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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  age  = 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.

‘Teenagers are into perfect‐looking things’: Dating, sexual attitudes and experiences of adolescents with severe obesity