Peer teasing is a problem that affects all children, not just the overweight or obese. It is estimated
that up to three-quarters of children suffer from some type of peer teasing [23]. Peer teasing is
characterized by the domination of one person over another, with the intent to harm repeatedly
[24]. Specifically, peer teasing is usually referred to as bullying, harassment, or victimization [23].
In the case of the overweight or obese, it is referred to as weight-based teasing [13,25]. Grignard
and colleagues [13] use the term “peer mockery” to define a psychosocial consequence resulting
from weight.
In U.S. culture, there is a strong emphasis placed on body size and shape. This emphasis may
explain why overweight children are commonly victims of weight-based teasing [25]. Weight-based
teasing is the means by which peers expose the physical differences of overweight and obese
individuals, particularly in children [26]. Inevitably, weight-based teasing can become harmful to
an child’s well-being [25]. Little public attention has been given to weight-based teasing; however,
with the increase of obesity in children [23,25,26], more research is dedicated to examining the
potentially harmful effects of weight-based teasing. Janssen et al. (2004) [28] examined the association
between weight-based teasing and weight status (BMI) in children 11 to 16 years of age.
It was observed that as teasing increased, BMI increased.
Social problems, such as self-induced isolation, are associated with psychosocial factors of
being overweight or obese [23,25,26]. These factors include low body satisfaction, self-esteem
issues, and comorbidities, such as depressive tendencies. Thus, weight-based teasing may increase
loneliness, sadness, and unhappiness about weight [23]. Possibly, because of a resulting low-body
image, overweight children seek isolation [26]. This self-induced isolation leads to ineffective
bonding, which leads to separation from peers [26]. Combined, weight-based teasing and a depressive
state can lead to suicidal thoughts or attempts [23,25]. This occurrence was noted in a study
by Eisenberg and Aalsma [23], who reported that weight-based teasing increased suicidal attempts
to two to three times higher in adolescents who were teased compared with those who were not.
Psychosocial problems associated with weight-based teasing intensify negative short-term and
long-term outcomes for overweight and obese adolescents. Short-term outcomes include low academic
success and poor high school performance. Long-term outcomes include lower marriage
rates and lower income [7,23,26,27].
SCHOOL
In the school environment, overweight children may be victims of negative stereotyping. These
negative stereotypes include inaccurate perceptions by peers, teachers, and administrators that overweight
children are lazy, stupid, and lack motivation [28]. In turn, this leads to a stronger expectation
for slimmer, fit individuals to achieve high scores in intelligence testing and education [29].
Overweight children and adolescents are found to be four times more likely than healthy children
and adolescents to report impaired school function [30]. These results were substantiated by a study
in Thailand, which reported that overweight children and adolescents in grades 7 through 9 were
twice as likely to have low grades in math and language as healthy children and adolescents [31].
Poor academic success includes poor grades, poor attitude toward school, and poor attendance
[23]. It is plausible that weight-based teasing contributes to the development of poor academic
success by causing overweight children to further develop low self-esteem [23]. In turn, low selfesteem
may further perpetuate poor academic performance, which includes poor grades, poor
attitude toward school, and poor attendance [23]. Low self-esteem promotes poor academic performance
because the child may come to believe less and less in his or her abilities. Therefore, it
is imperative to intervene and address weight-based teasing as soon as possible [7,23,25,26].
Intervention can include alteration of school rules, peer-teasing training for teachers, open forums
and discussions in classrooms on the subject, individual meetings, and extracurricular activities to
enhance bonding [23]. Other extreme measures, such as legislation, should also be considered,
especially when efforts to communicate with school administration have failed.
In a recent study, Latner and Stunkard [32] reported that the stigmatization of obese children
has significantly increased over the last 40 years. The overt discrimination of obese youth may
limit both their educational aspirations and achievements [7]. Research indicates that overweight
children assess their school performance and educational futures lower than do normal-weight
children [7]. This perceived low expectation may influence school attrition. We recently reported
[30] that obese children and adolescents involved in our study missed a mean of 4.2 days of school
in the month before the study. These missed days of school could lead to decreased school
performance, with possible long-term consequences. Research has also linked overweight adolescents,
especially girls, with fewer years of school completed [27]. Missed school days may subsequently
lead to decreased school performance. The negative impact of educational disturbances
may be long lasting. Overweight adolescent girls are less likely to attend college and as adults go
on to have lower household income than their peers who were normal weight as adolescents. The
implications of not attending college and not achieving higher-education status may also serve to
explain why overweight adolescents, as adults, have lower household income than adults who were
normal weight as adolescents [26,27].
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