COMMENTARY

The Pervasive Problem of Weight-Based Bullying in Youth

Rebecca M. Puhl, PhD

Disclosures

October 29, 2014

In This Article

Health Consequences of Weight-Based Bullying

Weight-based victimization from peers, parents, and educators places youth at increased risk for a variety of adverse health consequences. Youth who are bullied about their weight are more likely to have anxiety, depression, low self-esteem, and poor body image—and are more likely to commit suicide.[12,13,14,15,16,17] Of note, many of these studies control for BMI. So, taken together, they suggest that it is experiences of being teased and bullied, rather than body weight per se, that contribute to impaired psychological functioning.

In addition, youth who experience weight-based victimization are more likely to engage in maladaptive eating patterns, including binge eating, disordered eating, and increased food consumption.[18,19,20] Many youth also report diminished motivation and participation in physical activity and avoidance of exercise (eg, skipping gym class), often because weight-based teasing tends to occur in physical activity settings.[12,15,20,21]

For example, one study of 1555 adolescents found that 85% witnessed their overweight peers being teased and bullied during gym class.[5] Longitudinal evidence has suggested that being teased during physical activity predicts health-related quality of life for youth with overweight or obesity.[22]

Many of these adverse health behaviors can, in turn, reinforce additional weight gain and obesity in youth. A longitudinal study of girls aged 10-19 years (1213 black, 1166 white) observed that girls who were called "too fat" by family members or peers had higher odds of having an obese BMI nearly a decade later, findings that controlled for initial BMI.[23] A parallel line of evidence in adults shows that perceived weight discrimination increases the likelihood of becoming and remaining obese over time.[24]

Despite significant and increased national attention to childhood obesity by the medical field, the public health community, and the government, weight-based bullying remains a highly prevalent problem that has mostly been absent from the national discourse. The concerning health implications of weight-based victimization further suggest that this problem not only reduces the quality of life for children who face frequent torment because of their weight, but also could create barriers to effective prevention and treatment of obesity.

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