Background Many obese adolescent girls experience body weight related teasing and social 1-3 isolation at school . Obesity and body weight related teasing in particular are associated with impaired educational performance4-6. Perceptions of healthy weight children also indicate a link between obesity and educational performance7-8. Perceptions of obese adolescents are lacking.
Objectives This study aimed to obtain insight into (i) body weight related experiences of obese adolescent girls at school and (ii) how body weight and school experiences are perceived to influence educational performance.
“In class I’m ignored and I think it has to do with my body weight”: Experiences of obese adolescent girls at school Anne Martin1,2, Ailsa Niven1, David H Saunders1, John Sproule3 1Physical
Activity for Health Research Centre (PAHRC), Institute for Sports, Physical Education and Health Sciences, University of Edinburgh, UK. ²TeleScot Reserch Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, UK. 3Institute for Sports, Physical Education and Health Sciences, University of Edinburgh, UK. Email:
[email protected]
@DrAnneMartin
Methods
Using Nvivo 10, data were analysed following an inductive thematic analysis approach. Segments of text relevant to the research objectives were coded and similar codes were clustered together into hierarchical themes. Trustworthiness of the analysis was demonstrated through independent coding (AM, AN) and member checking.
Attitudes towards school
Five themes emerged on adolescents’ experiences in the school environment that are directly influenced by their body weight (Figure 1). Overall, obese adolescent girls reported a lack of friends and exposure to body weight related isolation, peer rejection and bullying. Classroom teachers were perceived to be supportive and non-judgmental. It was evident that all adolescent girls, despite their negative experiences, have a positive attitude towards some aspects of school (Figure 2). For example, it emerged that the adolescent girls take their education seriously and that they perform well academically. “I’m doing really, really well in school. It would be me getting compliments for my work. I always trying to do my best and concentrate. I really enjoy school. School is the thing that matters most in my life.” Family environment, peer behaviour and attitude to learning were understood to influence educational performance (Figure 2).
Factors influencing educational performance
Peer relationships Friendships, Negative experiences, Relationship with boys
“We have to look like a friendly person where people would go to and would get to know you. I think that is why I don’t have many friends. Because no one really, everybody has just prejudged me and not actually took the time to get to know me.”
Peer related negative emotions Reactions towards negative experiences, Peer support
Body weight related school experiences
Four obese Scottish adolescent girls (aged 12-15 years, mean body mass index 99.6th percentile relative to 1990 UK reference), recruited after completion of a weight management program, participated in a focus group of 90 minutes. The focus group question guide consisted of semi-structured, openended questions. The focus group was audio recorded and transcribed verbatim.
Results
Eating in school Differences between slim and obese girls, Experiences, Emotions
School clothes
“Even if you do buy something healthy they would laugh at you anyway. What should you been trying for?“
“When you go to science and stuff you get science jackets, lab coats to put on. Mine always pops off and the teacher goes, ‘right your jacket is too small go and get another one, come with me’. And everyone stares.“
Physical Education Perceptions about PE teachers, Experiences, Emotions
“And when I’m running they laugh because they say ‘Oh my god you are carrying two water melons in front of you’.”
Perceptions about classroom teachers Reported dedication to education with aspiration to move on to higher education
Better educational performance when having parents with academic education and having both mother and father at home.
Girls reported being on time for class and do not miss class.
Worse educational performance when distracted by peers during class and missing class due to peer pressure.
Girls preferred to be engaged in classwork rather than talking to classmates. This made them popular among teachers.
Pupils’ attitude to leaning rather than body weight was perceived as educational performance determining factor.
“I put my hand up quite a lot and just get on with work while people are gossiping and stuff.”
“I would be more upset if my teachers weren’t there, because they are really encouraging.”
Figure 1: Lower order and basic themes and related participants‘ responses of the higher order theme ‘Body weight related school experiences’.
Conclusions • Reported emphasis on education, despite negative psycho-social experiences at school, could be interpreted as a coping mechanism to gain rewards and avoid peer contact and thus peer rejection. • Obese adolescent girls perceived no direct link between body weight status and educational performance.
Figure 2: Lower order themes and related participants‘ responses of the higher order theme ‘Obesity and educational performance’.
References 1Murtagh, J. et al. (2006). A qualitative investigation into the lever and barriers to weight loss in children: opinions of obese children. Archives of Diseases Childhood 91 (11): 920-923. 2Curtis, P. (2008). The experience of young people with obesity in secondary school: some implications for the healthy school agenda. Health and Social Care in the Community 16 (4): 410-418. 3 Davis, SP. And Davis, M. (2008). A focus group study of African-American obese children in Mississippi. Journal of Cultural Diversity 15 (4): 158. 4Gunnarsdottir, T., et al. (2012). Teasing and social rejection among obese children enrolling in family-based behavioural treatment: Effects on psychological adjustment and academic competencies. International Journal of Obesity 36(1): 35-44. 5 Krukowski, R. A., et al. (2009). Overweight children, weight-based teasing and academic performance. International Journal of Pediatric Obesity 4(4): 274-280. 6 Martin A & Saunders DH (2015). Childhood obesity and educational attainment. Evidence from prospective cohort studies. UK Congress on Obesity, Liverpool, UK. Appetite; 87:384. 7 Zeller, MH., et al (2008). Negative peer perceptions of obese children in the classroom environment. Obesity 16 (4): 755-762. 8 Caird, J. et al. (2011). Childhood obesity and educational attainment: a systematic review. London: EPPI-Centre, Social Science Research Unit, Institute of Education, University of London.
• Mental, emotional and social wellbeing of obese adolescent girls at school should be promoted. • The findings of this study are not generalizable and thus further qualitative research on this topic is needed.
