Parent-Adolescent Weight Communication: Parental Psychosocial Correlates Among a Diverse National Sample.

Parental communication about body weight with their children is common across diverse families. The current study investigates how parents' feelings about their own bodies, beliefs about body weight, history of weight stigma, and weight-related characteristics contribute to the degree to which they talk about weight - both negatively and positively - with their adolescent children. The study sample was comprised of U.S. parents (N = 1936) from diverse racial/ethnic backgrounds with children aged 10-17 years old. Parents completed an online survey with measures assessing their frequency of engaging in negative and positive weight communication with their children, along with several relevant psychosocial factors (i.e. body satisfaction, experienced weight stigma, associative stigma, body appreciation, beliefs about weight controllability, weight bias internalization). Study findings paint a complex picture, including some psychosocial factors (e.g. weight bias internalization) that are related to both more frequent negative and positive weight communication. Notably, higher levels of associative stigma were related to more frequent negative parental weight comments, and less frequent positive weight socialization. Findings can inform healthcare professionals in raising parents' awareness about how their personal beliefs and feelings about their own weight and their child's weight can contribute to how they engage in communication about weight with their children.

Sexual Minority Youth Reporting SOGIE-Based Harassment to Adults at School: The Roles of Experienced Harassment, Outness, Safety, and Adult Support at School.

Despite a proliferation of bullying prevention programs in recent time, limited work has investigated support-seeking behaviors in response to elevated bullying levels among sexual minority youth (SMY). To address this gap, the current study examined how harassment targeting SOGIE (sexual orientation, gender identity, and gender expression), sexual identity outness, school safety, and perceptions of teacher/staff support were associated with SMY talking to an adult at school about harassment. A large contemporary national sample of SMY (N = 5538) between the ages 13-18 (Mage = 15.53, SD = 1.33) who experienced at least one form of SOGIE-based harassment in the past year was leveraged for analyses. Hierarchical multivariable logistic regressions revealed more frequent SOGIE-based harassment was associated with greater odds of reporting harassment to school personnel, particularly among SMY who felt safe at school. Findings highlight the need for school-based interventions to foster school safety among SMY who experience peer harassment to promote their reporting of this behavior.

Parental Communication About Body Weight and Adolescent Health: The Role of Positive and Negative Weight-Related Comments.

OBJECTIVE: Research has consistently documented adverse effects of parent weight-related comments on adolescent health. However, little empirical attention has focused on isolating the impact of weight-related comments from mothers versus fathers, and the valence of their comments. The present study examined the extent to which positive and negative weight-related comments from mothers and fathers are related to adolescent health and wellbeing, and whether these associations differ according to adolescent sociodemographic characteristics. METHODS: Data were collected from a diverse sample of 2032 U.S.-based adolescents aged 10-17 years (59% female; 40% White, 25% Black or African American, 23% Latinx). Online questionnaires assessed perceived frequency of negative and positive weight-related comments from mothers and fathers, as well as four indicators of adolescent health and wellbeing: depression, unhealthy weight control behaviors, weight bias internalization (WBI), and body appreciation. RESULTS: More frequent negative weight-related comments from parents were associated with poorer adolescent health and wellbeing, while positive comments contributed to lower levels of WBI and body appreciation; these associations were documented regardless of whether mothers or fathers were the source of such comments, and considerable consistency was demonstrated across adolescent sociodemographic characteristics. CONCLUSION: Findings highlight differences in adolescent health based on how parents discuss their body weight (i.e., negatively or positively), and similarity in associations regardless of whether mothers or fathers are the source of weight communication. These findings reiterate the importance of efforts to educate parents on ways to engage in supportive communication about weight-related health with their children.

Family-based weight stigma and psychosocial health: A multinational comparison.

