1. In a cross-sectional study of first graders, an elevated body mass index (BMI) was related to a slightly greater tendency to be identified by both teachers and peers as a victim of bullying and also as a bully perpetrator.

2. Among both boys and girls of differing BMIs, only obese children were at a higher risk of being classified as a bully-victim.

Evidence Rating: 2 (Good)

Study Rundown: Bullying is a pervasive phenomenon that has a significant impact on a child’s self-worth and school success. Past research has identified overweight and obese teens as a particularly vulnerable group for bullying, specifically finding that these teens are at an increased risk of being subject to verbal and relational victimization. This study investigated first graders to see if an elevated body mass index (BMI) was associated with an increased risk of bullying behavior and victimization using teacher and child reports. As an individual’s BMI increased, researchers found that victimization score similarly increased, although minimally. Compared to normal and overweight kids, obese children were at an increased risk of being bully-victims, which was defined as individuals having high scores on both the bully and victim scale. It is unclear if an individual’s categorization as bully or victim was based on current behavior or a rater’s overall impression, limiting interpretation of the data. However, the findings of this study remain important in identifying populations vulnerable to bullying and emphasize the necessity for early intervention on the part of physicians.

Click to read the study, published today in Pediatrics

Relevant Reading: Obesity and bullying: different effects for boys and girls

In-depth (cross-sectional, prospective study): Sixty-six hundred and ninety 5- to 6- year-old Dutch children from Generation R, a population based cohort, participated in this cross-sectional, prospective study. Teachers were asked to score students on items relating to physical, verbal, relational and material abuse. Participants were classified by teachers and peers as a bully if they scored 1 or greater on a series of question regarding bullying behavior. Children were categorized as victims of bullying based off of the number of classmate bullies they identified. A total of 4364 (65%) teacher- and 1327 (20%) child-generated bullying and victimization reports were collected. A 0.05 increase in victimization score was seen with every 1 point increase in BMI (95% CI: 0.03 – 0.07, P < 0.001). A high BMI was associated with greater bullying tendencies but confounding factors, such as gender and national origin, were thought to account for up to 40% of this association. Stratifying the data by gender, a relationship between high BMI and physical bullying was found for boys but not girls. Per teacher-generated reports only, obese children were more likely than their normal and overweight counterparts to be bully-victims (adjusted odds ratio = 2.25; 95% CI, 1.62 to 3.14).

More from this author: Weight loss interventions concurrently targeting parent and child benefits both parties; Severity of post-concussive symptoms not predictive of recovery 

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