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Young females labeled as 'too fat' more likely to become obese
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Weight labeling during early childhood — whether by a parent, sibling, friend, classmate or teacher — could lead to obesity later, according to findings from a research letter published in JAMA Pediatrics.
Jeffrey M. Hunger, MA, and A. Janet Tomiyama, PhD, both of the University of California, examined data from the National Heart, Lung, and Blood Institute’s Growth and Health Study that followed 1,213 black girls and 1,166 white girls living in northern California, Cincinnati and Washington, D.C., from age 10 to 19 years.
A. Janet Tomiyama
Height and weight were collected for participants at baseline and end of study; 57.9% (n=1,188) of the girls reported being told they were too fat at age 10 years. Parents or guardians provided income and education information. Anthropometry was conducted, and pubertal timing and weight labeling information was gathered. Logistic regression analyses evaluated the association between baseline labeling and obesity.
“Simply being labeled as too fat has a measurable effect almost a decade later. We nearly fell off our chairs when we discovered this,” Tomiyama said in a press release. “Even after we statistically removed the effects of their actual weight, their income, their race and when they reached puberty, the effect remained.”
Receiving a weight label at age 10 years remained a significant predictor of obesity at age 19 years (OR=1.66; 95% CI, 1.2-2.3). Probability changed based on the label coming from family members (OR=1.62; 95% CI, 1.18-2.22) or nonfamily members (OR=1.4; 95% CI, 1.01-1.94).
Public health policies that utilize stigmatizing weight as an anti-obesity effort, the researchers concluded, may hinder rather than help youngsters targeted.
“Researchers, public health officials, and clinicians should consider non-stigmatizing approaches to improving the health and well-being of overweight children,” they wrote.
Disclosure: The researchers reported no relevant financial disclosures.
Perspective
Back to TopTed Kyle, RPh, MBA
Time to put children first, ahead of a label
The research letter by Jeffrey M. Hunger, MA, and A. Janet Tomiyama, PhD, both of the University of California, recently published in JAMA Pediatrics adds to the considerable evidence of harm done by labeling children according to their weight status. They found that being labeled as “too fat” in childhood substantially raises the risk that a girl will have obesity at the age of 19 — independent of her childhood weight and other predictors of obesity in adulthood.
Weight bias is pervasive and insidious. People commonly assume that obesity is primarily the result of conscious choices. The scientific literature on obesity tells quite a different story. Roughly 60% of obesity risk is inherited. The remaining risk results from the interaction of genetic risk with individual choices, experiences, and our community environment for food and physical activity. The interactions are complex.
What is not so complex is the destructive effect of shaming and blaming people with obesity. It leads to worse outcomes in health, education, professional achievement and quality of life. And it starts at an early age, as the present study so concisely demonstrates.
For clinicians, the response to this body of knowledge can be straightforward. Treat every patient, of every size with equal respect. Parents and children do not need advice about their weight status as much as they need assistance with improving their health. Offering such assistance without judging parents or labeling children is a good place to start.
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