

When non-family members were the source of weight labeling at age 10, the girls who were weight labeled had 40 percent increased odds of being obese at age 19.

Dr. Tomiyama and Hunger wrote that these findings show that the relationship between weight stigma and weight gain can begin early in life and continue to have lasting effects past childhood.

The researchers also believe that weight stigma at an early age may increase obesity-related stress processes and coping behaviors that contribute to weight gain, such as overeating.

"Not only are stigmatizing approaches to weight loss ineffective, they can often lead to a worsened condition over time. The damage to self-confidence and self-esteem can be very difficult to overcome," said Rusty Gregory, a personal trainer and wellness coach in Austin, Texas and a dailyRx Contributing Expert.

"Instead, providing information on the pros and cons of achieving and maintaining a desirable weight can tip the decisional balance in favor of a healthier weight and lifestyle. This is more likely to produce an 'I can' mentality and increase desire to change," Gregory said.

The authors of this study concluded that incorporating weight stigma into public health policy has been ineffective. Therefore, other researchers, public health officials and doctors should consider employing non-stigmatizing approaches to improving the health and overall well-being of overweight children.

This study was published on April 28 in JAMA Pediatrics.

Review Date: 
April 26, 2014
Last Updated:
April 29, 2014