Obese kids face stigma, isolation

And they have to overcome many other additional barriers to lose weight, making it especially hard for them to shed the pounds, the findings suggest. The researchers analyzed 30 previously conducted studies, involving just over 1400 12-18 year olds, where young people had talked about three main areas: general and societal perceptions of differing body sizes; what it was like to be overweight; and what it was like to try and lose excess weight.

The analysis revealed that young people of all body sizes in the UK predominantly felt that the social implications of a large body size were more important than the health consequences. In general, young people thought that individuals were responsible for their own body size. They associated excess weight with negative stereotypes of laziness, greed, and a lack of control. And they felt that being overweight made an individual less attractive and opened them up to bullying and teasing.

Young people who were already overweight tended to blame themselves for their size. And those who were classified as very overweight said they had been bullied and physically and verbally assaulted, particularly at school. They endured beatings, kickings, name-calling, deliberate and prolonged isolation by peers, and sniggering/whispering. Some young people described coping strategies, such as seeking out support from others. But the experiences of being overweight included feeling excluded, ashamed, marked out as different, isolated, ridiculed and ritually humiliated. Overweight young people described others' responses to their appearance as a key factor in loss of confidence, anxiety, loneliness and depression, and a vicious circle of subsequent comfort eating and further weight gain.

The level of ridicule they faced made it hard for them to take part in exercise to lose weight, but so too did breathlessness on exertion and other complications of overweight, such as asthma. And the ready availability of calorie dense foods, poor dietary advice, and constant pressure to lose weight were cited as other barriers to achieving a healthy weight.

Few studies asked young people what would help them cope better with these pressures, but less judgemental responses from health professionals, and the support and encouragement of family and friends were seen as important. The study is published in the online journal BMJ Open.