Bullying compounds the problems for an epidemic of obese children

Bullying is a common problem for primary school and high school aged children. The self reported rate of bullying is about 10% of primary school aged children in Australia,7 but may be up to 25% in the United Kingdom.1 Bullying is also thought to be a risk factor for a number of psychiatric disorders including depression, somatization disorder and body dysmorphic disorder.2 The literature on childhood bullying links it to poor self-esteem, drug abuse and suicide in later life.

A large trial was conducted in Canada to examine the relationship between overweight/obese children and different forms of bullying. This Canadian study showed that overweight and obese children where at increased risk of relationship bullying (withdrawing friendship, spreading rumours) and overt bullying by either physical or verbal assault.⁸

A recent study conducted in Western Australia confirmed that overweight or obese children are more likely to be bullied than normal or underweight children.⁹ Obese children are also more likely to be the perpetrators of verbal bullying to other children.⁸ This may be in attempt to divert attention away from their own physical condition, as being overweight or obese is associated with negative stereotype behaviours from their peers.

Recognising the signs of bullying in a child is an important step in breaking the chain of negative outcomes. Some signs to be aware of include; increased stress, depression, unexplained bruising, recurrent abdominal pain and vomiting, frequent or repeated accidents, hyperventilation, submissive behaviour and school refusal.^1,3

Epidemiological studies show the incidence of bullying peaks in primary school years. This has lead many experts to consider school-based interventions. Studies also show primary school children are most sympathetic to the victims of bullies.⁷ This may be another reason for the effectiveness of primary school prevention and intervention programmes.

A number of studies have demonstrated school-based interventions as effective strategies to reduce bullying by 30 – 50%.³ Outpatient based family therapy has also been shown to significantly reduce anger and improve interpersonal relationships in adolescent boys who are perpetrators.³ Paediatricians are one group of doctors in which a screening role for at risk children has been proposed.³

It has also been suggested that targeting high-risk groups such as overweight and obese adolescents may increase the effectiveness of anti-bullying interventions.⁸ However the best way to approach this growing problem of bullying in overweight children remains an area of future research.

References:

1. Collier, J. Longmore, M. Brinsem, M. [editors] (2006) Oxford Handbook of Clinical Specialties. [Viewed online; Books@Ovid, April 23, 2007] Oxford University Press: Oxford.
2. Domino, F. [editor] (2007 ed) Body Dysmorphic Disorder [book chapter] in The five minute clinical consult. Lipincott Williams and Wilkins: Philadelphia.
3. Spector, N. Kelly, S. (2006) Paediatrician’s role in screening and treatment: bullying, prediabetes, oral health. Current Opinion in Paediatrics 18: 6; 661-670.
4. Buttriss, J. (2006) Stark reality-statistics on childhood obesity. Nutrition Bulletin 31:3; p175-177.
5. NSW Department of Health. Childhood Obesity. [Cited 16th August 2006] [http://www.health.nsw.gov.au/obesity/adult/background/background.html]
6. Olweus, D. (1994) Bullying at school: long term outcomes for the victims and an effective school based intervention program. In L.R. Huesman (ed) Aggressive behaviour; current perspectives. P 97-130. New York: Plenum.
7. Rigby, K. Slee, P. (1991) Bullying among Australian School children: Reported behaviour and attitudes towards victims. Journal of Social Psychiatry 131: 5; 615-627.
8. Janssen, I. Craig, W. Boyce, W. Pickett, W. (2004) Association between overweight and obesity with bully behaviours in school-aged children. Paediatrics 113: 5; p 1187-1194.
9. Bell, L. Byrne, S. Thompson, A. Ratnam, N. Blair, E. Davis, E. (2007) Increasing body mass index z-score is continuously associated with overweight children, even in the healthy weight range. Journal of Clinical endocrinology and Metabolism 9: 2; 517-522.