Despite years of consciousness-raising about the damaging effects of prejudice, stigma against overweight children is as common--if not more common--as it was 40 years ago, studies suggest.

In turn, overweight youngsters struggle with a range of difficulties related to such bias, including ostracism, low self-esteem, withdrawal from social activities and even suicidal thoughts and attempts, says Yale University psychologist Rebecca Puhl, PhD, who has written extensively on the topic.

"One of the most alarming things we're seeing is a lot of self-acceptance of these stereotypes, and that leads to internalization," Puhl says. "Not only do obese kids feel badly about themselves, but the more they feel they're to blame for their obesity, the worse they feel overall."

Recent studies show the following:

  • Higher bias rates. In the November issue of Obesity Research (Vol. 11, No. 3), psychologist Janet Latner, PhD, of the University of Canterbury in Christchurch, New Zealand, and physician Albert Stunkard, MD, of the University of Pennsylvania, reported a significant rise in bias toward obese children since 1961. The team replicated a 1961 study showing that children tended to pick an obese child as the one they liked the least in a set of six drawings. Four of the drawings showed children with a particular physical disability--including one sitting in a wheelchair with a blanket over the legs, one with facial disfigurement, one who was obese and one who was "normal."

In the new study, conducted with 458 fifth- and sixth-graders, the team found that children liked the obese child significantly less than in the 1961 study, and that the difference between how much they liked the healthy versus the obese child was about 41 percent greater than in 1961.

  • Links between teasing and negative self-image. A study in the August 2003 issue of The Archives of Pediatric & Adolescent Medicine (Vol. 157, No. 8) by Marla E. Eisenberg, ScD, a research associate at the University of Minnesota School of Medicine and School of Public Health, and colleagues found that teens who reported being teased about their weight were more dissatisfied with their bodies and considered and attempted suicide more often than peers who didn't report being teased.

  • Overweight teens have fewer friends. Also in the August issue of the pediatric Archives, Richard S. Strauss, MD, of the University of Medicine and Dentistry of New Jersey, and Harold A. Pollack, PhD, of the University of Michigan at Ann Arbor, found that, among 90,118 teens enrolled in the federally funded National Longitudinal Study of Adolescent Health, those who were overweight were more likely to be socially isolated and to be on the periphery of social networks than their normal-weight peers. They also received significantly fewer friendship nominations, though they themselves listed a similar number of friends as normal-weight adolescents.

Collectively, such findings suggest a strong need for anti-bias interventions, says Puhl. One of the few studies in the area, by Washington State University psychologist Lori M. Irving, PhD, and reported in a 2000 article in Eating Disorders: The Journal of Treatment and Prevention (Vol. 8, No. 2), suggests, encouragingly, that interventions designed to promote size acceptance can improve peer acceptance and reduce teasing of overweight kids.

One way to think about the problem is to separate the problem from the person, Puhl believes. "We do need to fight obesity," she says, "but we don't need to fight obese people."

--T. DeANGELIS

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