A recent England-wide survey found that nearly one quarter of all boys (23 percent) and 16 percent of all girls between the ages of 11 and 15 would be considered obese. Previous theories of overweight teens suggested lower levels of self-esteem, yet solid information regarding their feelings and mental condition is scant. Now, researchers, who have gathered and synthesized a collection of past studies, discovered that extreme-weight teens face stigma, discrimination, and isolation due to their size, and these factors combined with other barriers to losing weight make it especially hard for them to shed the pounds as they wish.

"Approaches that merely educate and admonish individuals about lifestyles and being overweight are not only insufficient but also potentially counterproductive," wrote the authors in an article published today in the journal BMJ Open. Roughly two out of every 10 children between the ages of 11 and 15 in England are classified as obese, yet researchers commonly do not know what these overweight teens think about their condition… or themselves.

To better understand this demographic group, a team of researchers funded by the UK’s Department of Health scanned 18 databases, 54 websites, and six journals in the fields of health, public health, education, social science, and social care to look for data concerning young people's views of body size. After excluding research dealing only with eating disorders, they identified 30 appropriate studies, that included overall approximately 1,400 young people.

After analyzing the data, the researchers discovered that young people of all body sizes noted and feared the social implications of obesity more than any health consequences. Additionally, young people of all sizes placed considerable emphasis on personal responsibility, suggesting they believed individuals alone are answerable for body size. Excess weight also brought to mind various negative stereotypes, including laziness, greed, and a lack of control. Across the board, teens felt that being overweight made an individual less attractive while simultaneously opening them up to bullying and teasing.

Meanwhile, the opinions of obese teens perfectly mimicked those of their peers; namely, they blamed themselves for their own large size. At the same time, they vividly and movingly narrated stories of severe, unrelenting abuse, including beatings, kickings, name-calling, deliberate and prolonged isolation, and sniggering/whispering. As described, most of these instances of physical and verbal assaults had taken place at school. Because their quotidian experiences included feeling excluded, ashamed, marked out as different, and ritually humiliated, coping and performing everyday activities, such as shopping, were difficult for them. That said, obese teens generally sought support from others as a way to deal with the pain.

Unfortunately, their hurt and shameful feelings got in the way of their ability to change. The overweight teens described a loss of confidence (brought on by public humiliation), which in turn inspired comfort eating — a vicious cycle. At the same time, all the ridicule they faced made it difficult for them to exercise as did the physical consequences of obesity, such as asthma. Again and again, the overweight teens mentioned support and encouragement from family and friends as important to them, along with less judgmental responses from health professionals.

“I ... just wanted to be part of the crowd and not to stick out like a sore thumb,” said one participant in the study, a sentiment echoed by other overweight teens. As most of us would suspected, then, obese teenagers just want to fit in and be like their peers. Maybe the very first step, then, to helping obese teens become the people they wish to be is teaching them first how to appreciate personal difference.

Source: Rees RW, Caird J, Dickson K, Vigurs C, Thomas J. ‘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. BMJ Open. 2014.