How Not to Talk to a Child Who Is Overweight

In a study published earlier this year in the journal Preventive Medicine, Dr. Puhl and her colleagues looked at the longitudinal effects of teenagers being teased about their weight. The study involved over 1,800 people who had been followed for 15 years and are now in their mid 30s.

“Weight-based teasing in adolescence predicted obesity, and also eating food to cope with emotions,” Dr. Puhl said. “These teasing experiences have long-lasting implications for health and for health behavior.” For women especially, these adolescent experiences of teasing by peers or family members were associated with binge eating, poor body image, obesity, and a higher B.M.I. 15 years later, she said; for men there were some of the same associations, including obesity as adults, if they had been teased by their peers as adolescents.

Research shows that two-thirds of adolescents in weight-loss camps report being bullied or teased about their weight, over 90 percent of the time by their peers, Dr. Puhl said. A third report that they are also teased by family members. “Pediatric health professionals may be one of the few allies to offer support and try to prevent harm.”

My colleague Dr. Mary Jo Messito, the director of the pediatric obesity program at Bellevue Hospital, said, “the worst thing to do is go into the room with an 11-year-old girl and say, your child is obese, the child will start to cry.” She recently saw a boy whose mother kept bringing up, “‘You don’t want to be like uncle so and so, he had to have this operation, he almost died’ — the kid is now terrified.”

Katherine Bauer, an epidemiologist who is an assistant professor in the department of nutritional sciences at the University of Michigan School of Public Health in Ann Arbor, cited what she called “the prevalent belief that people don’t know they’re heavy, and if we just inform them they will magically be motivated for behavior change.” In fact, she said, weight stigma…

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