WEDNESDAY, June 7, 2017 (HealthDay News) -- Overweight kids are excluded and ostracized by classmates in school more often than their thinner peers, new research indicates.
Examining friendship dynamics among more than 500 preteens in the Netherlands, California researchers found that those who were overweight or obese were 1.7 times more likely to be disliked by their peers.
Not surprisingly, the reverse was also true. Overweight or obese preteens were 1.2 times more likely to dislike their peers, the study revealed.
Study author Kayla de la Haye is an assistant professor of preventive medicine at the University of Southern California Keck School of Medicine. She also led earlier research that reinforces the new findings, which she said would be similar in the United States.
"We consistently find overweight kids are ostracized by their peers, which plays out over middle school and high school to the point where they're pushed to the periphery of these big social groups," de la Haye said.
"We really need to take this seriously," she added. "Experiencing stigma has such big implications for these kids, impacting their social development and mental health, and probably their physical health."
The number of obese children in the United States has tripled since 1970, now comprising about 17 percent of all American children, according to the U.S. Centers for Disease Control and Prevention. Meanwhile, childhood obesity worldwide rose by nearly one-third in just over 20 years, with about 42 million overweight or obese children in 2013, according to the World Health Organization.
De la Haye and her team based their findings on questionnaires given to children between the ages of 10 and 12 in classroom groups, who were asked to list their best friends and enemies.
Approximately one in six kids was overweight.
Overall, children were listed as a friend by five classmates and as an enemy by two. Overweight kids, however, were considered a friend by four classmates and were disliked by three. They were more likely to call classmates friends when the feeling wasn't mutual and they disliked greater numbers of their classmates than their thinner peers, the study found.
A vicious cycle can stem from these negative peer interactions, de la Haye said. Overweight children who feel socially isolated may end up eating more and participating less in sports and physical activities, leading to further weight gain.
"The medical community and [larger] community think they can't make obesity OK" because of its associated health risks, she said. "That sort of dominates the conversation. But we can't buy into this argument anymore that stigma is OK."
Dr. Elsie Taveras is a professor of nutrition at the Harvard T.H. Chan School of Public Health and chief of the Division of General Academic Pediatrics at Massachusetts General Hospital for Children. She wasn't surprised by the new findings.
"We've known for some time this starts young -- this weight bias and stigma," she said.
In her practice, Taveras said she often sees children who are bullied and marginalized because of their excess weight, which she said can trigger depression and other mood disorders.
"We always screen children with obesity for things like high blood pressure and diabetes, but a silent condition many experience is weight bias and stigma," said Taveras. "It's the type of thing clinicians rarely ask about, but also the thing that affects these children so much more, in some ways, than an abnormal cholesterol level."
Taveras and de la Haye agreed that addressing weight-based stigma, especially with children who aren't overweight, should be a standard component of obesity prevention efforts.
"It's been talked about traditionally as this individual problem -- when we see someone who's fat, they're [said] to be lazy, that it's some sort of failing," de la Haye said. "And that's really the opposite of what we now know causes obesity. It's really that we've created a society and environment that promotes lots of food consumption and makes it really hard to be active."
Taveras suggested parents of normal-weight children encourage them to include peers of all shapes and sizes in social situations.
"I'm sure [children] are hearing about tolerance and inclusion for other characteristics that may be as obvious as obesity," she said. "The message is to expand that language ... to think about the real, troublesome stigma happening with children with obesity."
The study was published June 7 in the journal PLOS One.
SOURCES: Kayla de la Haye, Ph.D., assistant professor, preventive medicine, Keck School of Medicine, University of Southern California, Los Angeles, Calif.; Elsie Taveras, M.D., M.P.H., chief, Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, and professor, pediatrics, Harvard Medical School, and professor, nutrition, Harvard T.H. Chan School of Public Health, Boston, Mass.; June 7, 2017, PLOS One