Abstract

Children who live with obesity often face bias, discrimination and stigma across all aspects of their lives which can deleteriously impact their health into adulthood. This retrospective, qualitative study captured the lived experiences of individuals who experienced obesity and weight-based stigmatisation during childhood. Semi-structured interviews were conducted with 18 adults living in the UK who had lived with severe or complex obesity during childhood. Questions explored family, community, school and clinical contexts with additional focus on long term impacts, physical and mental health. A thematic analytic framework was used to identify areas of salience and give meaning to the lived experiences, with findings used to provide recommendations for supportive practices for those working with children living with obesity. Key themes were: (i) Attitudes of others, (ii) Self-perception, (iii) Relationship with physical activity, (iv) Relationship with food, (v) Adverse Childhood Experiences and (vi) Healthcare. Daily weight based microaggressions, stereotypical assumptions of laziness or incapability, physical abuse and verbal abuse from family members, peers, strangers, teachers or healthcare practitioners, negatively impacted the self-perceptions and self-esteem of the participants during their childhood. Pre-existing health conditions and bullying by teachers/peers hindered physical activity for some. Participants experienced shame and negative perceptions from others about their eating which triggered frequent comfort and secret eating. As children they made severe but unsustainable attempts to lose weight with self-imposed starvation regimes, multiple diet plans or prescription amphetamines. Many of the participants had adverse childhood experiences which led them to developing maladaptive coping strategies such as substance abuse, eating disorders, social self-isolation, negative self-talk, self-harm and suicidal ideation. The design and size of items in schools or public spaces, such as clothing and seating, were inappropriate for those living with obesity and drew judgmental attention from others. Participants recounted experiences of diagnostic overshadowing where medical symptoms were habitually attributed to their weight, sometimes with immediate or delayed serious health outcomes. Recommendations are required to address widespread institutional, societal and personal weight-based biases: identify underlying causes of weight gain or disordered eating, and obesity-informed education in institutions, businesses and schools to build a robust culture of body acceptance.
Disclosures: None.