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Obesity's stigma lingers for teenage girls who attain normal BMI


White teenage girls with obesity who lose weight may benefit physically, but the weight change does not guarantee a boost to their self-esteem.

A new study has found that girls who attain normal body mass index (BMI) after being in the obese range continue to experience lower levels of self-esteem compared with teenagers who were never overweight or obese.

For the study, data was collected from the National Heart, Lung, and Blood Institute (NHLBI) Growth and Health Study (NGHS). Researchers followed for 10 years the health and weight of 2,206 black girls and white girls, starting when they were aged 9 to 10 years. The girls were separated into 1 of 3 groups—normal weight, transitioned out of obesity, and chronically obese—based on their BMI trends during the 10-year period. Self-perception profiles were administered to participants every other year.

The findings showed a difference in self-esteem levels between races. Self-esteem for black girls transitioning from the obese to the normal range rebounded compared with white girls; however, both races continued to have negative body perceptions.

"We found that obese black and white teenage girls who transitioned out of obesity continued to see themselves as fat, despite changes in their relative body mass," said researchers. "Further, obese white girls had lower self-esteem than their normal-weight peers, and their self-esteem remained flat even as they transitioned out of obesity."

They suggest that the lingering self-esteem and self-image disadvantages associated with obesity exposure—even when weight is lost—reinforce the importance of tailoring sensitive, nonstigmatizing interventions for children.

The researchers note that the NGHS data set used for the findings is from the 1980s and 1990s and doesn't reflect today's higher obesity rates. The Centers for Disease Control and Prevention reports that about 17% of American children aged 2 to 19 years are obese.

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