Family and media pressure to lose weight in adolescence linked to how people value themselves almost two decades later

Peer reviewed: Yes

Type of evidence: Observational study

Subject: People

UNDER STRICT EMBARGO until 00:30 hours [UK BST] Tuesday 16 April 2024 / 19:30 hours [US EDT] Monday 15 April 2024

Family and media pressure to lose weight in adolescence linked to how people value themselves almost two decades later

People who as teenagers felt pressure to lose weight from family or from the media, females, people who are not heterosexual, and people experiencing socioeconomic disadvantage, are most at risk of ‘internalised’ weight stigma, new research led by the University of Bristol has found. The study is published in The Lancet Regional Health Europe today [16 April].

‘Internalised’ weight stigma, is when people apply negative obesity-related stereotypes to themselves, such as thinking they are less attractive, less competent, or less valuable as a person because of their weight. This is the first time a study has used a large UK sample to examine who is most at risk.

In England, around one in four people are living with obesity, but it is highly stigmatised. Negative obesity-related stereotypes and weight-related discrimination are widespread in society. Experience of weight stigma is a major public health issue: people affected by weight stigma are more likely to have poor mental health, eating disorders and may delay seeking medical treatment. However, little is known about which population groups are at higher risk of internalised weight stigma, because previous research has used small, nonrepresentative samples. 

Using data from Bristol’s Children of the 90s (also known as the Avon Longitudinal Study of Parents and Children), this new study examined differences in internalised weight stigma in over 4,000 people aged 31 years by sex, ethnicity, socioeconomic factors, sexual orientation, and family and wider social influences in childhood and adolescence.  

The research found that feeling pressure from family to lose weight, weight-related teasing by family members, and feeling pressure from the media to lose weight as a teenager were all linked to higher levels of internalised weight stigma at age 31, and this was not explained by differences in body mass index (BMI). Being bullied in adolescence (at age 17 years) and adulthood (at age 23 years) were also independently linked to internalised weight stigma at age 31.

The study also found there are clear differences in internalised weight stigma between other groups of the population, which were also not explained by differences in BMI.  Females and people who did not identify as heterosexual are at greater risk of internalized weight stigma. People who had spent more of their 20’s as NEETs (not in education, employment or training), or whose mothers had fewer educational qualifications, are also more at risk of internalised weight stigma.

Dr Amanda Hughes, Research Fellow in the Bristol Medical School: Population Health Sciences (PHS) and corresponding author, said: “The family environment in adolescence, bullying, and pressure to lose weight from the media may have long-lasting impacts on how people value themselves based on their weight as adults.

“We have an opportunity to reduce weight stigma and its consequences by changing how we discuss weight in the media, in public spaces and in families, and how we respond to bullying in schools, workplaces, and other settings.

“This is crucial considering how common pressure to lose weight and weight-related bullying, stigma and discrimination are in many cultures around the world.”

The researchers now plan to explore in detail the psychological processes by which these social factors may influence internalised weight stigma.

The research was funded by the Economic and Social Research Council (ESRC), Medical Research Council (MRC), National Institute for Health and Care Research (NIHR), and Wellcome Trust. 

Paper

‘Demographic, socioeconomic and life-course risk factors for internalized weight stigma in adulthood: evidence from an English birth cohort study’ by Amanda M Hughes, Stuart W. Flint, Kenneth Clare, Antonis A. Kousoulis, Emily R. Rothwell, Helen Bould, and Laura D. Howe in The Lancet Regional Health Europe [open access]

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Notes to editors

A copy of the press preview paper is available on request.

Once the embargo lifts, the link to the paper is: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(24)00061-9/fulltext

For further information or to arrange an interview with Dr Amanda Hughes, please contact Joanne Fryer [Mon to Wed], email [email protected], mobile: +44 (0)7747 768805 or Caroline Clancy [Wed to Fri], email [email protected], mobile: +44 (0)7776 170238 in the University of Bristol Press Office.

About Children of the 90s Based at the University of Bristol, Children of the 90s, also known as the Avon Longitudinal Study of Parents and Children (ALSPAC), is a long-term health research project that enrolled more than 14,000 pregnant women in 1991 and 1992.  It has been following the health and development of the parents, their children and now their grandchildren in detail ever since.  It receives core funding from the Medical Research Council, the Wellcome Trust and the University of Bristol.

About the Economic and Social Research Council (ESRC) The Economic and Social Research Council (ESRC) is part of UK Research and Innovation, a non-departmental public body funded by a grant-in-aid from the UK government.

We fund world-leading research, data and postgraduate training in the economic, behavioural, social and data sciences to understand people and the world around us.

Our work helps raise productivity, address climate change, improve public services and generate a prosperous, inclusive, healthy and secure society.

About the National Institute for Health and Care Research

The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by: 

• Funding high quality, timely research that benefits the NHS, public health and social care; 
• Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services; 
• Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research; 
• Attracting, training and supporting the best researchers to tackle complex health and social care challenges; 
• Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system; 
• Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries. 

NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government. 

About National Institute for Health and Care Research Bristol Biomedical Research Centre (NIHR Bristol BRC) National Institute for Health and Care Research Bristol Biomedical Research Centre’s (NIHR Bristol BRC) innovative biomedical research takes science from the laboratory bench or computer and develops it into new drugs, treatments or health advice. Its world-leading scientists work on many aspects of health, from the role played by individual genes and proteins to analysing large collections of data on hundreds of thousands of people.

Bristol BRC is unique among the NIHR’s 20 BRCs across England, thanks to its expertise in ground-breaking population health research.

About Wellcome  Wellcome supports science to solve the urgent health challenges facing everyone. We support discovery research into life, health and wellbeing, and we’re taking on three worldwide health challenges: mental health, global heating and infectious diseases. 

About the Medical Research Council

The Medical Research Council is at the forefront of scientific discovery to improve human health. Founded in 1913 to tackle tuberculosis, the MRC now invests taxpayers’ money in some of the best medical research in the world across every area of health. Thirty-three MRC-funded researchers have won Nobel prizes in a wide range of disciplines, and MRC scientists have been behind such diverse discoveries as vitamins, the structure of DNA and the link between smoking and cancer, as well as achievements such as pioneering the use of randomised controlled trials, the invention of MRI scanning, and the development of a group of antibodies used in the making of some of the most successful drugs ever developed. Today, MRC-funded scientists tackle some of the greatest health problems facing humanity in the 21st century, from the rising tide of chronic diseases associated with ageing to the threats posed by rapidly mutating micro-organisms.

Issued by the University of Bristol Media team