Child and Adolescent Social Work Journal

, Volume 27, Issue 4, pp 309–321 | Cite as

The Impact of Stigma on the Child with Obesity: Implications for Social Work Practice and Research

  • Shawn A. Lawrence


Childhood obesity has greatly increased in the past 20 years and is highly stigmatized in today’s society. The effectiveness of obesity prevention efforts is threatened by the systemic impact of stigma that surrounds obesity. As childhood obesity increases so to does the responsibility of social workers to implement multi level interventions that not only assist children who are experiencing stigmatization, but are aimed at reducing stigmatization. This article reviews the origins of overweight stigmatization and the psychosocial influences of such stigmatization. The implications for social work practice and research from a systemic approach are addressed.


Obesity Children Stigma Social work 


  1. Ackard, D. M., Neumark-Sztainer, D., Story, M., & Perry, C. (2003). Overeating among adolescents: Prevalence and associations with weight-related characteristics and psychological health. Pediatrics, 111, 67–74.CrossRefPubMedGoogle Scholar
  2. Adams, G. R., Hickin, M., & Salehi, M. (1999). Socialization of the physical attractiveness stereotype: Parental expectations and verbal behaviors. International Journal of Psychology, 23(2), 137–149.Google Scholar
  3. Anderson, S. E., Cohen, P., Naumova, E. N., & Must, A. (2006). Association of depression and anxiety disorders with eight change in a prospective community-based study of children followed up into adulthood. Archives of Pediatrics & Adolescent Medicine, 160, 285–291.CrossRefGoogle Scholar
  4. Anesbury, T., & Tiggemann, M. (2000). An attempt to reduce negative stereotyping of obesity in children by changing controllability beliefs. Health Education Research, 15, 145–152.CrossRefPubMedGoogle Scholar
  5. Bell, S. K., & Morgan, S. B. (2000). Children’s attitudes and behavioral interventions toward a peer presented as obese: Does a medical explanation for the obesity make a difference? Journal of Pediatric Psychology, 25, 137–145.CrossRefPubMedGoogle Scholar
  6. Boutelle, K., Neumark-Sztainer, D., Story, M., & Resnick, M. (2002). Weight control behaviors among obese, overweight and nonoverweight adolescents. Journal of Pediatric Psychology, 27, 531–540.CrossRefPubMedGoogle Scholar
  7. Carr, D., & Friedman, M. A. (2005). Is obesity stigmatizing? Body weight, perceived discrimination, and psychological well-being in the United States. Journal of Health and Social Behavior, 46, 244–259.CrossRefPubMedGoogle Scholar
  8. Centers for Disease Control. (2009). Obesity: Halting the epidemic by making health easier: At a glance 2009. Retrieved on July 11, 2009 from
  9. Cook, S., Weitzman, M., Auinger, P. N., Nguyen, M., & Dietz, W. H. (2003). Prevalence of a metabolic syndrome phenotype in adolescents: Findings from the Third National Health and Nutrition Examination Survey 1988–1994. Archives of Pediatric and Adolescent Medicine, 157, 821–827.CrossRefGoogle Scholar
  10. Cramer, P., & Steinwert, T. (1998). Thin is good, fat is bad: How early does it begin? Journal of Applied Developmental Psychology, 19, 429–451.CrossRefGoogle Scholar
  11. Crandall, C. S., D’Anello, S., Sakalli, N., Lazarus, E., Nejtardt, G., & Feather, N. T. (2001). Antifat attitudes in six nations. Personality and Social Psychology Bulletin, 27, 30–37.CrossRefGoogle Scholar
  12. Crandall, C. S., & Martinez, R. (1996). Culture, ideology, and antifat attitudes. Personality and Social Psychology Bulletin, 22(11), 1165–1176.CrossRefGoogle Scholar
  13. Cusumano, D. L., & Thompson, J. K. (2001). Media influence and body image in 8–11 year old boys and girls: A preliminary report on the Multidimensional Media Influence Scale. International Journal of Eating Disorders, 29, 37–44.CrossRefPubMedGoogle Scholar
  14. Datar, A., Strum, R., & Magnabosco, J. L. (2004). Childhood overweight and academic performance: National study of kindergartners and first-graders. Obesity Research, 12(1), 58–68.CrossRefPubMedGoogle Scholar
  15. Davis-Coelho, K., Waltz, J., & Davis-Coelho, B. (2000). Awareness and prevention of bias against fat clients in psychotherapy. Professional Psychology: Research and Practice, 31(6), 682–684.CrossRefGoogle Scholar
  16. Davison, K. K., & Birch, L. L. (2004). Predictors of fat stereotypes among 9-year-old girls and their parents. Obesity Research, 12(1), 86–94.CrossRefPubMedGoogle Scholar
  17. Dietz, W. H. (1997). Periods of risk in childhood for the development of adult obesity—what do we need to learn? Journal of Nutrition, 127(Suppl.), 1884s–1886s.Google Scholar
