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Sticks and stones break bones, but words cut to the heart

Children Suffer From Weight-Focused Bias And Bullying  

It will not surprise many working in the field of weight and obesity — or even those in the general public — to read that multiple studies have confirmed that weight bias exists in our culture. But the extent to which children as young as three are subjected to this bias is alarming. Several studies report that among overweight youth, 30% of girls and 25% of boys experience weight-focussed peer victimization (Eisenberg, 2003). Vulnerability to bullying increases with body weight, with 60% of the heaviest children reporting harassment by their peers. The association between bullying and weight is so strong, in fact, that a child’s BMI can accurately predict the likelihood of future victimization. 

Youth themselves recognize that being overweight makes their peers a target for victimization. In a recent study by Rebecca Puhl, Director of Research and Weight Stigma Initiatives at the Rudd Center for Food Policy & Obesity at Yale University, 40% of adolescents reported that being overweight is the 
primary reason why peers are teased or bullied. In comparison, 37% of the teens listed being gay or lesbian as the primary reason for bullying. Race/ethnicity, physical disability and religion were each ranked as the primary motivator for bullying by less than 10% of those polled. 

The types of behaviour used against over­weight children tend to be similar to those used against bullied children in general — i.e., physical and verbal threats, name-call­ing, etc. However, there are important differences in the sources of the harassment. Non-overweight children tend to be bullied by one specific individual, while overweight youth are more likely to be bullied by their peers in general. When bullying comes from multiple sources, the child is more likely to withdraw socially. This isolation leaves them even more vulnerable, said Dr. Wendy Craig, Scientific Co-Director of  PREVNet (a national anti-bullying organization), speaking at the first Canadian Weight Bias and Discrimina­tion Summit held in Toronto last fall. 

Peers are not the only source of weight-based teasing. Among overweight girls and boys, as many as 47% and 34% respectively report being teased about their weight by their parents. “Home is not necessarily a safe environment for these children. Parents may be concerned about their child’s weight and want to help, but the messages are often communicated in a stigmatizing and painful way,” explains Dr. Puhl. 

Even when negative comments are not di­rectly targeted at children, kids still pick up on the negative “fat talk” around them. Mothers who complain about their own weight or “looking fat,” for example, can set up un­healthy feelings about body image and weight. “As caregivers, we need to be cautious about the language we use,” says Dr. Puhl. 

Children as young as three years of age appear to be susceptible to negative mes­sages about weight. Dr. Puhl notes that in studies toddlers have prefer­ences for thin playmates over their heavier peers and are more likely to describe an overweight child as “mean” compared to a thin child. 

Negative stereotypes associated with obe­sity appear in media for children of all ages, beginning with picture books and cartoons, where “bad” animals and characters are more likely to be drawn as obese. While such negative stereotypes have always appeared in magazines, television programs and films, children’s exposure to these media has sky­rocketed in recent decades.  

SERIOUS CONSEQUENCES 

Despite the ditty that “words will never hurt me,” youth are seriously impacted both mentally and physically by weight bias. “From a neurological perspective, these children who are constantly victimized look like children who are in chronic pain,” said Dr. Craig. “The research clearly shows that 
social pain is akin to physical pain in terms of its physiological effect.” 

Studies have shown that weight-focused bullying is associated low body satisfaction, low self-esteem, high depressive symptoms and thinking about and attempting suicide. In addition, regardless of their weight status, these bullied youth are more likely to be con­cerned about their weight, have poor self-perception of their physical appearance, engage in bulimic behaviours and prefer iso­lated, sedentary activities. Studies which control for body weight show that it is not the experience of being overweight that in­creases the risk for depression and anxiety, but rather the experience of being bullied that increases the risk, Dr. Puhl explains. 

Socially, these children are more likely to struggle with poor relationship quality, social rejection, poor academic outcomes and more school absences (not surprising, given that their primary exposure to their tormentors is at school). 

Some people may argue that stigmatizing overweight and obesity is acceptable because the shame will motivate weight loss. Re­search shows the opposite to be true. Overweight youth who are bullied are more likely to engage in unhealthy behaviours such as binge eating. “Stigma is a chronic stres­sor, and eating is a common coping mecha­nism,” says Dr. Puhl. In addition, children who are teased about their weight are more likely to avoid physical  activity, such as gym and school sports. 

Boys and girls may differ in their experiences with weight and victimization, as suggested by a 2008 study by Adams and Bukowski ( J Child Psychol Psychiatry, 2008 ). This report found that obese girls are at higher risk for being bullied, which promotes lower self-concept and increases their risk for increased BMI and depression. While obese boys were similarly at risk for victim­ization and lower self-concept, the end result was more likely to be a decreased BMI. 

Looking at the issue from another angle, a study by PREVNet found that both boys and girls with chronically high levels of eating problems were at much higher risk for victimization; as the eating problems increased, so did the bully­ing. “It is a very complex development,” said Dr. Craig. “Some kids have eating or weight is­sues and they become victimized. Other kids become victimized and that leads to eating problems. It is a mixed story. We can find evidence in the literature for both.” 

SEEKING SOLUTIONS 

Preventing victimization and the associated negative outcomes will require change on multiple levels, from the individual (e.g., recognizing that  overweight children are at higher risk for bullying and taking steps to in­tervene) to societal (e.g., educating people about the complex causes of 
obesity). 

An important step is to ensure that weight is on the agenda whenever anti-bullying ini­tiatives are discussed. Although there has recently been a lot of attention in the media about bullying related to sexual orientation and race, weight-based victimization has been absent in these discussions. “We need to ensure that as parents and as a society we communicate that it is not okay to tease about weight. Bullying is bullying, no matter what the  characteristic is,” says Dr. Puhl.