Links between obesity, weight stigma and learning in adolescence: a qualitative study

Abstract

Background Educational attainment is a key social determinant of health. Health and education are linked by multiple pathways, many of which are not well understood. One such pathway is the association between being above a healthy weight and lower academic achievement. While various explanations have been put forward to explain this relationship, evidence for causal pathways is sparse and unclear. This study addresses that evidence gap. Methods We interviewed 19 adults (late 20s; 14 female, 5 male) and one young person (14 years, male) from the UK in 2019/2020. Participants were recruited from the ALSPAC 1990s birth cohort, sampled to ensure diversity in socio-economic status and educational attainment, and a community-based weight management group for young people. Interviews focused on experiences of being above a healthy weight during secondary school and how this may have affected their learning and achievement. Interviews were face-to-face, digitally recorded, and transcribed verbatim. We analysed the data thematically. Results We identified key pathways through which higher body weight may negatively impact educational performance and showed how these are linked within a novel theoretical model. Because larger body size is highly stigmatised, participants engaged in different strategies to minimise their exposure to negative attention. Participants sought to increase their social acceptance or become less socially visible (or a combination of both). A minority navigated this successfully; they often had many friends (or the ‘right’ friends), experienced little or no bullying at school and weight appeared to have little effect on their achievement at school. For most however, the behaviours resulting from these strategies (e.g. disruptive behaviour, truanting, not working hard) or the physical, social or mental impacts of their school experiences (e.g. hungry, tired, self-conscious, depressed) made it difficult to concentrate and/or participate in class, which in turn affected how teachers viewed them. Conclusions Action to combat weight stigma, both within schools and in wider society, is urgently required to help address these educational disparities that in turn can impact health in later life.

Influence of Nutritional Status on Academic Performance: A Study of Schoolchildren in Eastern Morocco

“…Some scholars have proposed psychological factors, particularly related to body image stereotypes, as a potential explanation for this association. Stereotypes portraying overweight and obese individuals as lazy, lacking discipline, or less intelligent (Brownell et al, 2005;Griffiths et al, 2010;Komarraju & Dial, 2014;Krukowski et al, 2009;Langford et al, 2022;Puhl & Heuer, 2010) may adversely impact self-esteem and goal-setting, potentially leading to academic underachievement or school dropout. Li et al (2008) suggested that adiposity might affect cognitive functions, including learning and memory.…”

School absenteeism and impairment associated with weight bullying

“…Physical WB had the strongest association with absenteeism, with children who experienced physical bullying being approximately four times more likely to skip a particular class and five times more likely to skip school compared with children who did not experience physical WB. Prior qualitative research with young adults who had high body weight during secondary school identified the strategy of becoming “invisible,” including through absenteeism, as a method of avoiding being bullied (Langford et al, 2022). Prior research has also associated youth absenteeism with being fearful (Grinshteyn & Yang, 2017), which might further explain why children in our sample who experienced physical WB were particularly likely to have school absences.…”

Sociodemographic and Socioeconomic Factors Influencing the Body Mass Composition of School-Age Children

“…Orthopedic, neurological, pulmonary, gastroenterological, and endocrine conditions are more common in children with morbid obesity. Excess adiposity can affect a child’s immediate physical and mental health, educational achievements, quality of life, self-esteem, body image, and economic mobility [ 48 , 49 ].…”