Global and physical self-esteem and body dissatisfaction as mediators of the relationship between weight status and being a victim of bullying

Do Body Mass Index classes define our self-perceptions? Analysis of global, multidimensional, and physical self-esteem in women

Considered as an indicator of good mental health contributing to positive behaviors, self-esteem is impacted by body perception. Obesity is a risk factor for the development of low self-esteem, particularly among women. Age also plays a protective role in both the healthy population and those living with obesity. Since the relationship between self-esteem and BMI does not appear to evolve linearly, the aims of this study were (1) to analyze the link between BMI classes and global, multidimensional, and physical self-esteem, and (2) to identify a potential moderating effect of age. Global, multidimensional, and physical self-esteem were assessed using French versions of RSE, MSE and PSPP scales respectively in 454 women aged 18 to 75 stratified into five BMI groups: healthy weight, overweight, obesity class I, II and III. Global, multidimensional, and physical self-esteem appear to be related to BMI classes. Healthy weight women had significantly higher emotional, professional, physical domains and subdomains self-esteem scores than those in obesity class I, II or III. "Tipping points" associated with reaching a BMI threshold at which scores of self-esteem stabilize have been highlighted. These appeared at obesity class I and II, respectively, for the emotional and physical domains of self-esteem, and at overweight and obesity class II, respectively, for the physical strength and attractive body physical subdomains. Results also revealed a protective moderating effect of age on the relationship between BMI and physical self-esteem, and its subdomains. Obesity intervention programs should consider self-perceptions.

Bullying and anxiety/depressive symptoms in Latinx adolescents living with obesity: the mediating role of self-esteem

Bullying is a serious public health issue for adolescents in the United States. Previous studies have demonstrated associations between self-esteem, anxiety/depressive symptoms, and bullying victimization (BV); however, these relationships have not been extensively studied considering the overlap of social identities of Latinx adolescents living with obesity and overweight (LAWO), who are more likely to be victims of bullying. The current study aims to address these gaps by examining the relationship between BV and anxiety/depressive symptoms and the role of self-esteem while considering sex differences among LAWO (N = 139; female: n = 77, 55.4%; mean age = 12.9 years). Results for overall group showed that BV significantly predicted anxiety/depressive symptoms and self-esteem significantly mediated this relationship. Multigroup mediation analysis resulted in significant mediation by self-esteem for females. Results suggest that interventions that target self-esteem and consider culture would be beneficial for female LAWO.

Long-Term Relationships Between Negative Life Events and Suicidal Ideation Specifying Agnew's General Theory of Crime and Delinquency: A 7-Year Longitudinal Mediation Analysis

The purpose of this study was to examine the longitudinal mediationa(l pathways on the link between various straining experiences and suicidal ideation and to test whether its relationship was mediated by the role of negative emotions, constraints, and motivations. Data for this study were collected as part of the Korean Welfare Panel Study, which was a longitudinal study conducted among 7,027 Korean households, surveyed annually from 2006 to 2012. The results indicated that bullying victimization had important effects on negative emotions, although bullying victimization was not significant for later suicidal ideation. Peer delinquency was significantly correlated with negative emotions and positively predicted later suicidal ideation. Also, the significant impact of bullying victimization was transmitted to suicidal ideation through negative emotions. It implies that individuals' negative life events predicted strain or stressors generating negative emotions that, in turn, led to a high risk of suicidal ideation as a possible coping skill.

Gender Differences in the Effects of BMI on School Bullying and Victimization in China: Comparing Normal Weight, Underweight and Overweight Secondary School Students

Weight-related school bullying and victimization have become important public health issues among adolescents around the world. This study aims to examine gender differences in the effects of Body Mass Index (BMI) on school bullying and victimization among secondary school students. This study conducted a survey among 2849 adolescents—1393 girls (48.9%) and 1456 boys (51.1%). The students were between 12 and 18 years of age and were recruited from ten secondary schools in 2019 in Suqian City in China. The study showed that overweight boys were more likely to bully others and be bullied by peers compared to normal weight boys. In contrast, overweight girls reported less bullying than normal-weight girls. No significant relationship was found between overweight and victimization among female students. The implications for comprehensive sexuality education practices are also discussed.

