Being isolated due to being overweight can have long-term health consequences, and the study's lead author said reducing stigma should be part of anti-bullying efforts.
Overweight children are more likely to call people friends who do not feel the same way, and the isolation has health consequences, according to a new study.
A survey of 504 preteens from the Netherlands found that classmates often exclude overweight children from social circles; the overweight children list children as friends when the feeling is not returned, and overweight children were disliked more by peers than thin children.
Over time, the negative feedback creates stress that can cause depression and other physical problems, according to researchers reporting in the journal PLoS ONE. The findings have widespread implications as the problem of childhood obesity has increased 31% worldwide over 20 years; the World Health Organization estimated there were close to 42 million overweight or obese children in 2013.
The study eventually included 714 children, as 210 were listed as friends but did not take the survey. Overweight children typically listed as many friends as normal weight children, but they were 1.7 times more likely to be disliked and 1.2 times more likely to dislike others. Kayla de la Haye, PhD, the study’s lead author, said this results in a web of unreciprocated friendships and multiple “frenemies,” in which the children interact socially with an undercurrent of ill will.
De la Haye, assistant professor of Preventive Medicine at the University of Southern California’s Keck School of Medicine, said the challenges that overweight children have in peer relationships have long-lasting effects. “Our finding is alarming, because if we continue to have social environments where fat shaming is the norm, these kids will continue to be ostracized," she said in a statement. “Those adverse interactions increase the risk of loneliness, depression, poor eating habits, and illness.”
There is a risk of health consequences. “Research by others has shown people who chronically feel isolated, lonely, or socially disconnected experience greater inflammation and reduced viral suppression,” de la Haye said. “We’re not sure if that’s at play here, but a consistent body of research shows that negative social relationships can go under the skin and affect health.”
To conduct the study, researchers asked children ages 10 to 12 to list their best friends and their enemies. On average, children were listed as a friend by 5 other children and an enemy by 2. But overweight children were listed as a friend by just 4 classmates and were disliked by 3.
The survey found that overweight children had fewer friends overall, and the ones they had also tended to be overweight. About 16% of the children were overweight.
Childhood stigma perpetuates into adulthood, as people who are overweight face workplace discrimination and problems obtaining health coverage for obesity-related conditions. And, they are more likely to be unemployed.
“We want to reduce the stigma of being overweight,” de la Haye said. “We have anti-bullying campaigns based on sexual identity, race, and ethnicity. We should do more to integrate obesity in our anti-bullying repertoire.”
de la Haye K, Dijkstra JK, Lubbers MJ, van Rijsewijk L, Solk R. The dual role of friendship and antipathy relations in the marginalization of overweight children in their peer networks: the TRAILS study. PLoS ONE. 2017; 12(6) e0178130.