  18. Eisenberg, M. E., Neumark-Sztainer, D., & Story, M. (2003). Associations of weight-based teasing and emotional well-being among adolescents. Archives of Pediatric & Adolescent Medicine, 157, 733–738.CrossRefGoogle Scholar
  19. Eliadis, E. E. (2006). The role of social work in the childhood obesity epidemic. Social Work, 5(1), 86–88.Google Scholar
  20. Faith, M. S., Leone, M. A., Ayers, T. S., Moonseong, H., & Pietrobelli, A. (2002). Weight criticism during physical activity, coping skills, and reported physical activity in children. Pediatrics, 110, e23.CrossRefPubMedGoogle Scholar
  21. Falkner, N. H., Neurmark-Sztainer, D., Story, M., Jeffery, R. W., Beuhring, T., & Resnick, M. D. (2001). Social, educational, and psychological correlates of weight status in adolescents. Obesity Research, 9, 32–42.CrossRefPubMedGoogle Scholar
  22. Freedman, D. S., Kahn, H. S., Mei, Z., Gurmmer-Strawn, L. M., et al. (2007). Relation of body mass index and waist-to-height ratio to cardiovascular risk factors in children and adolescents: The Bogalusa Heart Study. American Journal of Clinical Nutrition, 86, 33–40.PubMedGoogle Scholar
  23. Gallagher, S., Tait, T. J., McCologan, B., Covey, T. M., & Halford, J. C. G. (2003). Negative judgments about male associates of obese females. Obesity Research, 11, A118–A119.Google Scholar
  24. Gortmaker, S. L., Must, A., Perrin, J. M., Sobol, A. M., & Dietz, W. H. (1993). Social and economic consequences of overweight in adolescence and young adulthood. New England Journal of Medicine, 399, 1008–1012.CrossRefGoogle Scholar
  25. Goodman, E., & Whitaker, R. C. (2002). A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics, 110, 497–504.CrossRefPubMedGoogle Scholar
  26. Gray, W. N., Kahhan, N. A., & Janicke, D. M. (2009). Peer victimization and pediatric obesity: A review of the literature. Psychology in the Schools, 46(8), 720–727.CrossRefGoogle Scholar
  27. Greenberg, B. S., Eastin, M., Hofschire, L., Lachlan, K., & Brownell, K. D. (2003). Portrayals of overweight and obese individuals on commercial television. American Journal of Public Health, 93, 1342–1348.CrossRefPubMedGoogle Scholar
  28. Hayden-Wade, H. A., Stein, R. I., Ghaderi, A., Saelens, B. E., Zabinski, M. F., & Wilfley, D. E. (2005). Prevalence, characteristics, and correlates of teasing experiences among obese vs. non-obese peers. Obesity Research, 13, 1381–1392.CrossRefPubMedGoogle Scholar
  29. Hebl, M. R., & Mannix, L. M. (2003). The weight of obesity in evaluating others: A mere proximity effect. Personality and Social Psychology Bulletin, 29, 28–38.CrossRefPubMedGoogle Scholar
  30. Hebl, M. R., Xu, J., & Mason, M. F. (2003). Weighing the care: Patients’ perceptions of physician care as a function of gender and weight. International Journal of Obesity and Related Metabolic Disorders, 27, 269–275.CrossRefPubMedGoogle Scholar
  31. Hedley, A. A., Ogden, C. L., Johnson, C. L., Carrol, M. D., Curtin, L. R., & Flegal, K. M. (2004). Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. Journal of the American Medical Association, 291, 2847–2850.CrossRefPubMedGoogle Scholar
  32. Hesketh, K., Wake, M., & Waters, E. (2004). Body mass index and parent-reported self-esteem in elementary school children: Evidence for a causal relationship. International Journal of Obesity, 28, 1233–1237.CrossRefPubMedGoogle Scholar
  33. Irving, L. M., & Neumark-Sztainer, D. (2002). Integrating the prevention of eating disorders and obesity: Feasible or futile? Preventive Medicine, 34, 299–309.CrossRefPubMedGoogle Scholar
  34. Katzmarzyk, P. T., & Davis, C. (2001). Thinness and body shape of Playboy centerfolds from 1978–1998. International Journal of Obesity and Related Metabolic Disorders, 25, 590–592.CrossRefPubMedGoogle Scholar
  35. Keery, H., Boutelle, K., van den Berg, P., & Thompson, J. K. (2005). The impact of appearance-related teasing by family members. Journal of Adolescent Health, 37, 120–127.CrossRefPubMedGoogle Scholar
  36. Latner, J. D., Rosewall, J. K., & Simmonds, M. B. (2007). Childhood obesity stigma: Association with television, videogame, and magazine exposure. Body Image, 4, 147–155.CrossRefPubMedGoogle Scholar
  37. Latner, J. D., & Stunkard, A. J. (2003). Getting worse: The stigmatization of obese children. Obesity Research, 11, 452–456.CrossRefPubMedGoogle Scholar
  38. Lawrence, S. L., Hazlett, R., & Hightower, P. (2010). Understanding and acting on the growing childhood and adolescent weight crisis: A role for social work. Health and Social Work, 35(2), 145–153.Google Scholar