The Impact of Teasing and Bullying Victimization on Disordered Eating and Body Image Disturbance Among Adolescents: A Systematic Review

Adolescence is a developmental period in which disordered eating and negative body image are highly prevalent, yet their risk factors are insufficiently understood and targeted. Despite research implicating both teasing and bullying victimization in the development of eating disorders, these strands of research are yet to be integrated. This systematic review hence aimed to identify whether teasing and bullying victimization are associated with greater risk of eating disorders and body image disturbance for adolescents. Systematic searches of PsycINFO and PubMed databases identified 79 papers that included quantitative analyses of the relationship between weight-related or nonspecific teasing or bullying victimization and disordered eating or body image disturbance. Overall, studies indicated that adolescents who are teased or bullied are more likely to experience disordered eating and negative body image compared to nonvictimized adolescents. This was more consistently observed in cross-sectional studies than in longitudinal findings. We identify several methodological limitations of the literature, including the infrequent consideration of potential mediating and moderating variables. Finally, we outline future directions such as temporal sequencing of the complex interrelationships among teasing and bullying, disordered eating, and body image disturbance in adolescents.

Pervasiveness, impact and implications of weight stigma

Evidence has accumulated to demonstrate the pervasiveness, impact and implications of weight stigma. As such, there is a need for concerted efforts to address weight stigma and discrimination that is evident within, policy, healthcare, media, workplaces, and education. The continuation of weight stigma, which is known to have a negative impact on mental and physical health, threatens the societal values of equality, diversity, and inclusion. This health policy review provides an analysis of the research evidence highlighting the widespread nature of weight stigma, its impact on health policy and the need for action at a policy level. We propose short- and medium-term recommendations to address weight stigma and in doing so, highlight the need change across society to be part of efforts to end weight stigma and discrimination.

FUNDING

None.

Assessment of Actual Weight, Perceived Weight and Desired Weight of Romanian School Children-Opinions and Practices of Children and Their Parents

Objective: Children and parental awareness regarding weight is linked to the development and management of overweight and obesity. The aim of this study is to assess the actual weight, perceived weight, and desired weight of Romanian school children. Methods: A cross-sectional study was conducted in 2019 in seven schools from two counties of Romania and included 880 pupils aged between 10 and 15 years old and 665 parents. We administrated confidential questionnaires to the participants, and we measured children’s weight and height during school activities. Results: A total of 61.0% of pupils had normal weight, 7.4% were underweight, and 31.6% were overweight or obese. A total of 66.7% of normal weight children, 56.5% of overweight children, and 40% of underweight children perceived their weight accurately. Regarding parents, a majority correctly appreciated the weight of their normal weight children and only a third appreciated correctly the body weight of their underweight and overweight children. Factors such as body mass index, gender, weight related behaviors, parents’ estimation about their children’s weight, discussions of weight topics inside family, and bullying, cyberbullying and exclusion from groups were associated with misperceptions. Conclusion: The study provides useful information for health education activities targeting both children and their parents regarding appropriate body weight management of children.

Bullying experiences, body esteem, body dissatisfaction, and the moderating role of weight status among adolescents

INTRODUCTION

The present study examined the relationships between bullying victimization experiences, body esteem (BE), and body dissatisfaction (BD) by obesity status.

METHODS

Using a cross-sectional design, adolescents (10-16y) from the U.S. completed surveys. Weight and height were objectively assessed. Bullying was assessed using the Personal Experiences Checklist, with a total score that included three subscales (cyber, verbal-relational, and physical). BE was assessed using total score on the BE Scale, and BD was assessed using the Body Image Assessment for Pre-Adolescents, operationalized as the discrepancy between current and ideal body figure. Linear regression models, controlling for sociodemographics, were used to examine obesity status (with vs. without obesity) and sex as moderators of the relationships between bullying, BE, and BD.

RESULTS

On average, adolescents (n = 328) were 12.6 ± 1.9 y, 45.4% male, 58.2% White, 35.7% Black, and 36.0% had obesity. Obesity status moderated the relationship between bullying experiences and BE, such that these relationships were only significant (B = -0.38, p<.05) among adolescents with obesity compared to adolescents without obesity. In both groups, greater verbal-relational bullying experiences were associated with lower BE, while greater physical bullying experiences were related to higher BE only among adolescents with obesity. In adolescent girls without obesity, greater cyberbullying experiences were associated with lower BD.