OBJECTIVE: Family-based weight stigma can be expressed as criticism, judgment, teasing, and mistreatment by family members because of an individual's body weight. The current study compared the prevalence and psychosocial correlates of family-based weight stigma among adult members of a weight-management program living in Australia, Canada, France, Germany, the UK, and the US. METHODS: Participants (N = 8100 adults who reported having ever experienced weight stigma; 95% female; 94% White) completed an identical online survey in their country's dominant language that assessed their experiences of weight stigma from 16 different family member sources, as well as internalized weight bias, body image, eating behaviors, perceived stress, and self-rated health. RESULTS: Family-based weight stigma, especially from mothers (49%-62%), spouses/romantic partners (40%-57%), and fathers (35%-48%), was highly prevalent across countries. Weight stigma from one's immediate family members was associated with indices of poorer psychosocial health across the six countries (ß coefficients = |0.08-0.13|). CONCLUSIONS: Findings highlight the need for weight stigma-reduction efforts to help family members distinguish between supportive, encouraging discourse and potentially weight-stigmatizing communication. Future research should examine the prevalence and correlates of family-based weight stigma in more diverse community samples, including among racially/ethnically and gender diverse adults, and in non-Western countries.

Parent-child communication about weight: Priorities for parental education and support.

BACKGROUND: Approximately 2/3 of parents talk about body weight with their children, which can include negative comments that have adverse health implications for youth. OBJECTIVES: To identify ways to improve supportive parent-child communication about weight, we assessed parent and youth perspectives of barriers to weight communication, preferences for educational resources and support, and whether perspectives differ across demographic groups and weight status. METHODS: In Fall 2021, online surveys were completed by two independent, unrelated samples of parents (N = 1936) and youth (N = 2032). Participants were asked about their perceived barriers to talking about weight, and what kinds of information and support would be most useful to them in fostering supportive communication. RESULTS: Parent and youth-reported barriers to weight communication included discomfort and lack of knowledge about weight, and views that weight does not need to be discussed. Most parents wanted guidance on how to navigate multiple weight-related topics with their children, including promoting positive body image and healthy behaviours, reducing weight criticism, focusing more on health and addressing weight-based bullying. Youth preferences for how their parents can be more supportive of their weight included avoiding weight-related criticism and pressures, increasing sensitivity and encouragement, and emphasizing healthy behaviours rather than weight. Few differences emerged based on sex and race/ethnicity, although several differences emerged for youth engaged in weight management. CONCLUSION: Parent and youth perspectives indicate a need for education to help parents engage in supportive conversations about body weight. Findings can inform efforts to reduce barriers and increase supportive weight-related communication in families.

"Look beyond the weight and accept me": Adolescent perspectives on parental weight communication.

Critical weight communication between parents and their adolescent children is prevalent and harmful. However, research on adolescent perspectives about parental weight communication is limited. The present mixed-methods study aimed to address this gap using inductive thematic analysis of 1743 adolescents' (Mage=14.61 years, SDage=2.48) preferences regarding parental weight communication in response to an open-ended prompt, and quantitative analyses to examine age, gender, race/ethnicity, and weight-related differences in subthemes. In their responses, adolescents articulated 1) whether and 2) how parental weight communication should-or should not-occur, and 3) what these conversations should entail. We identified 15 subthemes across these categories-the endorsement of which often varied by adolescents' demographic and anthropometric characteristics. For example, some adolescents (especially cisgender girls and transgender/gender diverse adolescents) preferred that their parents talk about weight less often (n = 184), while others (especially multiracial/ethnic or Hispanic/Latinx adolescents) hoped that, if parents were to discuss weight with them, they do so in a manner that was compassionate and respectful (n = 150). Across most subthemes, adolescents described adverse responses (e.g., feeling insecure, embarrassed, or hurt) when parents discussed their weight in non-preferred ways. Collectively, findings can inform interventions to promote more supportive health-focused communication in families.

Motivations for engaging in or avoiding conversations about weight: Adolescent and parent perspectives.

BACKGROUND: Little is known about parent and adolescent motivations for engaging in weight communication. OBJECTIVES: To assess parent and adolescent motivations for engaging in, or avoiding, weight communication, and whether these reasons differed across sex, race/ethnicity, weight, and engagement in weight management. METHODS: Independent samples of parents (N = 1936) and unrelated adolescents (N = 2032) completed questionnaires assessing their agreement with different reasons they engage in, or avoid, parent-adolescent weight communication, using 7-point Likert scales (strongly-disagree to strongly-agree). RESULTS: Parents, irrespective of sex, race/ethnicity, and child's weight status, expressed stronger motivations for engaging in weight communication in order for their child to feel good about his/her weight and body size compared to being motivated because a health professional raised their child's weight as a concern. Adolescent motivations for weight communication with parents stemmed from health concerns and worry about their weight; avoidance stemmed from feeling embarrassed, upset, or not wanting to obsess about weight. Differences emerged across sex and race/ethnicity but were most pronounced by weight status and weight management. CONCLUSION: Parents and adolescents have different motivations for engaging in or avoiding weight communication. Protecting adolescents' emotional wellbeing and body esteem are viewed as reasons for both engaging in or avoiding weight communication.

