Teenagers sit on a wall eating snacks.

Study ties harmful body comments in adolescence to substance use in adulthood

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July 22, 2019

Shaming or teasing comments made about a person’s weight, called weight stigma, can damage their self-esteem and start them down a path to poor health. Weight stigma in turn can trigger adolescents to adopt unhealthy weight control behaviors, such as laxative use or self-induced vomiting to control or reduce weight. Those behaviors also have strong links to later substance use, including alcohol, cigarettes or marijuana. 

Postdoctoral researcher Melissa Simone

A University of Minnesota School of Public Health study recently looked at how experiences with weight stigma and the use of unhealthy weight-control behaviors in adolescence potentially influence substance use in adulthood. The study found that girls who used unhealthy weight-control behaviors and experienced the harms of weight stigma during adolescence were likely to use substances as adults. 

The study, led by postdoctoral researcher Melissa Simone and co-authored by Professor Dianne Neumark-Sztainer, was published in the journal Social Science & Medicine.

“Stigma comes in many forms, such as questioning someone’s food choices or making fun of them for their body and calling them fat,” says Simone. “Our recent study highlights the negative impacts of weight stigma and how these behaviors often predict more risky behaviors later in life.”

The study analyzed survey data from 1,147 women participating in the school’s Project EAT, a long-term research project tracking the health and wellbeing of adolescents into adulthood. The researchers looked at participants’ reports of weight stigma and unhealthy weight-control behaviors from surveys completed at the start of the project when they were teenagers. The participants were then split into three groups based on their weight stigma experiences: those who reported no weight stigma; weight stigma only (being teased by peers or parents) with no sense of harm; and weight stigma with perceived harms (e.g., being bothered by teasing).

Next, the researchers reviewed surveys from the same participants completed 10 years later when they were young adults and identified any reported substance use.

The results showed:

  • participants who experienced the harms of weight stigma and used unhealthy weight-control behaviors in adolescence were likely to use substances in adulthood; 
  • among those who experienced the harms of weight stigma, the more unhealthy weight-control behaviors they practiced in adolescence, the more they used substances in adulthood;
  • unhealthy weight-control behaviors in the other two groups did not coincide with later substance use in adulthood.

“Regardless of why some people are more prone to experience the harms of weight stigma, the easiest and most effective way to prevent the harms is to reduce it across society,” says Simone. “We can all be part of the change.”

Simone suggests taking the following steps to eliminate stigma:

Challenge yourself to recognize stigmatizing thoughts regarding yourself or others 

  • Think about where the thoughts come from, if they are true, and if your own body size factors into your sense of personal value. 
  • Question if the size of someone else’s body matters to you.
  • Be aware of the influence weight stigma might have on another individual.

Challenge others to recognize stigmatizing thoughts 

  • Share knowledge of the health effects of weight stigma with others.
  • Explain how you are overcoming your own issues with weight bias. 

Make amends with yourself and others

  • Recognize that you’re still a good person who has been influenced by a culture that is overly weight-focused.
  • Try to apologize to yourself for the harmful things you’ve said about your own body.
  • When appropriate, apologize to others whom you may have stigmatized.

Additionally, Simone says policymakers and professionals can reduce body shaming by eliminating practices that unintentionally stigmatize people, such as measuring a child’s weight in the presence of others during school health screenings. Researchers can also identify the forms of stigma that are most damaging or prevalent or examine the presence of stigma in health care settings, which can keep patients from seeking care.

Simone is continuing her explorations of weight stigma by studying the sources and results of “weight talk” — comments and conversations regarding weight and body size —  across gender, sexual orientation, racial, and ethnic groups.

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