Abstract
Weight stigma is rooted in a fundamental misunderstanding of the origins of obesity, wherein the interplay of behavioral, environmental, genetic, and metabolic factors is deemphasized. Instead, the widespread societal and cultural presence of weight stigma fosters misconceptions of obesity being solely a result of unhealthy personal choices. Weight stigma is pervasive in childhood and adolescence and can affect individuals throughout their life. Although the prevalence of pediatric obesity remains high throughout the world, it becomes increasingly important to understand how weight stigma affects weight and health outcomes in children and adolescents with overweight or obesity, including in those with rare genetic diseases of obesity. We identified and reviewed recent literature (primarily published since 2000) on weight stigma in the pediatric setting. Articles were identified with search terms including pediatric obesity, weight bias, weight stigma, weight-based teasing and bullying, and weight bias in health care. In this narrative review, we discuss the stigma of pediatric obesity as it relates to the complex etiology of obesity as well as describe best practices for avoiding bias and perpetuating stigma in the health care setting.
Highlights
Childhood ObesityThe high prevalence of childhood obesity is recognized as a global public health priority.[1]
There remains a need to understand and appreciate the effects of stigma as a modifier of weight gain and poor health outcomes among children and adolescents with overweight and obesity due to various causes, including rare genetic diseases of obesity. The objective of this narrative review is to contextualize the stigma of pediatric obesity within its complex etiology, discuss the sources of weight stigma experienced by children and adolescents, give an overview of the psychosocial and physical consequences of weight stigma, and describe best practices for avoiding bias and perpetuating stigma in the health care setting
Stigma contributes to psychosocial impairments, unhealthy eating behaviors, and weight gain, as well as an enduring negative influence on weight control that continues into adulthood
Summary
The high prevalence of childhood obesity is recognized as a global public health priority.[1]. Immediate and long-term psychosocial health consequences, such as reduced self-esteem and depression, arise in children with overweight and obesity.[3,4] Of note, mental health concerns are the most commonly reported health risk among children with severe obesity,[5] emphasizing the importance of incorporating psychological interventions into other aspects of obesity care One such cause of poor physical health, mental health, and psychological outcomes in children with obesity is weight stigma.[4,6,7,8]. The objective of this narrative review is to contextualize the stigma of pediatric obesity within its complex etiology, discuss the sources of weight stigma experienced by children and adolescents, give an overview of the psychosocial and physical consequences of weight stigma, and describe best practices for avoiding bias and perpetuating stigma in the health care setting
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