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 In fact, it often has the opposite effect and contributes to
behaviors like binge eating, inactivity, social isolation, and
avoidance of routine medical checkups, the American Academy of
Pediatrics and the Obesity Society advise in a joint policy
statement.
“Keep it positive. We know that making change is tough, and patients
will likely have trouble initially meeting some of their goals, but
we can learn from these challenges and go from there,” said Dr.
Stephen Pont, lead author of the statement and founding chair of the
AAP Section on Obesity Executive Committee.
“Also, we know that children with obesity are more likely to suffer
from low self-esteem, depression, and anxiety so we want to be extra
mindful to focus on positive reinforcement and not negative
reinforcement when encouraging behavior change,” Pont, of Dell
Medical School at the University of Texas at Austin, said by email.
Keeping children from feeling stigmatized may also mean talking to
them about what they see in the movies and on television, a separate
study in the same issue of Pediatrics suggests. The authors of the
study analyzed kids’ movies and found that most of the movies
stigmatized weight.
Obesity is the most common chronic health problem among U.S.
children, doctors note in the policy statement. One in three kids
between the ages of 2 and 19 are overweight or obese.
Stigma and discrimination can add to their health problems and harm
their quality of life, making them feel isolated, embarrassed and
sad. Excess weight alone can be a predictor for victimization and
bullying.
Physicians must take a lead role in educating children and families
about how to help children achieve a healthy weight without making
kids feel stigmatized for their size, doctors argue in the
statement.
Kids who feel stigmatized often are victims of teasing, bullying and
harassment in school. Many children who see doctors about their
weight report being bullied in the past year, and it’s not uncommon
for kids to report this going on for more than five years.
“While there has been substantial attention to medical treatment and
intervention for obesity in youth, the social and emotional impact
of body weight – like stigma and bullying – often get neglected,”
said Rebecca Puhl, a fellow at the Obesity Society and deputy
director of the Rudd Center for Food Policy and Obesity at the
University of Connecticut in Hartford.
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There are ways pediatricians can speak to parents and children about
weight that are supportive and encouraging instead of sounding
unintentionally judgmental, Puhl said by email.
For starters, they can talk about “children with obesity” instead of
“obese children” to emphasize that this is a medical condition.
Using neutral terms like “weight” instead of negative terms like
“fat” or “obese” can also help, Puhl said.
This goes for parents, too.
“Parents need to think carefully before having conversations about
weight,” Puhl added. “As much as possible, parents should focus
their comments on health and health behaviors, identifying ways that
they and their children can practice healthier behaviors together as
a family.”
For the study of how weight is treated in kids’ movies, researchers
analyzed 31 films released from 2006 to 2010. Every film showed
obesity-promoting behaviors, like characters with unhealthy foods,
huge portions, sugary beverages and lots of screen time.
Most of the movies also stigmatized weight, with verbal insults
about body size, for example.
These scenes may be hard to avoid, but parents can use them as
teachable moments, said senior study author Dr. Eliana Perrin, who
did the study at the University of North Carolina at Chapel Hill and
is now director of the Center for Childhood Obesity Research at Duke
University in Durham, North Carolina.
When parents do watch with kids, they might say something like, “We
all laughed when so-and-so was made fun of, but I was thinking it
really wasn’t funny for her, was it?” Perrin suggested.
“In our family, I’d like us to be friends with people and kind to
people no matter what their size,” Perrin added. “Children with
obesity are smart, fun, athletic and hard-working.”
SOURCES: http://bit.ly/2mIgTno and http://bit.ly/2mKCETx Pediatrics,
online November 20, 2017.
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