Bullying Common in Kids With Food Allergies, Weight Problems

Pam Harrison

January 07, 2013

Bullying is common in children with food allergies (FAs), and it often takes the form of food threats, new research shows.

Eyal Shemesh, MD, Mount Sinai Medical Center, New York City, and colleagues found that 45.4% of children from a food allergy clinic and 36.3% of their parents indicated that the child had been bullied or harassed for any reason.

Almost one third of the children (31.5%) and almost one quarter of the parents (24.7%) reported that the child experienced bullying that was specifically related to the food allergy.

Critically, parents only knew about the child-reported bullying in about one half (52.1%) of the cases.

"Our clinic population is skewed toward more affluent white families, who would be expected to be less vulnerable to bullying," investigators write.

"It is, therefore, likely that our findings, alarming as they may already be, may still underestimate the true rate of bullying experienced by food allergic children."

The study was published online December 24 in Pediatrics.

Increased Distress, Decreased QOL

Children and their parents were recruited during visits to the Jaffe Food Allergy Institute at Mount Sinai Medical Center with a goal of obtaining data on 250 consenting patients and families.

Parents were asked to report on bullying related to food allergy as well as bullying for any other reason.

Various tools were used to assess child outcomes, including the Multidimensional Anxiety Scale for Children–10 Items (MASC-10) and the Pediatric Quality of Life Inventory 4.0 scale.

The Impact of Events Scale (IES) was used to assess parent outcomes, as was the 17-item Food Allergy Quality of Life–Parental Burden questionnaire, which measures the effect of the child's food allergy on parental quality of life (QOL).

Families were enrolled from April 2011 to November 2011; a total of 251 patients and parents completed the survey.

"Most (87%) of the children who were bullied about their FA reported that they told someone about what happened," the authors observe.

Some 71% of the children told their parents; 35% told a teacher; about the same proportion told a friend; and 20% told a sibling.

Some 13% of bullied children told the principal.

Among key additional findings from the survey, investigators found that bullying was significantly associated with increased distress and a decreased QOL in both parents and children, independent of the reported severity of the allergy itself.

Bullying for any reason was also associated with higher MASC-10 scores of anxiety among children.

Parental distress, as mirrored by IES and QOL scores, was also worse when parents thought that their child was bullied for any reason.

On the other hand, when parents were aware of the bullying, children were less anxious and had a better QOL.

Weight-Based Victimization

In a separate study on weight-based victimization (WBV) reported in the same issue of Pediatrics, Rebecca Puhl, PhD, Yale University, New Haven, Connecticut, and colleagues found that almost two thirds of adolescents between 14 and 18 years of age attending national weight loss camps reported WBV at school.

The risk for WBV increased as body weight increased, the heaviest of the youth almost inevitably experiencing WBV, usually during an extensive period.

The majority of the perpetrators were peers and friends, the authors note.

But physical education teachers and sport coaches, along with parents and teachers, also figured fairly prominently in the teasing and bullying.

More than one half of the adolescents surveyed reported WBV via cell phones or computers.

This suggests that it is likely that unknown individuals are indeed cyberbullies who use technology to retain their anonymity.

Best Hope

In a related editorial, Mark Schuster, MD, PhD, Boston Children's Hospital, and Laura Bogart, PhD, Harvard Medical School, Boston, Massachusetts, point out that students who are not allowed to bring peanut butter to school — for example, because a classmate has an allergy — might bully the classmate to gain popularity with others who resent the limitation.

"The potential for bullying underscores the importance of addressing food allergies in a way that protects but does not stigmatize children who have them," they write.

They also note that the study by Dr. Puhl builds on previous findings regarding bullying and obesity and highlights an additional consequence of the growth in obesity rates in recent decades: an increase in the number of children at risk of being bullied.

"Having everyone who engages with children participate in shifting the culture of bullying provides our best hope for tackling this challenging problem," they write.

None of the authors have disclosed any relevant financial relationships.

Pediatrics. Published online December 24, 2012. Full article, Full article, Editorial