For teen girls, being called "fat" by friends or family may contribute to later developing eating disorders, and the harsh word from family members seems to carry the most weight, a recent U.S. study suggests.
Weight stigma - the negative stereotypes, social devaluation and pervasive mistreatment of heavier individuals - is strongly implicated in disordered eating, the research team writes in the Journal of Adolescent Health.
Previous studies have found that being teased about weight is associated with binge eating and unhealthy weight control behaviors in boys and increased dieting in girls. The current study is one of the first to look at the long-term consequences of being labeled as "too fat," the authors note.
"How we talk about weight - especially with young girls - can have really negative effects on mental and physical health," said lead author Jeffrey Hunger, a psychologist at the University of California, Los Angeles.
"Labeling young girls as 'too fat' will never spur positive health behaviors; it is simply going to result in poor body image, unhealthy weight control practices, and disordered eating," he told Reuters Health in an email.
There is a lot of research showing that weight stigma is related to disordered eating, but not much of it follows people across time, Hunger said.
"With this study, I was hoping to contribute to our understanding of these longitudinal consequences by leveraging data from the NHLBI (National Heart, Lung, and Blood Institute) Growth and Health Study."
Hunger and a colleague examined data on 2,036 girls participating in that larger, long-term study. At age 14, the girls reported whether they had been told they were "too fat" by their parents, siblings, best girlfriends, boys they liked best, any other teens or their teachers.
At ages 14 and 19, the girls completed a questionnaire designed to assess unhealthy weight control behaviors, bulimic tendencies, drive for thinness and body dissatisfaction. At both evaluations, girls reported whether in the past 30 days they had engaged in unhealthy behaviors such as not eating, vomiting, taking diet pills or using laxatives; at age 19, they were also asked about smoking and skipping meals as weight control methods.
Compared with girls who did not report having been labeled fat at age 14, girls who were weight labeled at 14 had higher scores at age 19 on the eating disorders inventory, researchers found.
This association held after the study team adjusted for other possible influences, such as body mass index (BMI), race, parental income and education, and a girl's level of disordered eating behaviors at age 14.
The study also found that weight labeling by a family member was a stronger predictor of later disordered eating than labeling by nonfamily members.
"A somewhat surprising (yet frequently observed) finding is that the effects of weight stigma emerged independent of actual body size," Hunger noted.
It seems that there is something profoundly powerful about the social implications of being labeled "too fat" that is not limited to heavier girls, he said.
"That being said, heavier girls do disproportionately shoulder the burden of weight stigma, and stigma against heavier bodies is pervasive and systemic, so we should take care not to equate this to thinner girls' experiences of weight labeling," Hunger added.
First and foremost, if a parent suspects their child may have an eating disorder, they should have the child assessed by a specialist. Beyond that, parents can promote positive body image and healthy eating behaviors in a variety of ways, he said.
"They can take weight out of the conversation altogether when they are discussing health with their children. Our weight does not dictate our health and most certainly does not dictate our worth."
Parents can also model body positivity and health behaviors for their kids, Hunger suggested.
"Quit the negative 'fat talk,' chronic dieting, and body shame. Recognize and appreciate all that your body can do for you and find eating and exercise habits that are sustainable and enjoyable," he said.
© 2023 Thomson/Reuters. All rights reserved.