Almost every day at the public elementary school she attended in Montgomery County, Maryland, Stephanie heard comments about her weight. Kids in her fifth grade class called her “fatty” instead of her name, she recalled; others whispered, “Do you want a cupcake?” as she walked by. One classmate spread a rumor that she had diabetes. Stephanie was so incensed by his teasing that she hit him and got suspended, she said.
But nothing the kids did upset her as much as the conduct of her teachers.
For years teachers ignored her in class, even when she was the only one raising her hand, said Stephanie, whose surname is being withheld to protect her privacy. “I was like, ‘Do you not like me or something?” she recalled.
She felt invisible. “They would sit me in the back. I couldn’t see the board,” she said. When Stephanie spoke up once in middle school, a teacher told her, “I can’t put you anywhere else because you’re going to block other students.” She burned with embarrassment when her classmates laughed.
Nearly 20 percent of children in the U.S. — almost 15 million kids — were considered obese as of the 2020 school year, a number that has likely increased since the pandemic (new data is expected next year). The medical conditions associated with obesity, such as asthma, diabetes and sleep apnea, are well known. Children with obesity are also more likely to have depression, anxiety and low self-esteem.
Far less discussed are the educational outcomes for these children. Research has found that students with obesity are more likely to get lower grades in reading and math and to repeat a grade, and twice as likely to be placed in special education or remedial classes. They are also significantly more likely to miss school and be suspended or receive detention, and less likely than their peers to attend and graduate from college.
Researchers have suggested different reasons for this “obesity achievement gap,” including biological causes (such as reduced cortical thickness in the brain in children with obesity, which is linked to compromised executive functioning, and higher levels of the hormone cortisol, linked to poorer academic performance). They have also examined indirect causes of poor performance, such as that kids with obesity might miss school more often because of medical appointments or bullying.
But a relatively new area of research has shifted attention to educator bias. Studies have found that teachers often perceive children with obesity as emotional, unmotivated, less competent and non-compliant. That can lead to teachers giving these students fewer opportunities to participate in class, less positive feedback and lower grades.
Weight bias is part of American culture, said Rebecca Puhl, deputy director of the Rudd Center for Food Policy and Health at the University of Connecticut, who has studied childhood obesity and bias. “Teachers are not immune to those attitudes,” she said. While many school districts have tried in the last 20 years to reduce childhood obesity through more nutritious meals and increased exercise, Puhl and other experts say schools also need to train teachers and students to recognize and confront the weight bias they say is hampering the education of an increasing number of children.
Some advocates argue that childhood obesity, which has steadily risen over the last 40 years, should be seen as an “academic risk factor” because of its lasting effects on educational and economic mobility. “There’s certainly been a big push for racial and ethnic diversity, for gender identity diversity, that’s so important,” said Puhl. “But weight is often left off the radar, it’s often not getting addressed.”
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Stephanie, now 18, has struggled with obesity her whole life. Within her family, being overweight never felt like a problem. But school was different.
Beginning in kindergarten, her classmates told her she looked like a Teletubby, she said. Even teachers made comments related to her weight. “If someone brought pastries for a birthday, they would ask, ‘Are you sure you want to eat that? Why don’t you try carrots and hummus?’” Stephanie recalled. Once Stephanie listened as an educator told her mother to put her on a diet. She stopped eating lunch at school after that. “When I was home, I ran to food because it was like the only place I would feel comfortable eating,” she said.
There were a handful of occasions teachers noticed her for something besides her weight. Stephanie smiled as she recalled a time when an English teacher praised an essay she wrote; when she won second place prize in a coding camp; when she was named ‘cadet of the year’ in JROTC during remote school during the pandemic. In elementary school, she received the President’s Award for Educational Achievement, designed to reward students who work hard, often in the face of obstacles to learning.
It wasn’t enough to make her feel like she had educators on her side. “In school, they want you to confide in teachers, they made us believe that we can go to teachers for anything,” she said. “If you have no friends or if there’s no one to trust — you can always find a teacher who you can feel safe with, you can always trust them. So, I would try, but they always pushed me away.”
One interaction in particular shattered her confidence. Toward the end of seventh grade, Stephanie stayed to ask a question after class. Her teacher asked if she was a new student. “‘How did you not notice I was in your class and the entire year I turned in work?” Stephanie wondered. “That’s when I started to feel like I’m a shadow.” From that point on she stopped caring about getting good grades.
Liliana López, a spokesperson for Montgomery County Public Schools, said that teachers are not “expressly trained on weight bias,” but they “elevate all the identities individuals hold as valuable and we work with staff to identify ways they can create spaces full of affirmation, validation and significance for those identities.” Celeste Fernandez, spokesperson for the National Education Association, the nation’s largest teachers’ union, said her organization does not offer specific training or information on weight bias.
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Researchers are increasingly identifying links between poor outcomes for students with obesity and teacher’s attitudes toward kids. In 2015, Erica Kenney, an associate professor of public health nutrition at Harvard University, helped lead a team that analyzed data from a representative sample of children from across the nation. The researchers examined, among other things, whether the kids’ weight gain influenced teachers’ perceptions of their abilities and their standardized test scores.
