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Bullying involvement predicts eating disorder symptoms

Analysis of prospective, population-based data indicated bullying involvement predicted eating disorder symptoms among both the victims and the bullies.

“Eating behavior may be affected by bullying for several reasons. First, bullying may increase negative perceptions of one’s body either directly via teasing about one’s weight/appearance or indirectly through its effects on general self-esteem and emotional problems. Most studies of body dissatisfaction and disordered eating have focused on teasing that is appearance or weight-related [and suggest] moderate associations of teasing with body dissatisfaction, dietary restraint, and bulimic behaviors,” William E. Copeland, PhD, of Duke University Medical Center, Durham, North Carolina, and colleagues wrote.

William E. Copeland

To assess if bullying increases risk for eating disorder symptoms, researchers analyzed data for 1,420 study participants aged 9 to 25 years from the Great Smoky Mountains Study. Bullying involvement, symptoms of bulimia nervosa, anorexia nervosa and associated features were assessed via structured interviews.

Compared with individuals not involved with bullying, victims of bullying had an increased risk for anorexia nervosa (P = .02) and bulimia nervosa (P = .007) symptoms, as well as associated features (P < .001) during childhood and adolescence. These associations remained after accounting for prior eating disorder symptom status, preexisting psychiatric status and family adversities.

Bullies had an increased risk for bulimia (P = .04) and associated features (P = .02), while bully-victims had higher levels of anorexia symptoms (P = .001).

Specifically, victims were at risk for binge eating (P = .01), bully-victims exhibited more binge eating (P < .001) and use of vomiting as a compensatory behavior (P = .01).

Researchers found little evidence that these effects differed by sex.

Childhood bullying status was not associated with increased risk for persistent eating disorder symptoms into adulthood.

“All bullying groups — victims, bullies, and bully-victims — saw increases in at least one type of eating disorder symptom even after accounting for prior eating problems and preexisting psychiatric status and family adversities. Victims displayed the most pervasive pattern with increases in anorexic and bulimic symptoms as well as associated features,” Copeland and colleagues wrote. “In all cases, there was evidence that these associations might be mediated by increased depressive and anxiety symptoms.” – by Amanda Oldt

Disclosure: Copeland reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.