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MONDAY, Aug. 11, 2003 (HealthDayNews) -- Kids who are teased about their weight, regardless of how much they actually weigh, experience significant emotional distress, and some may even attempt suicide.
At the same time, kids who actually are overweight tend to have smaller social networks and be socially marginalized.
Both of these conclusions come from studies in the August issue of the Archives of Pediatrics and Adolescent Medicine, which is a special theme issue on obesity.
For the teasing study, researchers surveyed 4,746 teens in grades seven through 12 at 31 public middle and high schools in the Minneapolis-St. Paul area. The students answered questions about being teased, their body self-image and their self-esteem and depression. Trained staff members also took the height and weight of each participant.
All told, 81.5 percent of the original group completed the survey. Of these, 30 percent of girls and 24.7 percent of boys reported being teased by peers about their weight, while 28.7 percent of the girls and 16.1 percent of the boys were teased by family members. About 14.6 percent of the girls and 9.6 percent of the boys were teased by both peers and family members.
Teasing could have run the gamut from "Hey fatso! Get out of my way!" to the more gentle, "Maybe you should have a salad instead of a burger."
Teens who were taunted reported low levels of satisfaction with their body, low self-esteem, high depressive symptoms and thoughts about and attempts at suicide. Kids who got teased by both family members and peers had a higher rate of emotional distress than those who were teased by one group or the other.
Most startling was the finding that victims of weight-based teasing had a two-to-three-times higher rate of suicidal thoughts and attempts compared with kids who weren't teased.
Teasing had a detrimental effect, regardless of the kid's actual weight.
"This tells us the cultural importance of being thin and beautiful is very strongly present, especially for young people. And being told that they don't fit in with that ideal can have some very powerful effects for people's well-being," says Marla Eisenberg, the lead author of the study.
"To find it so clear across boys and girls, across racial groups, across weight categories really says we've tapped into something important. Being teased about your weight really hurts," adds Eisenberg, a research associate at the University of Minnesota School of Medicine and School of Public Health.
Eisenberg and her colleagues are working on a follow-up study with the same group of teens to see if the effects of being teased are lasting.
Certainly, adolescence isn't any easier for those who really are overweight. A second study in the same issue of the journal found that overweight teens tended to be socially marginalized.
"There may be a vicious cycle," says Dr. Henry Anhalt, director of pediatric endocrinology at Infants and Children's Hospital of Brooklyn at Maimonides Medical Center in New York City.
"On the one hand, obesity may result in poor social networks and this tends to create a situation where obesity is much more likely to be encouraged," says Anhalt, who is also director of the Kids Weight Down Program.
The authors of the second study looked at 90,118 children between the ages of 13 and 18 who were enrolled in the National Longitudinal Study of Adolescent Health (Add Health). Of the total, 17,577 received a detailed in-home assessment, including height and weight measurements.
Although overweight adolescents listed a similar number of friends as did teens of normal weight, the overweight adolescents were less likely to be listed as a friend by their peers. A normal-weight teen received an average of 4.79 friendship nominations, versus 3.39 for an overweight teen. In addition, overweight teens were 70 percent more likely to receive no friendship nominations than their normal-weight peers.
The differences were most pronounced among non-Hispanic whites and among girls, according to the study authors, who are affiliated with the University of Medicine and Dentistry of New Jersey, part of Robert Wood Johnson School of Medicine, and the University of Michigan School of Public Health.
Other studies in the August issue of the journal found: that there were links between obesity and depression; that there was no link between increased physical activity and less television watching; that almost one-third of overweight teens may have metabolic syndrome; and that fewer starchy foods helped teens lose weight.
"Every step we take towards further characterizing the social implications, as well as the medical implications, of obesity are important," Anhalt says. "This is going to be the largest health-care issue to face practitioners in coming years."