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Family Pressure To Lose Weight In Adolescence Linked to Internalized Weight Stigma

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A recent Lancet study of 4060 individuals reported that the pressure to lose weight from family and the media during adolescence could have long-lasting effects on a person’s internalized weight stigma.

“People who report experiences of weight-related stigma or discrimination are at greater risk of internalized weight stigma, usually defined as agreement with and self-application of negative weight stereotypes, often leading to reduced self-worth,” the researchers explained in the study. “Among people living with obesity, internalized weight stigma is linked to disordered eating, worse mental health, and healthcare avoidance.”

“People with a higher body mass index (BMI) report more experiences of weight-related stigma and greater internalized weight stigma. However, internalized weight stigma can also affect people within the recommended and underweight body mass index (BMI) categories, where it predicts disordered eating and drive for thinness, making it relevant for mental health across the body weight range,” they added. “Internalized weight stigma differs substantially between demographic groups. Risk is elevated for females, sexual minorities, and socioeconomically disadvantaged adults, and this is not explained by differences in BMI.”

Lead author Amanda M. Hughes from Bristol Medical School and colleagues used data from Bristol’s Avon Longitudinal Study of Parents and Children to examine how internalized weight stigma occurred in 4060 people who were aged 31 years but belonged to different socioeconomic and ethnic groups.

The 31-year-old participants completed questionnaires where they rated their agreement on a scale of 1 ( “does not apply to me at all”) to 7 (“applies to me perfectly”) with 11 statements like “I am less attractive than most other people because of my weight” and “I hate myself for my weight.”

The BMI also took into consideration each participant’s BMI at six points: mid-childhood age 7 years), later childhood (age 10 years), early adolescence (age 12.5 years), mid-adolescence (age 15.5 years), later adolescence (age 17.5 years), and early adulthood (age 24 years). The researchers recorded how often their parents passed comments on or teased them about their weight or how much they ate that made them feel bad at the age of 13 specifically. Each participant also reported to what extent their peers at school teased them about their weight and to what extent they felt pressure to lose weight from the media and their family, friends, and people they dated.

The researchers found that family and media pressure along with being teased by family members were linked to the highest levels of internalized weight stigma at 31 years.

"Several aspects of the social environment during development emerged as important for later internalized weight stigma: negative weight-related comments from parents, weight-based teasing from family, and pressure to lose weight from family at age 13 years were robustly associated with internalized weight stigma (IWS) in adulthood, even after accounting for both child and adult BMI, underscoring the importance of the family environment. Peer relations were also important: as well as weight-based teasing at school, bullying for any reason was associated with IWS at age 31 years, especially in late adolescence and early adulthood," the researchers explained.

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