CONCLUSIONS

The findings suggest different associations between sub-types of bullying victimization experiences and BE and BD, highlighting the importance of examining these associations separately by obesity status.

Global Dieting Trends and Seasonality: Social Big-Data Analysis May Be a Useful Tool

We explored online search interest in dieting and weight loss using big-data analysis with a view to its potential utility in global obesity prevention efforts. We applied big-data analysis to the global dieting trends collected from Google and Naver search engines from January 2004 to January 2018 using the search term “diet,” in selected six Northern and Southern Hemisphere countries; five Arab and Muslim countries grouped as conservative, semi-conservative, and liberal; and South Korea. Using cosinor analysis to evaluate the periodic flow of time series data, there was seasonality for global search interest in dieting and weight loss (amplitude = 6.94, CI = 5.33~8.56, p < 0.000) with highest in January and the lowest in December for both Northern and Southern Hemisphere countries. Seasonal dieting trend in the Arab and Muslim countries was present, but less remarkable (monthly seasonal seasonality, amplitude = 4.07, CI = 2.20~5.95, p < 0.000). For South Korea, seasonality was noted on Naver (amplitude = 11.84, CI = 7.62~16.05, p < 0.000). Our findings suggest that big-data analysis of social media can be an adjunct in tackling important public health issues like dieting, weight loss, obesity, and food fads, including the optimal timing of interventions.

Body mass index and peer victimization: A transactional model

Past research has shown concurrent associations between adolescent's body mass index (BMI) and classroom bullying victimization experiences. The goal of this three‐wave longitudinal study is to examine a transactional model of associations between BMI and bullying victimization among adolescents in India. We investigate concurrent unidirectional and bidirectional relations between BMI and victimization. In a sample of 1238 students from nine schools (Grades 7–9; M‐age_T1 = 13.15, SD = 1.16) in Indore, India, we used self‐ and peer‐reports to measure bullying victimization in the classroom, and objective measurement of students' height and weight to collect data on adolescents' BMI, across three waves in one school year. Structural equational modeling was used to test transactional relations between BMI and bullying victimization. For self‐reported victimization, there was no concurrent or over time association between BMI and victimization for boys or girls in the present study. For peer‐reported victimization, we observed concurrent associations between BMI and victimization for boys and girls and a prospective relation where higher BMI corresponded to less victimization over time for boys. The study yielded mainly concurrent relations between BMI and victimization among adolescents in India. Results from western countries may not generalize to India.

Perceptions of a Pragmatic Family-Centered Approach to Childhood Obesity Treatment

Background: Few studies have examined both parent and child preferences regarding family-based weight management programs (WMPs) delivered in primary care settings, especially among racial minority populations. The purpose of this study was to determine the perceptions that parents and their children/adolescents have about the components that should be included in a family-based WMP and to identify perceived preferences, benefits, and/or barriers to participation. Methods: A sample of 60 participants (30 parents and 30 children/adolescents) participated in 1 of 5 separate structured focus groups, using probing questions and the nominal group technique (NGT). Parents reported demographics for themselves and their children/adolescents. Themes from probing questions were identified using thematic analysis. Results: Parents were primarily African American (93%) and diverse in income. NGT sessions revealed that parents across all groups perceived that education on healthy eating, parental involvement, and effective program leaders are most important and have the greatest impact, while parental involvement was perceived as the easiest method to implement in a family-based WMP for childhood obesity. Children/adolescents perceived that education on healthy eating and exercise would have the greatest impact, while healthy eating and meal plans were perceived as the easiest methods to implement with a family. Parents and children/adolescents also identified improved psychological well-being (eg, decreased bullying, increased self-esteem, and motivation) as a desired program outcome. Conclusion: Parents and their children/adolescents highlighted the importance of physical and psychological health as targets in treatment. Feedback from patients can inform the design and implementation of family-based WMPs delivered in primary care settings.