Patient and Family Perspectives on Terms for Obesity.

OBJECTIVES: Parent communication about body weight is a sensitive topic, but limited research has studied youth preferences for words used to talk about their weight with parents. We assessed perspectives of weight-based terminology in 2 racially/ethnically diverse samples of youth and parents. METHODS: We collected online survey data from 2 panel survey samples between September and December 2021: youth aged 10 to 17 years (n = 2032) and parents of youth aged 10 to 17 years (n = 1936). Participants rated 27 different terms and phrases to describe body weight; parents reported on their usage of this terminology and youth reported their preferences for and emotional responses to terminology. Patterns were examined across sex, race/ethnicity, sexual orientation, and weight status. RESULTS: Youth reported preferences for words such as "healthy weight" and dislike of terms such as "obese," "fat," and "large," which induced feelings of sadness, shame, and embarrassment. Differences in youth preferences and emotional reactions were present across sex, sexual orientation, race/ethnicity, and weight status. This included a general pattern of lower preference ratings among girls (versus boys) and sexual minority (versus heterosexual) youth, and stronger preferences for words such as "thick" or "curvy" among racial/ethnic minority, sexual minority, and higher-weight youth. Use of most weight terms was higher among fathers compared with mothers, and by Hispanic/Latinx parents compared with white and Black/African American parents. CONCLUSIONS: Our findings underscore diversity of youth preferences and the need for individualized approaches that support effective parent and youth communication by using their preferred terms when discussing weight-related health.

The academic benefits of maintaining friendships across the transition to high school.

Extending past research on the social and academic disruption associated with the transition from middle to high school, this study examined the role of friendship stability. Specifically, the goal was to investigate how friendships maintained from middle school and perceived (academic and emotional) support from friends at ninth grade contributed to school-related affect (e.g., school belonging, academic identification, burnout) at 10th grade. Relying on a sample of 3410 ethnically diverse ninth grade students, multilevel structural equation modeling (MSEM) was conducted on 17,255 friendships. Friendships maintained from middle to high school (versus newly formed) provided greater academic support, and students with a greater number of stable friends reported higher levels of both academic and emotional support from friends. Tests of multiple mediation revealed that friendship maintenance across the high school transition was related with more positive school affect at 10th grade, in part due to higher levels of perceived academic support from friends (e.g., homework help, course-taking advice), but not emotional support. The findings underscore the academic value of maintaining social ties across the high school transition.

A Comprehensive Examination of the Nature, Frequency, and Context of Parental Weight Communication: Perspectives of Parents and Adolescents.

Research suggests that many parents make comments about their child's weight, which is associated with negative adolescent health outcomes. Gaps in this literature include an underrepresentation of fathers, limited knowledge regarding positive versus negative parental weight comments and differences across race/ethnicity, and adolescent preferences for parental weight communication. The present study addressed these research gaps through a comprehensive investigation of two diverse samples of U.S. parents (n = 1936) and adolescents (n = 2032), who completed questionnaires about their experiences and perspectives of parental weight communication. Positive weight comments from parents were more frequent than negative comments, though both were commonly reported across sex, race/ethnicity, and weight status. In general, boys, fathers, Latino/a parents and adolescents, and adolescents with a high BMI and/or engaged in weight management reported more frequent parental weight-talk. Parent-adolescent weight communication occurred both in-person and digitally, and across daily life contexts. Although the majority of parents communicated positive messages of body diversity and respect, 44% and 63% of adolescents said they never want their mothers and fathers, respectively, to talk about their weight. Adolescents were offered circumstances that would increase their comfort level in having these conversations. Findings have implications for health professionals working with families to promote supportive health communication at home.

Young Adult Adaptability to the Social Challenges of the COVID-19 Pandemic: The Protective Role of Friendships.

