June 01, 2019
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Weight-based teasing associated with yearly BMI gains in children

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Youths who reported they were teased or ridiculed about their weight increased their BMI by 33% more each year compared with a similar group who reported they had not been teased, according to findings published in Pediatric Obesity.

“Although some propose that weight stigma might be beneficial in that it ostensibly could motivate healthy behavioral changes, an extensive body of research indicates that the experience of weight stigma is associated with adverse psychological consequences among both children and adults, including low self-esteem, social isolation, truancy, and suicidal thoughts and behaviors,” Natasha A. Schvey, PhD, assistant professor in the department of medical and clinical psychology at Uniformed Services University of the Health Sciences in Bethesda, Maryland, and colleagues wrote. “Importantly, [weight-based teasing] is also associated with a host of behaviors and psychological constructs that may contribute to and exacerbate excess weight, including body dissatisfaction, compensatory behaviors, avoidance of physical activity and exercise, eating in secret and binge eating.”

Schvey and colleagues analyzed data from 110 children and adolescents with overweight (BMI above the 85th percentile) at baseline or with two parents with overweight or obesity, recruited for a longitudinal, observational study between July 1996 and July 2009 designed to identify biological and behavioral factors predictive of excessive weight gain (mean age at baseline, 12 years; 53% with overweight or obesity; 36% black; 55% girls). Participants were invited for annual follow-up visits for up to 15 years (mean follow-up time, 8.5 years; mean age at last follow-up visit, 20.3 years). Participants completed the Perception of Teasing Scale, a self-report questionnaire that assesses the frequency of teasing related to high-weight status and its effect on the individual. Researchers assessed responses to the weight-based teasing frequency subscale; participants were asked to indicate how often each experience occurred (ranging from a score of 1, “never,” to 5, “very often”). Total scores range from 6 to 30. Height, weight and body composition were assessed at baseline and at all follow-up visits.

Within the cohort, 43% of respondents (62% with overweight) reported at least one instance of weight-based teasing, according to researchers. Weight-based teasing reported at baseline was associated with BMI throughout the follow-up period (P < .001). In assessing the interaction of weight-based teasing by time, researchers found that children reporting greater weight-based teasing experienced a steeper gain in BMI across the follow-up period (P = .007).

Researchers found that children who reported high levels of weight-based teasing gained an average of 0.2 kg/m² per year more than those who did not report weight-based teasing, or a 33% greater gain in BMI. After adjusting for height and other variables, weight-based teasing was also associated with fat mass through the follow-up period (P < .001) and with a steeper gain in fat mass over time (P < .001), according to researchers. Children reporting weight-based teasing were estimated to gain a mean 1.36 kg of fat per year, whereas children who did not report weight-based teasing were estimated to gain a mean 0.71 kg of fat per year.

“Therefore, youth reporting high levels of [weight-based teasing] experienced a 91% greater gain in fat mass per year compared with youth with no [weight-based teasing],” the researchers wrote.

The researchers noted that weight-associated stigma may have made youths more likely to engage in unhealthy behaviors, such as binge eating and exercise avoidance. Another possible explanation is that the stress of being teased could stimulate the release of the hormone cortisol, which may lead to weight gain. – by Regina Schaffer

Disclosures: The authors report no relevant financial disclosures.