You’ve seen these kids. They stand apart at recess, with no one to talk to while other children hang out in small groups, run around raucously or play games. Or you may have seen them at lunch, sitting conspicuously alone, head down, at a long empty table.
That’s what it looks like to be fat-shamed and shunned by your peers when you’re an obese child. According to a recent study, this rejection starts as early as first grade. Children who are obese are less liked by their peers, and picked on and made fun of more often than peers of healthier weights, the study found. In response, heavy children are more likely to be withdrawn and show signs of depression.
KwiYun Yu, M.D., a child psychiatrist at Swedish, says this fits the profile of the obese children she sees. “They are targeted and isolated, and they are ashamed,” Dr. Yu says.
Schools can intervene, but Dr. Yu says the best help starts at home.
The study, published in the journal Child Development, looked at 1,164 first-graders from 29 rural schools in Oklahoma to examine the social and emotional lives of obese children. The adult obesity rates in the region, spread over eight counties, ranged from 28 to 41 percent. Obesity disproportionally affects kids from low-income families, and most of the children in the study fell into that group.
Social media becomes a cruel tool
• Severely obese children were teased more than overweight children.
• Obese children weren’t mentioned by peers when children were asked whom they liked to play with most and least.
• Severely obese children were actively rejected by their peers, frequently mentioned as their least favorite playmates and rarely mentioned as the most favorite.
• Severely obese children had more symptoms of depression than children who were overweight and normal weight.
With cruel words and images splashed across Facebook and Twitter, Dr. Yu says social media add a new dimension to fat-shaming. “The rejection is so public. The name-calling, the teasing and shunning – it’s out there for everyone to see,” she says.
“Some children react to the shaming and bullying by eating even more, which compounds their weight problems.”
Painful isolationThis emotional or stress eating can be a sign of depression, along with:
- Withdrawing and talking less to parents
- Sinking grades
- Inability to function as a student, friend or member of a household
- Defiance, rebelliousness
A growing problemWhat can be done to help these children? The authors of the study say schools need to act early to encourage inclusive, respectful behavior among peers and help shunned kids make friends.
Dr. Yu agrees, but says steps to address bullying and other harmful behavior tend to be more effective in affluent school districts than in poor ones. One problem is that poorer districts have fewer resources for special programs, and sometimes more immediate issues to address. These can include weapons, drugs and violence. “In these situations, bullying gets ignored,” Dr. Yu says.
Obesity in children is a growing problem in the U.S. Among children and adolescents ages 6 to 19, almost 1 in 3, or 33.2 percent, are considered to be overweight or obese. An estimated 4.5 million children and teens have severe obesity.
Help starts at home
In working with children who are obese, Dr. Yu doesn’t focus simply on a child’s weight. “Targeting weight gives you a really limited perspective,” she says. “We need to look at the context. Are there underlying emotional problems?”
In fact, she says, helping a child who is obese begins at home. “The gold standard of therapy involves not just the child but the entire family. We need to target changing the lifestyle within the family system.”
Therapy can help children emotionally, raise their awareness of healthy foods and encourage them to be more active, she says. But if parents don’t commit to improving a family’s diet, eating habits and activity levels, it’s extremely difficult for children to change on their own.
“If we want results, we must model change – not talk to kids about their weight and diet, but model what we want them to do,” Dr. Yu says. “A child’s self-esteem and a positive self-concept comes from parenting. We must model behavior that will give them those things.”
If your child is struggling with obesity and self-esteem or fat-shaming, Swedish Pediatrics can help you determine how best to help your child. If you want help for the whole family, talk to a Primary Care provider.