Presenter: Myles Faith, PhD From: UB Alberti Center for Bullying Abuse Prevention, Colloquium Series (April 4, 2017) More: gse.buffalo.edu/alberticenter ........ This presentation addresses the emerging science of weight teasing and bullying (WTB) towards obese youth. WTB appears to be very common among obese children when looking to community- and clinic-based studies examining prevalence. Interestingly, WTB is much more common among obese youth than is high blood pressure or type 2 diabetes. This talk also examines the challenges of assessing WTB among children, as well as gold-standard measurement tools in the field. A concern of WTB is its comorbidities: poorer body image, depression, suicidality, disordered eating and poorer academic performance. The issue of coping with WTB is also discussed, and how certain coping styles may help protect children against the detrimental effects of WTB. Finally, opportunities for new research are discussed. In sum, WTB may be dismissed by some parents, teachers or child health care providers (“sticks and stones may break your bones…”); however, the emerging data suggest the issue can be quite problematic for overweight youth.

1. Weight Teasing and Bullying in Children:
Assessment, Prevalence, and Comorbidities
Myles S. Faith, Ph.D.
Dept of Counseling, School, and Educational Psychology
University at Buffalo - SUNY

3. “It’s an honor to be
on the cover, but
the story is a total
joke … It’s terrible
… All it talks about
is me being fat …
Read it. It’s stupid.”
David Wells
[Associated Press:
July 6, 2000]
Reaction to weight teasing by an elite athlete

4. Food for Thought As You Listen
• Is weight teasing a form of ‘bullying’?
• If so, why?
• If not, why not?
• Under what conditions?
• Implications for school psychologists and
school-based policies?

5. Overview
• Assessment of weight teasing (WT)
• Prevalence of WT
• Correlates and health complications of WT
• Coping with WT
• Research Opportunities

6. Overview
• Assessment of weight teasing (WT)
• Prevalence of WT
• Correlates and health complications of WT
• Coping with WT
• Research Opportunities

7. Research on WT assessment began here

8. Dr. J. Kevin Thompson
University of South Florida

11. POTS
1. People made fun of you because you were heavy?
2. People made jokes about you being heavy.
3. People laughed at you for trying out for sports because you were
heavy?
4. People called you names like "fatso."
5. People pointed at you because you were overweight
6. People snickered about your heaviness when you walked into a
room alone.

12. POTS (continued)
7. People made fun of you by repeating something you said because
they thought it was dumb.
8. People made fun of you because you were afraid to do something.
9. People said you acted dumb.
10. People laughed at you because you didn't understand something
11. People teased you because you didn't get a joke.

13. * POTS has been used/validated in many
pediatric studies, examining weight teasing in
relation to body image, quality of life,
depression, disordered eating, and physical
activity traits.
* It arguably is the ‘gold standard’ (if there is
one).

14. Dr. Thomas F. Cash
Old Dominion University
Research assessing WT by families vs. peers vs. others began
here…

17. Hayden-Wade et al. (2005). Obesity Reviews, 13, 1381-1392

18. Weight Teasing Assessment Needs to
Consider Many Aspects
• Who is teasing? (Peers? Family? Other adults?)
• What is the frequency?
• Where is it occurring? (Home? School areas?)
• What are the (perceived) effects?
• Who is reporting (Child? Parent? Observer?)

19. Overview
• Assessment of weight teasing (WT)
• Prevalence of WT
• Correlates and health complications of WT
• Coping with WT
• Research Opportunities

20. University of Minnesota
Dr. Diane Neumark-Sztainer
• Population-based study of 4746
adolescents from 31 public
schools in St Paul/Minneapolis.
• Mean (SD) age: 14.9 (1.7) yrs.
• “Have you ever been teased or
made fun of by other kids
because of your weight?”
Neumark-Stainer et al. (2002). Int J Obes,
26,.123-131

21. Prevalence of Weight Teasing in
Girls
Weight Category Frequent Weight
Teasing (%)
Ever teased by
peers (%)
Ever
teased by
family
(%)
Underweight 44 48 24
Average Weight 19 21 24
Moderately Ovwt 29 31 34
Very Ovrwt 45 63 47

22. Prevalence of Weight Teasing in
Boys
Weight Category Frequent Weight
Teasing (%)
Ever teased by
peers (%)
Ever
teased by
family
(%)
Underweight 37 41 14
Average Weight 13 14 11
Moderately Ovwt 22 26 17
Very Ovrwt 50 58 34

23. Weight Teasing Prevalence in Ottawa
(N= 683 boys, 907 girls; Mean age= 14.7 yrs)
• McKnight Risk Factor Survey (1999) – assessing peer (8 q’s) and parent (3 q’s) teasing.
• Case = exposure to ‘a little’ or more teasing on any q’s.
• Wt teasing : 45% (ovwt-obese) vs. 22% (normal wt)
• Wt teasing in ovwt-obese: 52% (girls) vs. 30% (boys)
Goldfield et al. (2010). Paediat Child Health, 15, 283-288

24. Puhl et al. (2011). Journal of School Health, 81, 696-703

31. Some Reflections on Prevalence
• A reliable point estimate is hard to know.
• Too few studies.
• Methodologic, measurement heterogeneity.
• That said…. frequency is not rare or
infrequent. Rather, it appears very common
with increasing weight status.
• Sources include peers and family members.