The continuing COVID-19 pandemic enables assessment of the adaptability of young adults to non-normative stressors threatening their social-emotional wellbeing. Focusing specifically on a developmentally critical social challenge of restricted in-person contact, the goal of the current study was to examine the role of friendships in alleviating social-emotional problems. Data were collected via online surveys from an ethnically diverse sample (n = 1557) of 20 to 24-year-olds (62% cisgender female, 31% male, 7% gender diverse or gender questioning) in spring of 2021. Longitudinal data from an earlier time point involving an age-normative social challenge (transition out of high school) were used as a comparison. The comparisons between the transition from high school and the pandemic showed that whereas social anxiety and depressive symptoms increased, loneliness decreased. Participants also reported having slightly more friends and rated the overall quality of their friendships as somewhat higher. Regression analyses revealed that a greater number of friends over time and greater satisfaction with friend electronic communication during the pandemic were most robustly related to lower social and generalized anxiety as well as depressive symptoms, over and above earlier social-emotional wellbeing and a number of relevant correlates. Loneliness was protected by higher quality of friendships, greater contact with friends, as well as more frequent and satisfying electronic communication with friends. The results suggest that although young adults are facing emotional challenges during the continued pandemic, they are also able to adapt by keeping in touch with friends to decrease subjective sense of isolation. The findings have novel intervention implications to reduce loneliness.

Weight enumeration in United States anti-bullying laws: associations with rates and risks of weight-based bullying among sexual and gender minority adolescents.

Weight-based bullying is among the most prevalent forms of peer harassment and carries significant health consequences-particularly among adolescents who identify as a sexual and/or gender minority (SGM). We examined how anti-bullying legislation that includes weight as a protected class (enumeration) contributes to the prevalence of weight-based bullying and its adverse health sequelae among SGM adolescents. We collected data on weight-based bullying and health risk (stress, unhealthy eating behaviors, self-rated health) from the LGBTQ National Teen Survey and linked these to state anti-bullying legislation obtained from the United States (US) Department of Health and Human Services. Weight-based bullying was less frequent, but associated with greater health risk for SGM adolescents in states with, versus without, weight-enumerated anti-bullying laws. Adding weight as a protected class in anti-bullying legislation may be an effective strategy for reducing weight-based bullying, but additional supports are needed to support adolescents who continue to experience weight-based bullying.

Developmental changes in the frequency and functions of school-related communication with friends and family across high school: Effects on college enrollment.

As postsecondary education is an increasingly important developmental milestone for adolescents, it is critical to identify supports that help prepare youth for college. Building on evidence highlighting the role of parental input and guidance, the current study investigates how within-person changes in adolescent school-related communication (i.e., frequency of talking about school and educational planning) with friends and family across high school contribute to college preparedness and subsequent enrollment. Capitalizing on a diverse adolescent sample (N = 4,495), longitudinal analyses across high school showed that school-related communication with friends increased, but remained relatively stable with family, from Grades 9-12 (approximately ages 15-18 years). Parallel process latent growth curve modeling demonstrated that steeper increases in school-related communication with friends independently predicted college enrollment, consistently across racial/ethnic and parental education groups. Moreover, within-person changes in friend and family school-related communication across high school interacted in a compensatory fashion to predict grade point average and perceived college readiness at 12th grade. At a time of growing need for independence from parents, the findings highlight the positive developmental function of friends in helping adolescents reach a critical educational milestone. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Weight-based cybervictimization: Implications for adolescent health.

BACKGROUND: Despite the ubiquity of cybervictimization among youth, attention to weight-based cybervictimization is scarce. AIMS: This study assessed the prevalence of electronic forms of weight-based peer victimization (i.e., cybervictimization) and its associations with adolescent health, as indicated by somatic symptoms, stress, depression, and sleep trouble. MATERIALS & METHODS: A cross-sectional survey was conducted online with a community sample of 452 adolescents aged 11-17 years old (Mage  = 14.91 years). RESULTS: Thirty-three percent of adolescents reported at least one experience of weight-based cybervictimization, with elevated rates among those with overweight (45%) and obesity (60%). Weight-based cybervictimization was associated with higher levels of somatic symptoms (ß = 0.24; p < 0.001), stress (ß = 0.22; p < 0.001), depression (ß = 0.27; p < 0.001), and sleep trouble (ß = 0.20; p < 0.001); these associations were consistent across adolescent weight status. DISCUSSION AND CONCLUSION: Findings suggest that the health implications of weight-based victimization extend to the electronic context, and underscore the importance of addressing weight-based cybervictimization in antibullying initiatives to support healthy adolescent well-being.

