'Teenagers are into perfect-looking things': Dating, sexual attitudes and experiences of adolescents with severe obesity.

Background: This qualitative study explored the dating and sexual health attitudes and behaviours among adolescents with severe obesity (body mass index [BMI] > 99th%) attending a multidisciplinary weight-management programme.

Methods: Semi-structured interviews were conducted with 19 participants (12 females, 7 males; M  = 16.8) and analysed through reflective thematic analysis.

Results: Participants described polarized dating behaviours in which dating and sexual relationships were either avoided due to this not being a priority, lack of time, feared rejection, and/or body size as perceived barrier or in contrast, when approached, involved greater sexual risk.

Conclusions: These findings have numerous implications including the need for increased education on the romantic developmental challenges faced by adolescents with severe obesity, the importance of ongoing screening of high-risk sexual behaviours and body dissatisfaction from frontline care providers, and the ability to support referrals to psychosocial services when appropriate.