Childhood Obesity and Mental Health

The societal message about being fat is clear: it is bad to be fat. But why is it bad? As we discussed in the previous post, there are serious medical consequences of childhood obesity. However, this fact often clouds the clear bias and discrimination against obese kids. In fact, few problems in childhood may have as significant an impact on childhood emotional and mental development as obesity.

Seeing through fat-colored glasses

Try as we might, there is a pervasive, underlying prejudice against obese people, including children. Much press and media coverage is given to the astounding medical costs due to obesity. However, the majority of obese people are not discriminated against because they are medically compromised. They are stigmatized because their obesity is viewed as a reflection of poor character. Studies have shown that common stereotypes associated with obese people include attitudes that they are lazy, incompetent, lacking in self-discipline, self-indulgent and emotionally unhealthy. 1,2 Nowhere is this more prevalent than with children.

Negative attitudes towards obese children develop very early. Studies have found that kids as young as 3-years old associate overweight children with being mean, stupid, ugly, unhappy, lazy, less desirable as friends and as having fewer friends.3,4 Interestingly, children held these negative stereotypes for both obese children and adults regardless of the child’s own weight, age or gender.5 This means that overweight and obese children hold these beliefs about other overweight and obese children and adults. Eventually, they turn these negative views inward and research shows that these attitudes only grow in breadth and magnitude as children age.

Blame, fault and judgment

“I hate myself for being fat.” These words came out of an obese child’s mouth in my office and reflects a pervasive underlying belief that leads to blame and judgment.  Even amongst children, it is believed that obesity is under personal control, leading to many judgments about obese children (and their parents) as well as obese adults. Because of this, as children age, they begin to internalize these negative messages and become more and more dissatisfied with their own bodies. This often results in persistent disturbances in body image and greatly reduces self-esteem as these children age.

The psychological impact of this can be huge – studies have shown that obese children have lower self-esteem; more dissatisfaction with their bodies; higher rates of loneliness, sadness and nervousness; increased risk of depression; and increased rates of suicide.6,7,8,9 What’s worse is that children internalize these messages and assume that it is their fault that they are overweight and subsequently blame themselves for the negative social experiences that they confront because of being obese.10 This sets into motion a downward spiral that is usually incredibly difficult to break.

The Road to Recovery

Obese children need help. They need help from their parents, educators, health care providers and society at large. It’s unlikely that food advertisers and fast food marketers are likely to change their bombardment of our kids with messages about consuming nutritionally devastating foods, so we need to do everything we can to help our kids not only understand what they need to do, but do it. Part 4 of this series will outline several ways this can be done, as well as outline a program that can be used to help both children and adults get on the road to recovery.


  1. Puhl R, Brownell KD. Bias, discrimination and obesity. Obesity Res 2001; 9:788-805.
  2. Paul RJ, Towsend JB. Shape up or ship out? Employment discrimination against the overweight: Employees Responsibilities and Rights Journal 1995;8:133-145.
  3. Cramer P, Steinwert T. Thin is good, fat is bad: How early does it begin? J Appl Dev Psych 1998;19:429-451.
  4. Brylinskey JA, Moore JC. The identification of body build stereotypes in young children. J Res Pers 1994;28:170-181.
  5. Tiggermann M, Anesbury T. Negative stereotyping of obesity in children: The role of controllability beliefs. J Appl Soc Psych 2000;30:1977-1993.
  6. Strauss RS. Childhood Obesity and Self-Esteem. Pediatrics 2000; 105;1:1-5.
  7. Eisenberg ME, Neumark-Sztainer D, Story M. Assoications of weight-based teasing and emotional well-being among adolescents. Arch Pediatr Adolesc Med 2003; 157: 733-38.
  8. Sheslow D, Hassink W, Wallace W, DeLancey E. The relationship between self-esteem and depression in obese children. Ann NY Acad Sci 1993;699:289-291.
  9. Wallace W, Sheslow D, Hassink W. Obesity in children: a risk for depression. Ann NY Acad Sci 1993;699:301-303.
  10. Pierce JW, Wardle J. Cause and effect beliefs and self-esteem of overweight children. J Child Psychol Psychiatry 1997;38:645-650.