Policies to address weight discrimination and bullying: Perspectives of adults engaged in weight management from six nations.

OBJECTIVE: Across the world, it remains legal to discriminate against people because of their weight. Although US studies demonstrate public support for laws to prohibit weight discrimination, multinational research is scarce. The present study conducted a multinational comparison of support for legislative measures to address weight discrimination and bullying across six countries. METHODS: Participants were adults (n = 13,996) enrolled in an international weight-management program and residing in Australia, Canada, France, Germany, the UK, and the US. Participants completed identical online surveys that assessed support for antidiscrimination laws and policies to address weight bullying, demographic characteristics, and personal experiences of weight stigma. RESULTS: Across countries, support was high for laws (90%) and policies (92%) to address weight-based bullying, whereas greater between-country variation emerged in support for legislation to address weight-based discrimination in employment (61%, 79%), as a human rights issue (57%), and through existing disability protections (47%). Findings highlight few and inconsistent links between policy support and sociodemographic correlates or experienced or internalized weight stigma. CONCLUSIONS: Support for policies to address weight stigma is present among people engaged in weight management across Westernized countries; findings offer an informative comparison point for future cross-country research and can inform policy discourse to address weight discrimination and bullying.

School Safety Among Sexual and Gender Minority Adolescents: Implications for Eating and Weight Control Behaviors.

BACKGROUND: Unhealthy weight control and disordered eating behaviors are prevalent among adolescents who identify as a gender and/or sexual minority (SGM). The current study examined how perceptions of school safety contribute to reduced negative weight control and eating behaviors across adolescents with diverse sexual and gender identities. METHODS: Data on perceptions of school safety, as well as negative weight control and disordered eating behaviors (ie, binge eating, eating to cope), were drawn from a large national sample of SGM secondary school students (ie, grades 7-12; N = 17,112; LGBTQ National Teen Survey). RESULTS: Differences in negative weight control and disordered eating behaviors emerged as a function of gender identity and sexual orientation. School safety was significantly associated with fewer negative weight control behaviors (B = -0.30, p < .001), reduced binge eating (B = -0.19, p < .001), and less eating to cope (B = -0.21, p < .001). Despite slight variation in the strength of these associations, the protective effects of school safety were significant across sexual and gender identities. CONCLUSIONS: Findings suggest that efforts to support feelings of school safety among SGM students are likely to have positive implications for eating and weight-related behaviors, and emphasize the need for interventions to promote climates of safety and inclusion within the school setting.

Reducing Educators' Weight Bias: The Role of School-Based Anti-Bullying Policies.

BACKGROUND: Educators' negative weight biases toward students with high body weight have been well-documented. The present investigation examined whether inclusion of body weight in school anti-bullying policies is associated with lower levels of weight bias among educators. METHODS: Data on explicit weight bias was collected from a sample of secondary school teachers and principals in the United States (N = 246) and examined in relation to the presence of weight-related language in each participant's school district anti-bullying policy. RESULTS: The results indicate that, although educators on average make negative judgments about individuals with high weight, these biases were lower for educators whose school district anti-bullying policy included enumeration of body weight. Notably, this association did not hold when policies enumerated "appearance." CONCLUSIONS: The study findings suggest that the explicit mention of "weight" in school anti-bullying policies may represent a feasible mechanism to reduce explicit weight bias among U.S. secondary school educators.

Adolescents' Exposure to and Experiences of Weight Stigma During the COVID-19 Pandemic.

