Obese Children Face More Bullying

• Children's Health • • Obesity • May 03, 10

Obese children were almost twice as likely to be bullied as normal-weight children, regardless of other demographic, social, and academic factors, a multicenter study found.

The unadjusted odds ratio of being bullied for an obese child was 1.85 (95% CI 1.37 to 2.51), according to Julie C. Lumeng, MD, of the University of Michigan, Ann Arbor, and colleagues.

And the odds ratio for bullying for an overweight child was 1.26 (95% CI 0.90 to 1.77), the investigators reported online in Pediatrics.

“Parents of obese children rate bullying as their top health concern, and obese children who are bullied experience more depression, anxiety, and loneliness,” they wrote.

But children may be bullied for many reasons, and whether obese children are targeted because of their weight or because of other confounding factors had not previously been determined.

So Lumeng and colleagues recruited 821 children from ten study sites participating in the longitudinal Eunice Kennedy Shriver National Institute of Child Health and Human Development Study of Early Child Care and Youth Development.

Height and weight were measured for the study subjects in third, fifth, and sixth grades.

Obesity was defined as body mass index (BMI) at or above the 95th percentile, and overweight was classified as BMI between the 85th and 95th percentiles.

At all three time points, mothers, teachers, and children completed questionnaires regarding bullying. Mothers and teachers also rated the children’s social skills.

In the third and fifth grades, children were administered a validated test measuring academic achievement.

The researchers found that 17.3% of children were obese and 14.6% were overweight in the third grade. Slightly more than half were male, and 18.9% were nonwhite.

Mean income-to-needs ratio (the ratio of total family income relative to the poverty level for a family of a particular size) was 4.0.

The schools the children attended were 72.7% white, and 29.2% of children received free or reduced-price lunches.

Mean social skills rating scores were 105.2 and 101.9 by parent and teacher report, respectively, and mean academic scores were 110.7 and 115.9 in reading and math, respectively.

After adjusting for all these demographic, social, and academic factors, the odds ratio for being bullied was 1.63 (95% CI 1.18 to 2.25) for an obese child and 1.13 (95% CI 0.79 to 1.61) for one who was overweight.

The investigators also examined the possibility that being bullied predicted later weight gain, possibly because being bullied created stress that resulted in behaviors such as comfort food consumption.

However, they found no association between being bullied in third grade and an increase in BMI z-score during the subsequent two years (β = 0.050, 95% CI −0.049 to 0.149, P=0.32).

“The higher odds of being the victim of bullying among obese children were equally strong across children who were male and female, white and nonwhite, and poor and non-poor and across schools of all types of demographic profiles and 10 U.S. study sites,” they wrote.

In addition, the association also was seen across the spectrum of social skills and academic achievement.

The researchers had hypothesized that any association between obesity and being bullied might be eliminated or at least attenuated if the child was nonwhite, of low socioeconomic status, having lower social or academic skills, or attending a racially diverse school, or subject to other factors potentially associated with bullying.

“None of these factors, however, protected the obese child from being bullied more often. In effect, being obese, by itself, seems to increase the likelihood of being a victim of bullying,” they stated.

The study had limitations, the researchers acknowledged, primarily relating to the generalizability of their findings.

For instance, despite the fact that the sample was drawn from ten sites nationwide, the findings cannot be assumed to be representative of the entire U.S. pediatric population.

Some attrition occurred, and the demographic data were only available for children attending public, not private, schools.

Nonetheless, the study has important implications. “Interventions that address bullying within schools are badly needed, as are interventions that address obesity at both the individual and community levels,” they wrote.

Future research could also address the negative perceptions of obesity and overweight by children—and of society at large—and “to fashion messages aimed at reducing the premium placed on thinness and the negative stereotypes that are associated with being obese or overweight.”

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Primary source: Pediatrics
Source reference:
Lumeng J, et al “Weight status as a predictor of being bullied in third through sixth grades” Pediatrics 2010; DOI: 10.1542/peds.2009-0774.