Do you have a child who is living in a larger body? Are you worried about your “fat” kid? You should be, but not because of their adipose tissue. The reason you should be worried about your child who lives in a larger body is that fat stigma begins early and can have a significant impact on your child’s lifelong health. While popular media and healthcare providers scream about the dangers of fat cells, the real danger is weight stigma and weight discrimination.

What is weight stigma?

Weight stigma is discrimination or stereotyping based on a person’s weight. It reflects internalized societal attitudes towards body size and impacts how we treat each other. For example, weight stigma leads many people to believe that a person who is living in a larger body is lazy, eats unhealthy food all the time, and is less intelligent and worthy of respect. This leads to discrimination that has a lifelong impact on health.

The leading perpetrators of fat stigma are media and entertainment outlets, which frequently portray strongly biased views of people living in larger bodies. Media and entertainment outlets including newspapers, magazines, books, movies, documentaries, videos, photographs, social media accounts, and more, depict fat people in dehumanizing and stigmatizing images. Fat people are shown eating fattening foods (compared to thin people with colorful salads), sitting (compared to thin people exercising), and wearing tight, ill-fitting clothing (compared to stylish thin people). Fat people are portrayed in the media as lazy, weak-willed, self-indulgent, and a drain on the nation’s resources.

The second leading source of weight stigma are people in the medical and healthcare professions, creating a significant barrier to healthcare for anyone who lives in a larger body. No visit to the doctor, regardless of the purpose, begins without an attempt to weigh the body. And for anyone in the “overweight” and above categories according to BMI, every visit includes a lecture about weight reduction, despite the fact that there is no proven, safe, and effective method for reducing weight. This leads to delayed diagnosis and treatment for many people who have serious medical conditions but are told simply to move more and eat less to address their symptoms, or that they must lose weight before treatment can begin.

What happens to fat kids?

Our kids grow up in an ecosystem that is full of weight stigma. As early as preschool, children prefer very thin to overweight ﬁgures in drawings and stories (Su & Aurelia, 2012). By elementary school, obese children report unsatisfactory peer relations, including social rejection (e.g., Gable, Krull, & Chang, 2009; Gunnarsdottir, Njardvik, Olafsdottir, Craighead, & Bjarnason, 2012).

Children who are living in larger bodies are at increased risk for being targets of weight-related teasing (Gray, Kahhan, & Janicke,2009), and they also experience more non-weight-related teasing and bullying (Gunnarsdottir et al., 2012), and other forms of victimization such as physical aggression (Hayden-Wade et al., 2005).

Fat kids are treated differently by their peers as early as the ﬁrst grade. They are less likely to be well-liked and well-treated and they struggle with loneliness and friendships. Severely obese children are more likely to be rejected, made fun of, teased, picked on, and disliked (Harrist, Swindle, Hubbs-Tait, Topham, Shriver, and Page, 2016).

Fat stigma leads to poor health and eating disorders

While the “War on Obesity” has failed to reduce the national weight, it has succeeded in increasing fat stigma, which many researchers say is more health-damaging than fat itself. Weight teasing and bullying in adolescence leads to higher BMIs 15 years later. This means that the “War on Obesity” is actually causing people to gain weight. People who are exposed to weight stigma are also more likely to exhibit eating disorder behaviors including extreme dieting and self-induced vomiting (Puhl, et al., 2017).

In cultures with fat stigma, we see more young women who express dissatisfaction or disgust with their bodies, which is an essential precursor (and continuing accompaniment) of eating disorders. (Polivy and Herman, 2002). There is a strong relationship between the “obesity epidemic” and the proliferation of eating disorders. “If fat bodies were accepted and not hated in our culture, fat people would not embark on restrictive eating or disordered eating in order to lose weight, and the majority would not develop eating disorders.” (Watkins and Hugmever, 2012)

It is important to note that to solution to help your child live a healthy life when they are living in a larger body is not to put them on a diet or promote weight loss. It is to help them manage the impact and reduce their exposure to weight stigma.

Here are 3 things you can do if you are a parent to a child who is “fat,” “overweight,” or “living in a larger body.”

