The pain lingers for white teen girls who are told they are too fat

West Lafayette, Indiana - White teenage girls who are told by their parents or friends that they are too fat have more depressive symptoms when they are young adults, according to new research from Purdue University.

"While it's great to see intervention efforts helping young people with physical activity and diet, there is a mental health component related to the stigma of obesity that needs to be addressed," said Sarah A. Mustillo, an associate professor of sociology who studies obesity in childhood and adolescence. "If an obese girl was called fat at age 11 or 12, she had more depressive symptoms in her late teens and early 20s compared to obese teens who were not called fat."

A similar, but smaller, effect was found for obese girls ages 13-14.

"The effects were small, but given the increased risk of depression among women, identifying the impact of factors that can be modified is valuable," Mustillo said. "This is a reminder that stigma-laden labels are powerful and can influence individual well-being for the long-term."

The study, which is published in Social Psychology Quarterly, followed females from as young as ages 9 and 10 for 10 years starting in 1987. The physical and mental health of 2,379 girls was monitored annually as part of the National Growth and Health Study. Data was collected during physical exams, nutrition and physical assessments, and questionnaires. In this sample, 8 percent of the white girls and 18 percent of the black girls were obese at baseline.

Although the black girls in this study reported more fat labeling than the white girls they did not have the same long-term effects as the white teenagers.

"This study doesn't address the causes of the difference, but other research suggests that the black community is more accepting of a wider range of body types and sizes and that black teenage girls may have better coping skills," Mustillo said.

The researchers also don't know if the label of "too fat" was made in a teasing way or meant as a general comment.

"White children who were labeled fat at the younger ages of 9 and 10 experienced increased distress at the time, but the effects were short-term," Mustillo said. "However, if they were called fat as a teenager then they were at risk of depressive symptoms as a young adult. Identity is more stable in late childhood, such as at ages 9 and 10, but those tumultuous early adolescence years are vulnerable to negative perceptions such as the shame, self-loathing and rejection often associated with obesity. This study suggests those feelings can stick with them."

Mustillo's previous research found that even if obese young women were able to return to the normal weight range in their teen years, the negative self-perception was still there.

"Again, helping young people with obesity needs to go beyond the physical aspect," Mustillo said.

According to the Centers for Disease Control and Prevention, approximately 17 percent, or 12.5 million, children ages 2-19 are obese. The data set used for this study represents a time when obesity was not as prevalent.

"Now we're looking at if and how today's higher prevalence of obesity affects the level of stigma and acceptance," Mustillo said. "Another development is the American Medical Association's identifying obesity as a disease. In doing so, will this reduce the stigma associated with obesity?"

This article also was co-authored by Kristen Budd, a Purdue alumna and now assistant professor at Indiana University South Bend, and Kimber Hendrix, a Purdue graduate student in sociology. The data set is from the National Heart, Lung and Blood Institute.

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