UCSF

Objectives

To evaluate the prevalence of weight discrimination (the perception of being treated unfairly based on weight) and its sociodemographic associations among early adolescents aged 10 to 13 in the United States.

Methods

We analyzed cross-sectional data from the Adolescent Brain Cognitive Development (ABCD) Study in Year Two (2018-2020). Multivariable logistic regression analyses were conducted, with perceived weight discrimination as the dependent variable and age, sex, sexual orientation, race and ethnicity, body mass index (BMI) category, household income, and highest parental education level as adjusted independent variables. Interaction with BMI category and weight discrimination by sex, sexual orientation, race and ethnicity, and household income was tested for.

Results

In our analytical sample (N = 7129), we found that 5.46 % of early adolescents reported experiencing weight discrimination. Adolescents with BMI percentile ≥95th (adjusted odds ratio [AOR], 6.41; 95 % confidence interval [CI], 4.71-8.70), <5th (AOR, 3.85; 95 % CI, 2.10-7.07), and ≥85th to <95th (AOR, 2.22; 95 % CI, 1.51-3.25) had higher odds of experiencing weight discrimination compared to adolescents with BMI percentile 5th to <85th. Sex and race and ethnicity modified the relationship between BMI category and weight discrimination. Adolescents who identified as gay/bisexual (AOR, 3.46; 95 % CI, 2.19-5.45) had higher odds of experiencing weight discrimination compared with heterosexual adolescents.

Conclusions

Our results underscore the need for anti-bullying campaigns and positive media representation of all body types. Clinicians should recognize that sexual minority youth disproportionately experience weight discrimination, emphasizing the need for affirmative healthcare and early intervention to prevent the mental health impacts of such discrimination.