1. What you can do at home

If you have a child who is living in a larger body, then how you treat them at home can be an important balm against the fat stigma they will experience in the world. A safe, secure home environment free of fat stigma can go a long way to preventing the troubles associated with living in a larger body in our current society. Here are a few basic rules to implement at home. These rules must be enforced across all family members and anyone who enters your home without exception. Your child needs to truly believe that your home is a safe place, free from judgment.

No diets – nobody in the home should even go on a restrictive diet with the purpose of losing weight. No food policing – a wide variety of food should be available to everyone in the home without restriction or monitoring. No fat shaming – nobody in the home should ever tease or criticize another person’s body, whether they are in the family, outside of the family, a celebrity, a stranger, etc. No body-type glorification – everyone should learn to avoid making comments about “perfect bodies” and glorifying any particular body type, praising people for weight loss, discussing methods to achieve weight loss or a “perfect butt,” “washboard abs,” etc. No scales – there is no reason to keep a scale in the home. Throw it away. Health at Every Size philosophy – learn about and embody the HAES philosophy that any body can be healthy.

Please remember that your child’s siblings can be a major source of shame and ridicule for your larger child. You must maintain strict rules for sibling behavior and make sure you never encourage (and actively discourage) any form of teasing about weight or body size.

2. What you can do at school

School is the place in which your child is most at risk of fat stigma. Approximately 43% of overweight or obese adolescents reported being teased by peers (Van den Berg, Neumark-Sztainer, Eisenberg, & Haines, 2008). To help your child, you must advocate for them at the school and classroom level. Here are a few goals for your child’s school environment:

Language – your child should be able to expect an environment in which body size is not criticized or stigmatized by teachers. Any discussions about being healthy must be decoupled from body weight. Dress codes – larger children should be held to the same dress code standards as smaller children. This means that short-shorts may reveal more “skin” on a larger child, but if the length of the shorts is identical in comparison to the child’s height, a child living in a larger body should not be penalized differently than a child living in a smaller body. Weighing – children should not be weighed at school. There is no educational justification for weighing children at school, and it can be a shameful event for a child who is living in a larger body.

It may be tricky to advocate for your child’s safety at school, but it is essential. To get started, review Linda Bacon’s guide for teachers and administrators.

Also, help your child build friendships from an early age. Studies have found that just one friend in a class can buffer the negative effect of poor treatment by peers. (Reiter-Purtill, Ridel, Jordan, & Zeller, 2010)

3. What you can do at the doctor’s office

Weight stigma in the healthcare setting is pervasive and leads to lifetime health impacts, including fewer doctors’ visits, screenings, immunizations, and more. Help your child learn to navigate the health system while living in a larger body by doing the following:

Don’t weigh my child: unless your child is going on medication or going into surgery, there should not be a reason for them to be weighed every time they go to the doctor. Talk to your doctor in advance about avoiding the shame-inducing and unnecessary act of being weighed at every appointment. Ask whether being weighed is a medical necessity or simply part of their administrative process. Stand up for your right to protect your child from being weighed unless medically necessary (and no, being “overweight” does not justify being weighed at every visit). Don’t tell my child to lose weight: there is not a single proven weight intervention yet. While most people can lose weight short-term, intentional weight loss results in regain and even additional pounds two years later. Tell your doctor not to suggest weight loss – even the seemingly benign “move more/eat less,” which is entirely unhelpful. Treat my child without bias: weight bias is unconscious, which is why it’s so damaging in the healthcare setting. Bring it to the forefront by talking to your child’s doctor about weight bias. Tell your child’s doctor that you expect them to treat your child as if your child is living in an “average” sized body.

You may feel intimidated and uncomfortable advocating for your child in this way, but you simply must. If your child’s doctor is not open to having these discussions with you, then you must find a different doctor. Period.

A child who is living in a larger body needs a parent who is aware of the nature of body weight and weight stigma and is willing to create safe spaces and reduce stigma in the education and healthcare settings. With your attention and care, your child can avoid the worst socio-emotional impacts of living in a larger body.

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