Youth perspectives on weight-related words used by healthcare professionals: A qualitative study

BACKGROUND

Although healthcare professionals often consider body weight a sensitive and difficult topic to discuss with children, a contextualized and comprehensive understanding of youth perspectives on weight-related words used in healthcare has yet to be established. This qualitative study aims to explore perspectives of Dutch children on the terminology healthcare professionals use when discussing weight.

METHODS

Fourteen interviews and one focus group discussion were held with children (age 8-16) who were in care because of their weight. A toolkit with customizable interview techniques was used in order to facilitate reflection and tailor the interview to each respondent. A narrative content analysis was conducted.

RESULTS

Respondents attached both clear and subtle differences in meanings to (certain) weight-related words. Their perspectives were not unanimous for any single word. Moreover, at times, respondents framed certain words in positive or negative ways or used a word they disliked to describe themselves. This illustrates that meanings of weight-related words are not fixed but context and situation specific.

CONCLUSION

This study revealed that meanings children assign to weight-related words are shaped by their experiences in the broader social context, especially at school, as well as with (previous) healthcare professionals. It pointed towards the importance of bedside manner, acquaintanceship, and support. Healthcare professionals treating children because of their body weight are advised to invest in a good patient-caregiver relationship, pay attention to children's previous (negative) social weight-related experiences, and reflect critically on their own preconceptions about body weight and the impact these preconceptions might have on their patient-caregiver relationships.

Low Self-Esteem for Physical Appearance Mediates the Effect of Body Mass Index on Smoking Initiation Among Adolescents

Objective

Adolescence is a period during which youth may begin experimenting with substances. Youth with overweight or obesity may be at increased risk for substance use, including cigarette smoking. Understanding the associations between smoking and excess weight and the pathways associated with increased likelihood for smoking initiation is of particular importance given the increased risk for negative health outcomes associated with each.

Methods

Using longitudinal panel data from 1,023 middle school youth (baseline age M = 12.5, 52% female), we tested whether smoking initiation was concurrently and prospectively predicted by self-reported body mass index (BMI) and whether self-esteem for physical appearance (SEPA) mediated the effect of BMI on risk of early initiation.

Results

BMI predicted smoking initiation concurrently and prospectively in unadjusted models. In adjusted models, SEPA mediated the effects of BMI on smoking initiation. Bootstrapped mediation results indicated that the positive relationship between BMI and subsequent smoking initiation was significantly mediated by lower SEPA (B =.10, 95% confidence interval [0.01, 0.22]).

Conclusions

Adolescents who have overweight or obesity are more likely to feel negatively about their appearance and bodies, and this negative perception may result in experimentation with cigarettes. Cigarettes may be used by youth with overweight or obesity in an effort to manage weight, to cope with low self-esteem or for other reasons. Future research should explore the motives and psychosocial context of smoking initiation among adolescents with overweight/obesity further (e.g., with whom they first try smoking, perceived benefits of smoking).

Predictors of One-Year Change in How Youth Perceive Their Weight

Overall, perceptions of being at "about the right weight" appear advantageous for youth physical and mental health, regardless of BMI classification, whereas perceptions at either extreme (overweight or underweight) may negatively impact health behaviours and mental health. Instead of considering weight misperceptions as problematic, some researchers have proposed that underestimations of weight status may offer resiliency among individuals with overweight or obesity. Promoting "about right" WPs and preventing change to overweight or underweight perceptions may offer an effective public health strategy for supporting youth health over time. However, limited prospective evidence exists on factors that shape perceptions of weight status over time. The current study examined modifiable predictors of one-year change in weight perception among youths. We used 2-year linked data of 18,112 grade 9-12 students from Year 3 (Y₃:2014-2015) and Year 4 (Y₄:2015-2016) of the COMPASS study. Generalized Estimating Equation models tested screen use, physical activity, and bullying victimization as predictors of change from perceptions of "about the right weight" to "overweight" or "underweight" perceptions, adjusting for Y₃ covariates (body mass index, ethnicity, and grade) and school cluster. Results support the value of team sports among females and resistance exercise among males as protective against changes to overweight or underweight perceptions over one year. Also, various forms of bullying victimization predicted overweight perceptions in males and females. Watching TV/movies or messaging/texting for over 2 hours/day was associated with overweight and underweight perceptions, respectively, in females only. Playing video/computer games for over 2 hours/day was associated with overweight perceptions in males and underweight perceptions in females. Findings support the potential of bullying prevention, limiting certain screen use, and supporting engagement in team sports for females and resistance exercise for males as strategies to maintain perceptions of being at "about the right weight."

