Since the pandemic started, people of all ages have gained weight. At the same time, the rate at which youth and young adults are seeking treatment for eating disorders, particularly anorexia nervosa and binge eating disorder, has increased.
While the reasons for these changes are complex, pandemic-related stress and weight bias — the belief that a thin body is good and healthy, while a large body is bad and unhealthy — are prominent contributors.
As researchers who study health behaviors and are also parents of young children, we often see health research and health initiatives that place a disproportionate emphasis on weight.
That’s a problem for two big reasons.
First, it draws attention away from better predictors of chronic disease and strategies to address these factors. Although a high body mass index, or BMI, is one risk factor for various chronic diseases, it is only one of many, and far from the strongest. And while moderate weight loss does reduce chronic disease risk for some people, about 80 percent of individuals who manage to lose weight regain it. The other 20 percent describe their ongoing efforts to maintain their weight loss as stressful and exhausting.
Second, disproportionate emphasis on weight reinforces weight bias. Weight bias, in turn, contributes to weight-related discrimination, like bullying and teasing, which is common among youth. Across diverse samples surveyed, 25 percent to 50 percent of children and adolescents report being teased or bullied about their body size, and these experiences are linked to disordered eating and depression, as well as poorer academic performance and health.
To best support the physical and emotional health of children during this pandemic, we suggest reducing the emphasis on body size. Below are some specific tips for parents, teachers and medical providers.
1. Stop using the words ‘fat,’ ‘obese’ and ‘overweight’
When asked, children and adults with larger bodies consistently indicate that these are the least preferred and most stigmatizing terms to talk about body size, while “weight” and “body mass” are the most preferred.
So, consider modeling less stigmatizing language. For example, if your teen refers to her friend as “overweight,” respond by saying, “Yes, your friend does have a larger body.” Likewise, if your doctor refers to your child as “obese,” ask them to share their “body mass index percentile” instead. Or, better yet, ask them not to talk about weight at all, which leads us to our next recommendation.
2. Focus on health behaviors
Considering that behavioral weight loss programs are ineffective for the majority of people, we recommend focusing on behaviors that are more easily changed and have stronger influences on health and well-being. Regular physical activity, for example, improves mood and lowers risk for heart disease and type 2 diabetes, even in the absence of weight loss.