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A new joint statement from the American Academy of Pediatrics (AAP) and The Obesity Society (TOS) addresses weight stigma in overweight or obese children and assesses how this discrimination can exacerbate health problems and impede quality of life.

Published in , the statement offers guidance for pediatricians and healthcare professionals on how to reduce weight discrimination, as well as how to educate others about the negative consequences of such actions, wrote the authors, led by Stephen J. Pont, MD, MPH, of Dell Children's Medical Center of Central Texas, and colleagues from the AAP Section on Obesity Executive Committee.

"Treating children and teens who have obesity means more than just changing nutrition and physical activity habits. It's also about addressing the social and emotional impact that excess weight can have on their quality of life," stated Pont in a press release. "Through these new recommendations, we hope to encourage more effective and empathetic approaches in how we address and care for children and families with obesity."

The document noted that weight stigma has numerous consequences for children's psychological and physical health, including unhealthy behaviors that promote obesity and weight gain. The organizations cited weight-based teasing as a common contributor to social isolation, with one study reporting that more than two-thirds of nine- to 11-year-olds who perceived themselves as having excess weight believed they would have more friends if they lost more weight.

In addition to weight-based bullying from peers and educators in school settings, victimization can also occur at home, with 37% of adolescents reporting being bullied or teased about their weight by a parent. "This issue needs to be on the radar for pediatric health professionals, who may be among the few allies who can offer support and help prevent youth from further harm from these experiences," stated coauthor Rebecca Puhl, PhD, deputy director for the Rudd Center for Food Policy & Obesity and a TOS fellow.

Pont and colleagues recommended using practices such as role modeling, behavior change counseling, and creating a safe and welcoming clinical space in order to help mitigate weight stigmatization in clinical practice.

The team also emphasized the importance of language and word choice, encouraging "people first" language, such as saying "children with obesity" instead of "obese children," as well as neutral words like "weight" and "body mass index."

"Words are powerful and can encourage or do harm, and so when working with families trying to make healthy changes, I remind myself: be nice, be patient," said Pont. "If we are aware and avoid words or actions that could be felt as stigmatizing by our patients, then they will be more successful."

Several additional recommendations noted in the document to help pediatricians effectively prevent obesity among youth included the following:

• Work with schools to ensure that anti-bullying policies include protections for students who are bullied about their weight
• Speak out against stigmatizing depictions in the media via commentaries, letters to the editor, professional presentations, and social media campaigns

• Empower families and patients to manage and address weight stigma in schools, communities, and their homes

• Encourage parents of patients to check with their children's teachers to ensure that plans are in place to address weight-based victimization

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