Teasing children about weight increases risk of self-stigma as adults, study finds | Obesity

Parents who tease their children about their weight are putting them at greater risk of feeling bad about their bodies decades later, regardless of whether they grow up to have obesity or not, a groundbreaking study has found.

Thirteen-year-olds who felt pressure from family members to shed pounds and endured weight-based teasing showed higher levels of internalised weight stigma when they turned 31, according to research by the University of Bristol published on Tuesday in the Lancet Regional Health Europe journal.

Internalised weight stigma causes people to think they are less attractive, less competent, or less valuable as a person because of their weight, even if they do not have obesity or are underweight. It is linked to eating disorders and an increased drive for thinness.

The research found “strong and long-lasting effects on adult psychological health” caused by pressure from parents and families as well as bullies and the media.

The findings came from more than 4,000 children from in and around Bristol who were first studied in the 1990s and are now 33. It is the first study to explore the effects of such pressure across decades of people’s lives, the authors claim.

Obesity UK told a 2022 parliamentary inquiry into the impact of body image on physical and mental health that weight stigma was associated with depression and anxiety and compromised psychosocial wellbeing, could lead to avoidance or delay in adopting healthier habits and was associated with an increased risk of mortality independent of a person’s weight.

“Given substantial evidence that internalised weight stigma has serious implications for mental and other aspects of health, these findings will be crucial for targeting prevention programmes and supporting people most at risk,” the study authors concluded.

At age 13 the children were asked about how often their mother or father had made a comment about their weight and how much they were eating that made them feel bad, to what extent family members and people at school teased them about their weight or body shape, and how much pressure they felt to lose weight from family, friends and people they dated.

Eighteen years later, the same 4,060 people, now adults, were asked to rate their agreement with questions such as “I hate myself because of my weight” and “I am less attractive than most other people because of my weight”.

The researchers found that negative weight-related comments from parents, and feeling under pressure to lose weight from family and the media had the strongest associations with adults suffering with weight stigma and the connections were “robust”.

“The kids who get these comments from family members almost 20 years later have a more negative evaluation of themselves,” said Dr Amanda Hughes, a co-author of the report and a fellow at Bristol medical school’s department of population health science. “This is predicting a difference in people’s self-esteem and psychological health.”

She urged parents to “be really careful” when they talk to children about weight.

“This isn’t to say you shouldn’t be promoting healthy eating or saying exercise is a good thing, but it is about why you are making that case,” she said. “It’s about encouraging healthy eating practices for their own sake or because it makes you feel good. Don’t make it about ‘you need to be thin to be good’.”

Separately, people who were bullied as children also showed greater weight stigma, but the effect diminished depending on how long ago the bullying happened.

As the people in the study were children well before social media, the findings on the effects of media are likely to be out of date. Further research is needed to track the impact of the children’s exposure to social media later in life.

Hughes said it may not all be negative as social media could also be how people connected to body positive content.