OBJECTIVE: The COVID-19 pandemic has increased attention to the proliferation of pediatric obesity amidst significant changes in weight-related health functioning (e.g., compromised physical activity, limited food access, increased stress). The present cross-sectional study investigated adolescents' feelings about their bodies and perceived changes in weight stigma from peers, parents, and social media during the pandemic. METHODS: Four hundred fifty-two adolescents (11-17 years old) completed an online survey during the Fall of 2020. Measures assessed perceived changes in exposure to weight stigmatizing social media content (stress eating jokes, weight gain memes) and experiences of weight stigma (weight-based bullying, teasing, hurtful comments) by parents and peers, as well as body dissatisfaction, during the COVID-19 pandemic. Weight status and gender were examined as individual difference variables. RESULTS: The majority (53%) of adolescents reported increased exposure to at least one form of weight stigmatizing social media content during the pandemic. Additionally, pandemic-related increases in body dissatisfaction were prevalent (41%), especially among girls with higher body mass index (≥85th percentile; 67%). On average, the extent to which adolescents experienced weight-based mistreatment from parents and peers remained consistent with their pre-pandemic experiences. CONCLUSIONS: Overall, these findings highlight changes in the social messages that adolescents receive about their bodies, as well as their subjective body satisfaction, during the pandemic. Results underscore the need for healthcare providers and mental health professionals to be aware of the potential rise in weight stigma during the pandemic, and encourage families and schools to engage in supportive, rather than stigmatizing, weight-related communication with youth.

Adolescent academic worries amid COVID-19 and perspectives on pandemic-related changes in teacher and peer relations.

Despite recognition of the potential impact of the COVID-19 pandemic on secondary schooling experiences, little empirical evidence has captured adolescents' perspectives on the extent of academic and social disruption resulting from the pandemic. The present study examined adolescents' academic worries amid the COVID-19 pandemic and their perspectives on pandemic-related changes in teacher and peer relations. Participants were 452 adolescents (55% female) between the ages of 11 and 17, who completed online surveys asking them about their worries about their schoolwork and educational futures, perceived support from teachers, and perceptions of electronic (cyber) bullying during the pandemic. Results indicated that COVID-related academic worries pertaining to motivation to focus on and complete schoolwork were most frequent. High school students and female students reported heightened academic worries compared to middle school students and male students. In addition, the majority of adolescents indicated decreased support from teachers during the COVID-19 pandemic, including more than two-thirds (69%) who reported reduced communication with teachers. Adolescents perceived relative consistency in electronic (cyber) bullying throughout the pandemic, and a third of students indicated that cyberbullying has become more of a problem and increased in frequency during this time period. Perceived changes in cyberbullying were consistent across grade level and gender. Findings emphasize the psychosocial implications of the COVID-19 pandemic on adolescents' secondary schooling experiences and underscore the importance of bolstering social resources to minimize the short- and long-term impact of the pandemic on students' academic functioning. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries.

BACKGROUND/OBJECTIVES: Considerable evidence from U.S. studies suggests that weight stigma is consequential for patient-provider interactions and healthcare for people with high body weight. Despite international calls for efforts to reduce weight stigma in the medical community, cross-country research is lacking in this field. This study provides the first multinational investigation of associations between weight stigma and healthcare experiences across six Western countries. METHODS: Participants were 13,996 adults residing in Australia, Canada, France, Germany, the UK, and the US who were actively enrolled in an internationally available behavioral weight management program. Participants completed identical online surveys in the dominant language for their country that assessed experienced weight stigma, internalized weight bias, and healthcare behaviors and experiences including perceived quality of care, avoidance or delay of seeking care, experiences with providers, and perceived weight stigma from doctors. RESULTS: Among participants who reported a history of weight stigma (56-61%), two-thirds of participants in each country reported experiencing weight stigma from doctors. Across all six countries, after accounting for demographics, BMI, and experienced stigma, participants with higher internalized weight bias reported greater healthcare avoidance, increased perceived judgment from doctors due to body weight, lower frequency of obtaining routine checkups, less frequent listening and respect from providers, and lower quality of healthcare. Additionally, experienced weight stigma (from any source) was indirectly associated with poorer healthcare experiences through weight bias internalization, consistently across the six countries. CONCLUSIONS: Weight stigma in healthcare is prevalent among adults actively engaged in weight management across different Western countries, and internalized weight bias has negative implications for healthcare even after controlling for BMI. The similar findings across all six countries underscore the negative consequences of weight stigma on healthcare behaviors and experiences, and emphasize the need for collective international efforts to address this problem.