Weight-based victimization is a frequent experience for adolescents, but little is known about their emotional reactions and coping strategies in response to weight-based teasing and bullying. The present study examined the ways that adolescents cope with experiences of weight-based victimization at school. An initial sample of 1,555 students from two high schools in central Connecticut completed a comprehensive battery of self-report measures to assess their experiences of weight-based teasing and bullying at school, affective responses to these experiences, and coping strategies used to deal with incidents of weight-based victimization. Only those students who reported experiencing weight-based victimization (N = 394) were included for the purposes of the present study. Of this sub-sample, 56% were females, 84% were Caucasian, and the mean age was 16.4 years. Weight-based victimization resulted in 40-50% of adolescents feeling sad and depressed, worse about themselves, bad about their body, angry, and some feeling afraid. Gender differences emerged with respect to how boys and girls react to experiences of weight-based victimization. However, structural equation model estimates demonstrated that both boys and girls who reported negative affect in response to weight-based victimization were more likely to use coping strategies of avoidance (e.g., avoiding gym class), increased food consumption, and binge eating. Binary logistic regressions showed that the odds of students skipping school or reporting that their grades were harmed because of weight-based teasing increased by 5% per teasing incident, even after controlling for gender, age, race, grades, and weight status. To our knowledge, this study is the first systematic examination of affective reactions and coping strategies among overweight adolescents in response to weight-based victimization. These findings can inform efforts to assist overweight youth to cope adaptively with weight-based victimization.

Youth perceive frequent and multiple forms of weight-based victimization. Schools' efforts to address weight bias and assist overweight and obese students are important.

BACKGROUND:Research demonstrates that health providers express negative attitudes toward overweight and obese patients that can be conveyed through weight-related language, yet little is known about people's perceptions of weight-related language used by providers. The current study examined public preferences and perceptions of weight-based terminology used by health-care providers to describe excess weight. METHOD: A national sample of American adults (N ¼ 1064) completed an online survey to assess perceptions and preferences associated with 10 common terms to describe body weight. Participants rated how much they perceived each term to be desirable, stigmatizing, blaming or motivating to lose weight (using five-point Likert scales), and how they would react if stigmatized by their doctor's reference to their weight. RESULTS: The terms 'weight' (3.43, 95% confidence interval (CI) 3.35-3.50) and 'unhealthy weight' (3.24, 95% CI 3.15-3.33) were rated most desirable, and the terms 'unhealthy weight' (3.77, 95% CI 3.69-3.84) and 'overweight' (3.51, 95% CI 3.43-3.58) were rated most motivating to lose weight. The terms 'morbidly obese', 'fat' and 'obese' were rated as the most undesirable (95% CI 1.61-2.06), stigmatizing (95% CI 3.66-4.05) and blaming (95% CI 3.62-3.94) language used by health providers. Notably, participant ratings were consistent across socio-demographic variables and body weight categories. A total of 19% of participants reported they would avoid future medical appointments and 21% would seek a new doctor if they felt stigmatized about their weight from their doctor. CONCLUSION: This study advances our understanding of why individuals prefer particular weight-related terms, and how patients may react if their provider uses stigmatizing language to refer to their weight. It also offers suggestions for practical strategies that providers can use to improve discussions about weight-related health with patients.

WHAT'S KNOWN ON THIS SUBJECT: Studies have linked bullying with BMI, with overweight and obese youth vulnerable to bullying and its negative psychological and health consequences. However, there has been little comprehensive assessment of weight-based victimization, especially in weight loss treatment-seeking samples of youth.WHAT THIS STUDY ADDS: WBV is prevalent in treatment-seeking youth, who report victimization from peers (92%), friends (70%), parents (37%), and teachers (27%). Providers should discuss WBV in their assessment and treatment of pediatric patients who are overweight or obese.abstract OBJECTIVE: Few studies have comprehensively examined weight-based victimization (WBV) in youth, despite its serious consequences for their psychosocial and physical health. Given that obese and treatmentseeking youth may be highly vulnerable to WBV and its negative consequences, the current study provides a comprehensive assessment of WBV in a weight loss treatment-seeking sample.METHODS: Adolescents (aged 14-18 years; N = 361) enrolled in 2 national weight loss camps were surveyed. An in-depth assessment of WBV was conducted by using an online survey, in which participants indicated the duration, typical locations, frequent perpetrators, and forms of WBV they had experienced. RESULTS:Findings indicate that 64% of the study participants reported WBV at school, and the risk of WBV increased with body weight. Most participants reported WBV enduring for 1 year (78%), and 36% were teased/bullied for 5 years. Peers (92%) and friends (70%) were the most commonly reported perpetrators, followed by adult perpetrators, including physical education teachers/sport coaches (42%), parents (37%), and teachers (27%). WBV was most frequently reported in the form of verbal teasing (75%-88%), relational victimization (74%-82%), cyberbullying (59%-61%), and physical aggression (33%-61%). WBV was commonly experienced in multiple locations at school.CONCLUSIONS: WBV is a prevalent experience for weight loss treatmentseeking youth, even when they are no longer overweight. Given the frequent reports of WBV from adult perpetrators in addition to peers, treatment providers and school personnel can play an important role in identifying and supporting youth who may be at risk for pervasive teasing and bullying. Pediatrics 2013;131:e1-e9 AUTHORS:

These findings have important implications for framing messages in public health campaigns to address obesity, and suggest that certain types of messages may lead to increased motivation for behavior change among the public, whereas others may be perceived as stigmatizing and instill less motivation to improve health.

OBJECTIVES: Little research has been performed to examine patient perceptions of weight-related language, especially related to childhood obesity. In this study we assessed parental perceptions of weight-based terminology used by health care providers to describe a child's excess weight and assessed perceived connotations associated with these terms including stigma, blame, and motivation to reduce weight. METHODS: A national sample of American parents with children aged 2 to 18 years (N = 445) completed an online survey to assess their perceptions of 10 common terms to describe excess body weight in youth (including “extremely obese,” “high BMI,” “weight problem,” “unhealthy weight,” “weight,” “heavy,” “obese,” “overweight,” “chubby,” and “fat”). Parents were asked to use a 5-point rating scale to indicate how much they perceived each term to be desirable, stigmatizing, blaming, or motivating to lose weight. RESULTS: Regression models revealed that the terms “weight” and “unhealthy weight” were rated as most desirable, and “unhealthy weight” and “weight problem” were rated as the most motivating to lose weight. The terms “fat,” “obese,” and “extremely obese” were rated as the most undesirable, stigmatizing, blaming, and least motivating. Parents' ratings were consistent across sociodemographic variables, body weight, and child's body weight. CONCLUSIONS: The results of this study have important implications for the improvement of health care for youth with obesity; it may be advantageous for health care providers to use or avoid using specific weight-based language during discussions about body weight with families. Pediatricians play a key role in obesity prevention and treatment, but their efforts may be undermined by stigmatizing or offensive language that can hinder important discussions about children's health.

Similar to other health disciplines, professionals treating eating disorders are not immune to weight bias. This has important implications for provision of clinical treatment with obese individuals and efforts to reduce weight bias in the eating disorders field.

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