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Reviewed by Ashley Solomon, PsyD, CED-S

Himmelstein, M. S. & Puhl, R. M. (2018). Weight-based victimization from friends and family: implications for how adolescents cope with weight stigma. Pediatric Obesity. E-publication ahead of print.

https://doi.org/10.1111/ijpo.12453

As our culture focuses more sharply on issues surrounding both body weight and bullying, increasing attention is being paid to the impact of weight-stigmatization and weight-based victimization on health outcomes. Youth with larger bodies are frequently targets for teasing, bullying, and other forms of aggression. While we most commonly consider peers to be the source of this victimization, research has demonstrated the prevalence of weight-based victimization coming from friends, teachers, and family as well. Understanding how adolescents respond and cope with weight-based victimization is important, as it allows us to develop supportive responses and intervention.

Himmelstein and Puhl’s study examined the coping responses of youth faced with weight-victimization, analyzing how the source of the victimization may impact the style of response. For example, they aimed to understand if adolescents experiencing teasing from friends would cope differently than if they experienced teasing from teachers. They also explored the adolescents’ perceptions of what is most needed to support youth like them facing victimization.

Himmelstein and Puhl utilized a sample of adolescent individuals ages 13 to 18 who were seeking weight loss via a summer camp to examine their coping responses. It should be noted that this sample was not representative of the wider population of youth in larger bodies as it was predominantly white and those attending camp likely had a higher level of resources than others.

The study demonstrated that, not surprisingly, weight was the most reason for teasing most frequently reported by the adolescents. Peers were the most frequent source of this teasing, followed by friends, family members, and then teachers. Boys reported a greater frequency of weight-based victimization from peers compared to girls, while rates of family teasing were equal among boys and girls. Across gender, the authors found that the manner in which youth coped with weight-based teasing did differ based on the source. Weight-based teasing from friends was found to be related to greater negative emotions, such as anger, sadness, and feeling worse about themselves. Meanwhile, adolescents who were most frequently teased by friends and family reported acting indifferent (e.g. doing nothing, ignored it). Girls were more likely than boys to report coping with weight stigma by eating for comfort of binge eating. Lastly, youth with the highest rates of internalized weight bias (directing shame and blame toward self) responded to victimization with increased negative emotions, avoidance behaviors (e.g. skipping school), and coping by eating.

Why is This Important?

These results offer insight into the experiences of youth, and later adults, who experience weight-based victimization as young people. In particular, recognizing and addressing the substantive impact of internalized weight stigma on health and well-being outcomes is crucial. It is also important to recognize that while adolescents may demonstrate more “indifference” to weight stigma by those closest to them, this may be a function of learned helplessness and lead to greater internalization of the bias.

While we are often quick to associate weight with poor health outcomes, we must thoroughly evaluate the mediating role of weight stigma and coping on these outcomes. Notably, adolescents in this study overwhelmingly endorsed “parental support” as the number one need for helping them cope, even among those reporting teasing by family. Families have a vital role to play in helping youth navigate the continuingly hostile world for people of size.

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