Experiences of weight teasing in adolescence and weight-related outcomes in adulthood: A 15-year longitudinal study

Abstract

Weight-based teasing is common among youth, but little is known about its long-term impact on health outcomes. We aimed to 1) identify whether weight-based teasing in adolescence predicts adverse eating and weight-related outcomes 15 years later; and 2) determine whether teasing source (peers or family) affects these outcomes. Data were collected from Project EAT-IV (Eating and Activity in Teens and Young Adults) (N=1830), a longitudinal cohort study that followed a diverse sample of adolescents from 1999 (baseline) to 2015 (follow-up). Weight-based teasing at baseline was examined as a predictor of weight status, binge eating, dieting, eating as a coping strategy, unhealthy weight control, and body image at 15-year follow-up. After adjusting for demographic covariates and baseline body mass index (BMI), weight-based teasing in adolescence predicted higher BMI and obesity 15 years later. For women, these longitudinal associations occurred across peer and family-based teasing sources, but for men, only peer-based teasing predicted higher BMI. The same pattern emerged for adverse eating outcomes; weight-based teasing from peers and family during adolescence predicted binge eating, unhealthy weight control, eating to cope, poor body image, and recent dieting in women 15 years later. For men, teasing had fewer longitudinal associations. Taken together, this study shows that weight-based teasing in adolescence predicts obesity and adverse eating behaviors well into adulthood, with differences across gender and teasing source. Findings underscore the importance of addressing weight-based teasing in educational and health initiatives, and including the family environment as a target of anti-bullying intervention, especially for girls.

Eating Behaviors, Weight Bias, and Psychological Functioning in Multi-ethnic Low-income Adolescents

“…The majority of the stigma reported came from peers, other children and their parents. This is an important finding because a longitudinal study examining WB and adverse eating and weight related outcomes found WB from both family and peers predicted unhealthy weight control behaviors and higher body dissatisfaction in females and higher BMI in males (Puhl et al, 2017). Our results also indicate WB was positively correlated with BMI which is consistent with previous reports (Bucchianeri et al, 2014;Feeg et al, 2014;Friedman et al, 2005;Puhl, Peterson, & Luedicke, 2013).…”

“…This finding is similar to other studies demonstrating the highest amount of WB occurred in youth with higher BMIs (Hayden-Wade et al, 2005;Puhl et al, 2017), which can increase the risk of body dissatisfaction, depressive symptoms and suicidal Fig. 1.…”

“…This finding is supportive of the data that shows that eating can be used as a coping mechanism to counter the effects of distress experienced from WB (Hübner et al, 2016;Puhl et al, 2017;Puhl & Brownell, 2006). WB is not the only pathway to disordered eating and obesity, but it is a risk factor that has been identified in previous studies (Kirsch, Shapiro, Conley, & Heinrichs, 2016;Neumark-Sztainer et al, 2007;Puhl et al, 2017). A recent longitudinal study found WB during childhood may lead to emotional eating negatively affecting long-term weight loss maintenance in adulthood (Hübner et al, 2016).…”

“…ideation (Russell-Mayhew, McVey, Bardick, & Ireland, 2012;Taylor, 2011). This finding is supportive of the data that shows that eating can be used as a coping mechanism to counter the effects of distress experienced from WB (Hübner et al, 2016;Puhl et al, 2017;Puhl & Brownell, 2006). WB is not the only pathway to disordered eating and obesity, but it is a risk factor that has been identified in previous studies (Kirsch, Shapiro, Conley, & Heinrichs, 2016;Neumark-Sztainer et al, 2007;Puhl et al, 2017).…”

“…Higher levels of WB are associated with unhealthy coping strategies, such as eating more food (Puhl et al, 2017;Puhl & Brownell, 2006), higher body mass index (BMI; Myers & Rosen, 1999;Mamun, O'Callaghan, Williams, & Najman, 2013;Neumark-Sztainer et al, 2007;Takizawa, Danese, Maughan, & Arseneault, 2015), body dissatisfaction, and lower psychosocial functioning (Annis, Cash, & Hrabosky, 2004;Bucchianeri, Eisenberg, Wall, Piran, & Neumark-Sztainer, 2014). Additionally, obese individuals experiencing WB are at increased risk for depression and other mental health disorders (Bucchianeri et al, 2014;Friedman et al, 2005).…”