  39. Lawrie, S., Sullivan, E. A., Davies, P. S. W., & Hill, R. J. (2006). Media influence on the body image of children and adolescents. Eating Disorders, 14, 355–364.CrossRefPubMedGoogle Scholar
  40. Levine, M., & Smolak, L. (2001). Primary prevention of body image disturbance and disordered eating in childhood and adolescence. In J. Thompson & L. Smolak (Eds.), Body image, eating disorders, and obesity in youth: Assessment, prevention, and treatment (pp. 237–260). Washington: American Psychological Association.CrossRefGoogle Scholar
  41. Lewis, S. T., & Van Puymbroeck, M. (2008). Obesity-stigma as a multifaceted constraint to leisure. Journal of Leisure Research, 40(4), 574–588.Google Scholar
  42. McCabe, M. P., & Ricciardelli, L. A. (2004). Body image dissatisfaction among males across the lifespan: A review of past literature. Journal of Psychosomatic Research, 56, 675–685.CrossRefPubMedGoogle Scholar
  43. McClanahan, K. K., Huff, M. B., & Omar, H. A. (2008). Overweight children and adolescents: Impact on psychological and social development. International Journal of Child Health and Human Development, 1(4), 377–384.Google Scholar
  44. Neumark-Sztainer, D., Falkner, N., Story, M., Perry, C., Hannan, P. J., & Mulert, S. (2002). Weight-teasing among adolescents: Correlations with weight status and disordered eating behaviors. International Journal of Obesity, 26, 123–131.CrossRefPubMedGoogle Scholar
  45. Neumark-Sztainer, D., Story, M., French, S. A., Hannan, P. J., Resnick, M. D., & Blum, R. W. (1997). Psychosocial concerns and health compromising behaviors among overweight and nonoverweight adolescents. Obesity Research, 5, 237–249.PubMedGoogle Scholar
  46. Paul, R. J., & Townsend, J. B. (1995). Shape up or ship out? Employment discrimination against the overweigh. Employee Responsibilities Rights Journal, 8, 133–145.CrossRefGoogle Scholar
  47. Penny, H., & Haddock, G. (2006). Anti-fat prejudice among children: The “mere proximity” effect in 5–10 year olds. Journal of Experimental Social Psychology, 43, 678–683.CrossRefGoogle Scholar
  48. Pierce, J. W., & Wardle, J. (1997). Cause and effect beliefs and self-esteem of overweight children. Journal of Abnormal Psychology, 38, 645–650.Google Scholar
  49. Powlishta, K. K., Serbin, L. A., Doyle, A. B., & White, D. R. (1994). Gender, ethnic and body mass type biases: The generality of prejudice in childhood. Developmental Psychology, 30(4), 526–536.CrossRefGoogle Scholar
  50. Puhl, R. M., & Latner, J. D. (2007). Stigma, obesity and the health of the Nation’s children. Psychological Bulletin, 13(4), 557–580.CrossRefGoogle Scholar
  51. Richardson, S. A., Goodman, N., Hastorf, A. H., & Dornbusch, S. M. (1961). Cultural uniformity in reaction to physical disabilities. American Sociological Review, 26, 241–247.CrossRefGoogle Scholar
  52. Schwartz, M. B., O’Neal Chambliss, H., Brownell, K. D., Blair, S. N., & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11(9), 1033–1039.CrossRefPubMedGoogle Scholar
  53. Spear, B. A., Barlow, S. E., Ervin, C., Ludwig, D. S., Saelens, B. E., Schetzina, K. E., et al. (2007). Recommendations for the treatment of child and adolescent overweight and obesity. Pediatrics, 120(Suppl. 4), S254–S288.CrossRefPubMedGoogle Scholar
  54. Strauss, R. S. (2000). Childhood obesity and self-esteem. Pediatrics, 105, 1–5.CrossRefGoogle Scholar
  55. Stroup, D. F., Johnson, V. R., Proctor, D. C., & Hahn, R. A. (2009). Reversing the trend of childhood obesity [Electronic version]. Preventing Chronic Disease, 6(3). Retrieved July 12, 2009, from
  56. Tiggemann, M. (2005). Body dissatisfaction and adolescent self-esteem: Prospective findings. Body Image, 2, 129–135.CrossRefPubMedGoogle Scholar
  57. Warschburger, P. (2005). The unhappy obese child. International Journal of Obesity, 29(Suppl. 2), s127–s129.CrossRefPubMedGoogle Scholar
  58. Weiss, R., Dziura, J., Burgert, T. S., et al. (2000). Obesity and the metabolic syndrome in children and adolescents. New England Journal of Medicine, 350, 2362–2374.CrossRefGoogle Scholar
  59. Young, L. M., & Powell, B. (1985). The effects of obesity on the clinical judgments of mental health professionals. Journal of Health and Social Behavior, 26(3), 233–246.CrossRefPubMedGoogle Scholar
  60. Zabinski, M. F., Saelens, B. E., Stein, R. I., Hayden-Wade, H. A., & Wilfley, D. E. (2003). Overweight children’s barriers to and support for physical activity. Obesity Research, 11, 238–246.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.School of Social WorkUniversity of Central FloridaOrlandoUSA

Personalised recommendations