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AAP: Empathetic counseling needed to address pediatric obesity stigma
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A ‘patient first’ approach using positive language and actions is encouraged when treating children who have overweight or obesity to reduce the stigma surrounding the conditions, according to a policy statement issued by the AAP Section on Obesity and The Obesity Society.
“Treating obesity is complex and challenging,” Stephen J. Pont, MD, MPH, FAAP, founding chair of the AAP Section on Obesity Executive Committee and medical director of the Texas Center for the Prevention and Treatment of Childhood Obesity, said in a press release. “Sometimes, we can forget the burden that weight stigma places on children and families struggling with obesity.”
The prevalence of obesity is notable, with one-third of children in the United States being overweight or obese and 17% between the ages of 2 and 19 years of age experiencing obesity. These statistics make obesity the most common chronic condition among children in the country.
The stigma most frequently experienced by children includes victimization, teasing and bullying in the school setting. According to researchers, weight is the one of the most commonly reported reason for bullying in this environment, with 71% of children attempting to lose weight citing overweight and obesity as a catalyst for bullying in the past year. Over one-third of these children claim that this bullying has been ongoing for more than 5 years.
“Youth face weight teasing and victimization at school from peers but sometimes also at home from parents,” Rebecca Puhl, PhD, deputy director for the Rudd Center for Food Policy & Obesity and a fellow with The Obesity Society, said in the release. “This issue needs to be on the radar for pediatric health professionals, who may be among the few allies who can offer support and help prevent youth from further harm from these experiences.”
“Words are powerful and can encourage or do harm, and so when working with families trying to make healthy changes, I remind myself: be nice, be patient,” Pont said in the release. “If we are aware and avoid words or actions that could be felt as stigmatizing by our patients, then they will be more successful.”
The policy statement suggests that health care professionals working with overweight or obese children should use nonbiased behavior and language with their patients. Examples of nonbiased language embraces using a ‘people first’ approach when discussing patients’ conditions in which patients are not referred to as ‘obese patients’ but rather ‘patients with obesity.’
Pont and colleagues suggest tactics such as motivational interviewing and focusing on stigma and bullying that these children may face during appointments. The researchers also recommend training and educational programs in medical schools regarding weight stigma. Additionally, this stigma should be addressed in families because family members can become advocates for children in both the home and school settings.
“Treating children and teens who have obesity means more than just changing nutrition and physical activity habits. It’s also about addressing the social and emotional impact that excess weight can have on their quality of life,” Pont said in the release. “Through these new recommendations, we hope to encourage more effective and empathetic approaches in how we address and care for children and families with obesity.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
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