Besides health problems, overweight kids also face social marginalisation as they are more likely to be rejected as friends by peers who are of normal weight, a study indicates.
"We found consistent evidence that overweight youth choose non-overweight friends more often than they were selected in return," said David Schaefer, an associate professor at Arizona State University.
However, overweight youth were mostly indifferent to the weight status of their friends, the findings showed.
Overweight youth often reach out to non-overweight peers for friendship but are sometimes rebuffed in those efforts.
"This is especially troubling since friendships are important sources of support and companionship," said Sandra Simpkins, an associate professor at Arizona State University.
Not having or losing friends is associated with higher depression and lower self-worth for young people, which could exacerbate the health problems associated with being overweight, Simpkins added.
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The study involved 58,987 students in 88 middle and high schools in the US.
Researchers utilised social network analysis in order to account for different types of friend selection processes, such as attraction based on similarities, meeting during extracurricular activities, or meeting through a mutual friend.
This allowed the researchers to isolate the effect of weight status on friend selection.
"Long-term implications of the study include considering ramifications of social marginalisation for prevention and intervention strategies that support the emotional development of overweight youth," Simpkins said.
The research appeared in American Journal of Public Health.