32. Overview
• Assessment of weight teasing (WT)
• Prevalence of WT
• Correlates and health complications of WT
• Coping with WT
• Research Opportunities

33. Correlates of Weight Teasing
• Depression, suicidality, body image
• Disordered eating patters
• Physical activity attitudes
• Educational attainment

34. Weight-Teasing and Suicidal Tendencies in Adolescent
Females: “Project EAT” Cohort (N= 2357)
0
10
20
30
40
50
60
Suicidal Ideation Suicidal Attempts
Percent
No Tease Peer Tease Family Tease Both Tease
Eisenberg et al. (2003). Arch Ped Adol Med, 157, 733-738

35. Obesity Level (Y1)
Teasing (Y1)
Weight Dissatisf (Y3) Appearance
Dissatisfaction (Y3)
Depression (Y3)
-.51
.661.13.76
-.30.24
Weight Teasing, Body Image, and Depression
Source: Thompson et al. (1995). Into J Eat Dies

36. Correlates of Weight Teasing in Overweight
(n= 70) and Non-Overweight (n= 86) Youth
• Reduced Confidence in Physical Appearance (r= -0.31)
• Reduced Liking for Social Activities (r= -0.25)
• Greater Liking for Isolative Sedentary Activities (r= 0.45)
• Greater bulimic behavior (0.40) [Overweight youth only]
Hayden-Wade et al. (2005). Obesity Research, 13, 1381-1992.

42. Key Findings
• Teasing/social rejection associated with poorer
teacher-reported child academic ability (r= -0.33**).
• In logistic regression models identifying students in
the lowest 30% of academic achievement, the only two
predictors were parental education and teasing/social
rejection history (R2
= 36.41%).

43. Overview
• ‘Childhood bullying’ as an anchoring social issue.
• Assessment of weight teasing (WT)
• Prevalence of WT
• Correlates and health complications of WT
• Coping with WT
• Research Opportunities

45. Coping Skills and WT
• Not all obese children exposed to teasing have a ‘negative’
emotional or behavior reaction.
• Some are buffered or ‘protected’.
• What are they doing or thinking differently?

46. • In 2000, we were unaware of validated
measures for use with children of “coping
strategies” for appearance or weight teasing.
• Began collaboration with Timothy Ayers.
• Adapted the Children’s Coping Strategies
Checklist (Ayers et al., J Personality, 1996,
64, 923-958).

47. Study Sample
Faith et al. (2002). Pediatrics, 110, e23.
• 576 5th
– 8th
graders.
• Mean Age: 11.63 (boys) and 11.62 (girls)
• Mean BMI: 19.02 (boys) and 19.92 (girls)
• Ethnicity: 87% Caucasian, 8% Hispanic, 3%
Asian, 1% African American, 1%
Unidentified.
• 82% Response rate to survey

48. Coping with Appearance Teasing Scale
Composite Scale Items Description
Problem-focused
Coping
6 Efforts to understand and to
behaviorally/mentally handle the
teasing situation.
Avoidant Coping 11 Efforts to engage in repression,
wishful thinking, or avoidance of
the teasing situation.
Cognitive Restructuring 6 Efforts to think optimistically or
maintain a positive outlook
regarding the teasing situation.
Faith et al. (2002). Pediatrics, 110, e23.

49. Faith et al. (2002). Pediatrics, 110, e23.
Weight Teasing is related to reduced physical activity,
but this was moderated by coping skills

51. content analyses of transcripts (N=
47)
• Psychological Avoidance – Disengagement
• Seeking social support.
• Confrontation
• Stress reduction
• Self protection
• Losing Weight
• Compensation

53. Overview
• Assessment of weight teasing (WT)
• Prevalence of WT
• Correlates and health complications of WT
• Coping with WT
• Research Opportunities

54. Research Opportunities (1)
• Prospective research examining the ways in which WT
may be contributing to overeating, inactivity, and
excess weight gain.
• Research examining coping-based interventions to
enhance quality of life, mental health, and behavioral
outcomes in obese children.

55. Research Opportunities (2)
• Studies examining the impact of WT on learning,
school engagement, and academic performance.
• Qualitative and quantitative studies exploring WT
within families, including parent perceptions.
• Identifying opportunities for school psychology, more
broadly, in addressing this topic.

56. New/Developing UB Projects & Collaborations
• Obesity, weight teasing, and school engagement (w/ Dr.
Kristin Finn)
• Obesity, bullying exposure, and academic performance in a
US population-based sample (w/Jonathan Huston).
• Cognitions and coping with weight teasing (w/ Kimberley
Silla)
• Weight teasing, mental health, and implications for school
psychologists (w/ Katie Boutot)

57. New/Developing UB Projects & Collaborations
• “Obesity in the Schools” course – upcoming fall (Drs. Wendy
Guyker and Jeremy Finn).
• Overall support and various idea brainstormings: Dr. Jeremy
Finn
• GSE and Dr. Jaekyung Lee (Child Nutrition, Health, Learning
Lab)

58. Your thoughts???
• Is weight teasing a form of ‘bullying’?
• If so, why?
• If not, why not?
• Under what conditions?
• Implications for school psychologists and
school-based policies?

59. Thank you