Links between obesity, weight stigma and learning in adolescence: a qualitative study.

BACKGROUND: Educational attainment is a key social determinant of health. Health and education are linked by multiple pathways, many of which are not well understood. One such pathway is the association between being above a healthy weight and lower academic achievement. While various explanations have been put forward to explain this relationship, evidence for causal pathways is sparse and unclear. This study addresses that evidence gap. METHODS: We interviewed 19 adults (late 20s; 14 female, 5 male) and one young person (14 years, male) from the UK in 2019/2020. Participants were recruited from the ALSPAC 1990s birth cohort, sampled to ensure diversity in socio-economic status and educational attainment, and a community-based weight management group for young people. Interviews focused on experiences of being above a healthy weight during secondary school and how this may have affected their learning and achievement. Interviews were face-to-face, digitally recorded, and transcribed verbatim. We analysed the data thematically. RESULTS: We identified key pathways through which higher body weight may negatively impact educational performance and showed how these are linked within a novel theoretical model. Because larger body size is highly stigmatised, participants engaged in different strategies to minimise their exposure to negative attention. Participants sought to increase their social acceptance or become less socially visible (or a combination of both). A minority navigated this successfully; they often had many friends (or the 'right' friends), experienced little or no bullying at school and weight appeared to have little effect on their achievement at school. For most however, the behaviours resulting from these strategies (e.g. disruptive behaviour, truanting, not working hard) or the physical, social or mental impacts of their school experiences (e.g. hungry, tired, self-conscious, depressed) made it difficult to concentrate and/or participate in class, which in turn affected how teachers viewed them. CONCLUSIONS: Action to combat weight stigma, both within schools and in wider society, is urgently required to help address these educational disparities that in turn can impact health in later life.

Weight Bias During the COVID-19 Pandemic.

PURPOSE OF REVIEW: This review explores potential sources of weight bias and stigma during the COVID-19 pandemic, including "quarantine-15" messages and discussion of obesity in media and public health campaigns. We examine evidence of the effects of weight bias on well-being during the pandemic and highlight unanswered questions to be addressed in future research. RECENT FINDINGS: Studies that have investigated weight change during stay-at-home orders have yielded mixed findings and relied predominantly on self-reported retrospective recall, thus providing weak evidence of a widespread "quarantine-15" effect. No studies to date have evaluated the effects on weight stigma and health of obesity-focused COVID-19 media and public health messages. Individuals with a history of experiencing weight bias may be more vulnerable to binge eating and psychological distress during the pandemic. Weight bias and stigma during the COVID-19 pandemic, and their effects on health and well-being, warrant greater investigation and consideration in public health efforts.