Teen Obesity and Denial

If teens don't realize they're overweight, they won't make positive changes.

Teen obesity can be hard to spot
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Could obesity denial be harming our kids' health? Many parents worry about what to do if our teens ask, "Am I fat?" But we might also need to worry about what to do if they don't ask. Because teen obesity is a problem—one that adolescents aren't very good at seeing it in themselves.

In fact, tweens and teens who are overweight are less and less likely to realize it. One research study asked 12- to 16-year-olds, "Do you consider yourself to be overweight, underweight, or just about the right weight?" Researchers surveyed teens from 1988-1994 and again from 2007-2012.

In the more recent time period, teens who actually were overweight or obese were 29% less likely to perceive themselves as overweight, compared to the teens studied earlier.

Teen Obesity Denial: Why It Happens

Why the shift in perception? For one thing, there are more overweight and obese teens now than there were in previous generations—up to twice as many. So what teens see as "normal" has changed. They compare themselves to their peers, not to the number on a scale or a doctor's chart. They may think "I'm not fat. That big guy over there, now he's fat!" when truthfully, both are at an unhealthy weight.

Pressure to slim down may also play a role. “In the wake of the obesity pandemic, the media, weight loss industries, and medical communities have encouraged adolescents to maintain slender frames," says Jian Zhang, MD, of Georgia Southern University, the lead investigator on the research study.

"Facing harsher messages, more and more overweight and obese adolescents may be increasingly reluctant to admit that they are overweight,” Dr. Zhang says.

Additionally, teens' bodies change a lot during adolescence. And definitions of overweight and obesity have been adjusted over the years as physicians and scientists learn more about the condition.

Teen Obesity Denial: Why It's Harmful

If we don't want kids to be ashamed or embarrassed of their bodies, shouldn't it be okay for them to feel like their weight is just fine, especially compared to their peers? Yes and no. We certainly want to encourage kids to feel confident about themselves. And we don't want to tolerate them being shamed about what they eat or how they look.

Yet being overweight does have real health consequences—both physical and emotional ones that can last for years. And if teens don't realize they have a problem, they have no motivation to solve it. "Becoming conscious of one’s excess weight is the precursor to adopting behavioral changes necessary for appropriate weight control," says Dr. Zhang.

Tackling a Tough Topic

First, don't be in denial yourself. If your child's BMI is measured at school, don't dismiss the results. It isn't a perfect measure, but it's one indicator (of many) that you should not ignore. Ask your child's doctor if you should be concerned. Then talk frankly with your teen.

I know that's not easy: One survey of parents found they would rather discuss sex, drugs, alcohol, or smoking than talk about weight. Many worry that confronting a tween or teen about her weight will “cause a complex,” prompting her to eat more in an emotional response, develop an eating disorder, and/or shut down and refuse to address the topic further.

It may help to remember that the important factor here is health. Bodies can be many shapes and sizes and still be healthy. Making, discussing, and praising healthy choices allows you to maintain a continuing dialogue with your child about health and fitness. When the subject of weight does come up, terms such as "above average weight" or even "overweight" may sound less judgmental, and more health-focused, than words like "chubby" or "obese."

If you do need to encourage your child to change his habits, do it positively. Instead of criticizing or nagging (“Why are you eating so many cookies?”), stock your kitchen with healthy treats and then praise him when he chooses one.

Avoid using food as a punishment or a reward, or calling certain foods “bad” or “good.” With your doctor's help, you can develop a plan that will improve your teen's physical health while preserving his emotional health too.


Lu H, Tarasenko Y, et al. More Overweight Adolescents Think They Are Just Fine: Generational Shift in Body Weight Perceptions Among Adolescents in the U.S. American Journal of Preventive Medicine Vol 49 No 5, November 2015.

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