‘It’s on your conscience all the time’: a systematic review of qualitative studies examining views on obesity among young people aged 12–18 years in the UK

Abstract

ObjectiveTo explore the perspectives of young people in the UK on obesity, body size, shape and weight.DesignSystematic review of qualitative studies using thematic synthesis.Data sourcesSensitive searches of 18 electronic databases from 1997 to February 2010 supplemented by grey literature searches.Study selectionStudies produced since 1997 using qualitative methods to collect perspectives of people aged 12–18 years in the UK, reporting methods for data collection or analysis. Studies of people with eating disorders and those rated low in reliability and usefulness were excluded.ResultsSearches identified 30 studies involving over 1400 young people from a range of contexts. Young people of all sizes placed considerable emphasis on personal responsibility, and on the social, rather than health implications of being overweight. Young people with experience of obesity described severe, unrelenting, size-related abuse and isolation. Regardless of their own size, young people were judgemental of individuals who were overweight, but those with experience of obesity described an environment that contained multiple barriers to weight loss. Only one study asked young people directly what might support them to have a healthy body size. Study findings were configured under three main themes, labelled with quotes from included studies: general perceptions of size and society's responses (‘It's on your conscience all the time’); the experiences of young people who were overweight (‘If I had the choice I wouldn't be this size’) and these larger young people's experiences of trying to loose weight and suggestions for action (‘Make sure, even when it's hard, you've got people there’).ConclusionsThe perspectives of young people in the UK, when synthesised across the spectrum of body sizes, paint a picture of a stigmatising and abusive social world. Research and policy need to engage young people actively so as to address the social implications of obesity.

Association of a history of childhood-onset obesity and dieting with eating disorders

“…However, inadequate attention is paid to the sub-sequent psychological impact of childhood obesity (Russell-Mayhew, McVey, Bardick, & Ireland, 2012). Modern society, in fact, perceives obesity as unattractive (Rees, Caird, Dickson, Vigurs, & Thomas, 2014), which strengthens the widespread opinion that slimness is necessary for success and respect. The media emphasizes thinness and often portrays those with obesity as having a lack of self-control and willpower.…”

Understanding teenage obesity

“…More importantly Rees's study highlights the physical nature of abuse that some young people have to deal with and the social consequences of this (8). Although this study did not explore mental health issues other non-UK studies have highlighted that obesity in the young people may be a significant trigger for mental health issues including, poor self-esteem, anxiety and poor body image (7).…”

“…Interestingly these young people did not necessarily make the link between obesity and ill health though they did articulate the importance of losing weight for future health (8). Expressing views about what happened when they tried to lose weight many expressed that they had difficulties moderating the food they ate and expressed a great deal of frustration at repeatedly trying and failing to lose weight.…”

“…These included, depression, anxiety, fear of going out, poor self-confidence and feelings of loneliness. Coping strategies including withdrawal from social situations and comfort eating (8).…”

Overweight adolescents and asthma: Revealing motivations and challenges with adolescent-provider communication

“…Physicians may benefit from learning adolescents' feelings about discussing weight and possible motivations to make changes. An important feature in this conversation may be incorporating the link between overweight and asthma symptoms, supported by better knowing how teens perceive messages that launch deeper discussions on this topic [14].…”