Gaining weight didn’t change a child’s test scores, the researchers found, but, based on surveys, it was significantly linked to teachers having lower perceptions of students’ ability, for both girls and boys. In other words, kids who gained weight faced a small but significant“academic penalty” from their teachers, Kenney said.
A separate study, involving 130 teachers, found that educators were more likely to give lower grades to essays if they believed a child who was obese had written them. For the study, Kristin Finn, a professor in the school of education at Canisius University, in Buffalo, New York, took four essays written at a sixth grade level and paired them with stock photographs of students who looked similar but some had been digitally altered to appear overweight. The overweight students received moderately lower scores.
Finn found that the teachers were more likely to view the students with obesity as academically inferior, “messy” and more likely to need tutoring. In surveys, teachers also predicted that students with obesity weren’t good in other subjects such as math and social studies.
“To be able to make a judgment about somebody’s mathematical abilities based on a short essay seemed pretty remarkable,” said Finn. Yet, teachers maintained that they were personally unbiased in their evaluations. “They all think that they’re treating these children fairly,” she said.
Teachers’ perceptions of children’s academic potential matters: Their recommendations can affect not only students’ grades, but also their access to higher level courses, competitive programs, specialized camps and post-secondary opportunities including college.
Girls are at particular risk of being stigmatized for being obese, research has found. In one study, nearly a third of women who were overweight said they had had a teacher who was biased against them because of their weight. Students who face other barriers including poverty are also more likely to be penalized for being overweight, what is called a “double disadvantage.”
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Covid, which hit during the spring of Stephanie’s eighth grade year, was a welcome interruption. She loved learning in the privacy of her home and not being “judged for my body,” she said.
When schools reopened in the fall of 10th grade, Stephanie couldn’t bear the thought of returning. She had gained weight during remote learning, some 100 pounds. Citing her asthma and her father’s diabetes, she applied for a waiver that would permit her to attend classes virtually. But “the real reason was because I was ashamed of what I look like,” she said.
She received the waiver and continued her high school studies at home.
After a 2022 diagnosis of Polycystic Ovary Syndrome, which had made her body resistant to insulin, Stephanie decided to undergo bariatric surgery. Following the operation, Stephanie lost more than half her body weight. When she returned to her high school to take exams, people were suddenly nice to her, she said. It frustrated her, she said: “I’m the same person.”
Negative perceptions of people with obesity start early. In one study, children as young as 3 who were shown drawings of people of varying weights perceived the obese people as “mean” more often than “nice.” In another study, when 5- and 6-year-olds were shown images of children of different body sizes, most said they did not want to invite the heavier children to their birthday party.
Experts argue that administrators and teachers must become more sensitive to and knowledgeable about the challenges facing children with obesity. Yolandra Hancock, a pediatrician who specializes in patients with obesity and a former teacher, said she frequently intervenes with educators on behalf of her patients with obesity. One 7-year-old boy was often late to class because he found it difficult to climb the three flights of stairs to get there.
“The assistant principal actually told him if he wasn’t so fat, he would be able to get up the stairs faster,” Hancock said. She explained that the student wasn’t walking slowly because of “laziness” but because obesity can cause a bowing of the leg bones, making it hard to navigate steps. Giving the student more time between classes or arranging for his classes to be on the same floor would have been simple fixes, she said.
In another case, an elementary school student with obesity was getting into trouble for requesting frequent bathroom breaks, a result of his large abdomen putting pressure on his bladder, similar to what happens during pregnancy. “He came close to having an accident,” Hancock said. “His teachers wouldn’t allow him to go to the restroom and would call his mother to complain that he wasn’t focusing.” She wrote to the school requesting that he be allowed to go to the restroom whenever he needed. “If you don’t allow them to do what it is that their body needs,” Hancock said, “you’re creating more barriers to them being able to learn.”
Research has found that teachers can play an important “buffering role” in reducing bullying for children with obesity. In one study, children who believed educators would step in to prevent future bullying did better in school than those who didn’t share this conviction.
But often teachers don’t intervene, said Puhl, the University of Connecticut researcher, because they believe that if students “want the teasing to stop, they need to lose weight.” Yet “body weight is not a simple issue of eating less and exercising more,” she added, but is instead a highly complex condition influenced by genetics, hormones, culture, environment and economics.Bullying and mistreatment don’t motivate people to lose weight, Puhl said, but often contribute to binge eating, reduced physical activity and weight gain.
One way to help, would be for schools to include body weight in their anti-bullying policies, Puhl said. At present, most schools’ anti-bullying policies protect children on the basis of race, ethnicity, gender identity, disability and religious beliefs, “but very few mention body weight.” That lack is really shocking, she added, “because body weight is one of the most prevalent reasons that kids are bullied today.”
This spring, Stephanie went back to school to attend her graduation ceremony and receive her diploma. She still struggles with body image but is determined to put her negative experiences behind her and start fresh in college this fall, she says.
She plans to study psychology. “I want to understand people better, because I didn’t feel heard and there were a lot of things I didn’t speak about,” she said. “I just want to help people.”
Contact the editor of this story, Caroline Preston, at 212-870-8965 or preston@hechingerreport.org.
This story about childhood obesity awareness was produced by The Hechinger Report, a nonprofit, independent news organization focused on inequality and innovation in education. Sign up for the Hechinger newsletter.