The early stigma of being labeled that way may
worsen the problem rather than encouraging girls to become
healthier, but more research is needed to be sure, the study authors
“This study is one step closer to being able to draw that
conclusion, but of course we can't definitively say that calling a
girl "too fat" will make her obese,” said senior author A. Janet
Tomiyama of the University of California, Los Angeles.
“This study recruited girls when they were age 10 and followed them
over nine years, so we know it's more than just a one-time
connection, which makes me believe that it's an important question
to continue researching,” Tomiyama told Reuters Health in an email.
She and her coauthor examined data from an existing study that
followed girls through their teen years. At age 10, the girls
answered the question, “have any of these people told you that you
were too fat: father, mother, brother, sister, best girlfriend, boy
you like best, any other girl, any other boy, or teacher?”
Out of just over 2,000 girls, a total of 1,188 answered “yes” to any
of the choices.
Those girls were more likely to have a body mass index (BMI) – a
measure of weight relative to height — in the obese range ten years
later than girls who answered “no,” according to the results in JAMA
“We know from considerable evidence that youth who feel stigmatized
or shamed about their weight are vulnerable to a range of negative
psychological and physical health consequences,” said Rebecca Puhl,
deputy director of the Rudd Center for Food Policy & Obesity at Yale
University in New Haven, Connecticut.
“This study suggests that negative weight labels may contribute to
these experiences and have a lasting and potentially damaging impact
for girls,” said Puhl, who was not part of the study.
Girls who had been labeled “fat” were still at higher risk of
obesity even when researchers accounted for their BMIs at age 10,
household income, race and parental education level.
The effect seemed to be strongest when the labels came from family
members, which increased the risk of obesity later by 60 percent,
compared to 40 percent when the comments came from friends or
teachers. But it’s not wise to make too much out of the difference
between those numbers, since this was only an exploratory study,
She was not at all surprised that over half of girls had been
“The pressure to be thin in our society is intense, and other
research shows that people label both themselves and others as
'overweight' even if their objective body mass index is in the
'normal weight' range,” she said.
[to top of second column]
Females are exposed to weight stigma more often, but
the connection may be present for boys as well, she noted.
There are ways for parents to address weight and health issues with
their children that don’t involve labeling, Tomiyama said.
“There's no need to say the ‘f’ word at all if you want to improve
your child's health,” she said.
Parents could instead focus on the health of the family as a whole,
said Angelina Sutin, who was not involved in the new study.
Sutin studies psychological wellbeing and health disparities at
Florida State University College Of Medicine in Tallahassee.
“The best approach would be to start kids early on a path toward
healthy living by eating healthy food and being physically active,”
Sutin told Reuters Health in an email.
“This applies equally to parents as it does to kids – children model
their parents’ behavior, so if kids see their parents making healthy
choices, they are more likely to also make healthy choices,” she
Parents could identify activities the child enjoys and work on ways
to do more of them, she added.
“I think the focus of the conversation needs to change,” Tomiyama
said. “Right now, we have a laser focus on weight instead of health,
but many studies show that weight is a really imprecise indicator of
“Parents can talk to their child about adopting healthy behaviors
without once mentioning weight,” she said.
JAMA Pediatrics, online April 28, 2014.
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