title: Are K-12 school environments harming students with obesity? A qualitative study of classroom teachers.
abstract: OBJECTIVE
  Weight bias can negatively impact health, and schools may be risky environments for students with obesity. We aimed to explore teachers' perceptions of the school experiences and academic challenges of students with obesity.
  
  
  METHODS
  We conducted interviews with 22 teachers in the Northeast, mid-Atlantic, and Midwest in July-August 2014. All interviews were transcribed verbatim, coded, and analyzed for important themes by two researchers using the immersion/crystallization approach.
  
  
  RESULTS
  Most teachers felt that students with obesity were more likely to have academic difficulties. Two main perceptions of the reasons for these difficulties emerged: (1) obesity led to lower self-esteem that caused students to participate less, and (2) poorer nutrition, increased screen time, and reduced physical activity were simultaneously causing obesity and poorer academic performance. A few teachers described colleagues who felt students with obesity were not as motivated to work hard in school as their peers. Many teachers described school health promotion efforts focused on weight reduction that could exacerbate weight stigma and risk of disordered eating.
  
  
  CONCLUSIONS
  Students with obesity, particularly girls, may be at risk for negative social and academic experiences in K-12 schools and may be perceived as struggling academically by their teachers.
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA. ekenney@hsph.harvard.edu.
authors.forename: Erica L
authors.initials: EL
authors.lastname: Kenney
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
authors.forename: Morgan T
authors.initials: MT
authors.lastname: Redman
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
authors.forename: Shaniece
authors.initials: S
authors.lastname: Criss
authors.affiliation: Departments of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
authors.forename: Kendrin R
authors.initials: KR
authors.lastname: Sonneville
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.|Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA, 02131, USA.
authors.forename: S Bryn
authors.initials: SB
authors.lastname: Austin
mesh_terms: D000124:Achievement; D000293:Adolescent; D001290:Attitude; D002648:Child; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology*; D036301:Qualitative Research; D012572:School Health Services; D000070777:School Teachers / Q000523:psychology*; D012574:Schools; D012649:Self Concept; D012931:Social Environment; D057545:Social Stigma; D013334:Students / Q000523:psychology
keywords: Academic achievement; Qualitative research; Schools; Teachers; Weight stigma