Body Weight, Body Weight Perception, and Bullying Among Adolescents in Malaysia

Body weight is a factor, with body weight perception a mediator, toward being a victim of bullying. This study aimed to explore the association between body weight, body weight perception, and bullying among students 13 to 17 years of age in Malaysia. Data were collected using a self-administered questionnaire. A 2-stage stratified cluster sampling design was used, and 212 schools across Malaysia were selected for this survey. Body weight was measured and body weight perception was the student's reflection of their body weight. The prevalence of being bullied among adolescents in Malaysia was 16.2%. Being too thin or being obese increased the probability of being bullied. Students with a normal body mass index, but with a misperception of their body weight, also had increased odds of being bullied. Obesity prevention, together with instilling positive body weight perception, should be part of all programs directed toward tackling the problem of bullying.

Weight Bias in Educational Settings: a Systematic Review

PURPOSE

To conduct a systematic literature review of empirical peer-reviewed published studies on the prevalence of weight bias among students, pre-service, and in-service teachers and its impact on the educational experiences and health of students from kindergarten to postsecondary settings.

METHODS

Keywords were searched on three main concepts, (i) weight bias/stigma, (ii) obesity/overweight, and (iii) education, within eight databases. Our search yielded 8323 individual records, of which 45 studies satisfied our inclusion criteria.

RESULTS

Most studies were conducted in K-12 school settings (n = 41), were quantitative in design (n = 37), and used student samples (n = 18). Weight bias is prevalent in educational settings, among peers at school as well as pre-service and in-service teachers, and negatively impacts students' health and educational experiences.

CONCLUSION

These results highlighted the impact of weight bias in creating inequity for students with obesity as well as several underexamined areas, such as weight bias in postsecondary settings and attitudes among teachers and pre-service teachers. Innovative strategies to address weight bias in educational settings are needed.

Clinical Considerations Regarding the Use of Obesity Pharmacotherapy in Adolescents with Obesity

A growing number of youth suffer from obesity and in particular severe obesity for which intensive lifestyle intervention does not adequately reduce excess adiposity. A treatment gap exists wherein effective treatment options for an adolescent with severe obesity include intensive lifestyle modification or metabolic and bariatric surgery while the application of obesity pharmacotherapy remains largely underutilized. These youth often present with numerous obesity-related comorbid diseases, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, obstructive sleep apnea, nonalcoholic fatty liver disease, musculoskeletal problems, and psychosocial issues such as depression, anxiety, and social stigmatization. Current pediatric obesity treatment algorithms for pediatric primary care providers focus primarily on intensive lifestyle intervention with escalation of treatment intensity through four stages of intervention. Although a recent surge in the number of Food and Drug Administration-approved medications for obesity treatment has emerged in adults, pharmacotherapy options for youth remain limited. Recognizing treatment and knowledge gaps related to pharmacological agents and the urgent need for more effective treatment strategies in this population, discussed here are the efficacy, safety, and clinical application of obesity pharmacotherapy in youth with obesity based on current literature. Legal ramifications, informed consent regulations, and appropriate off-label use of these medications in pediatrics are included, focusing on prescribing practices and prescriber limits.

The Role of Shame in the Relation Between Peer Victimization and Mental Health Outcomes

Youth who experience peer victimization are at risk of developing mental health problems. However, little is known about the emotional causal mechanisms linking peer victimization with these negative outcomes. This study investigated whether shame mediated this relationship. At three time points (T1-T3), 396 10- to 13-year-olds completed measures of peer victimization, shame (characterological, bodily, and behavioral; shame proneness), and mental health (depression, social anxiety, and externalizing behavior). Three multiple mediation models tested the indirect effects of T1 victimization on T3 mental health through the four T2 shame-related variables. Analyses revealed indirect effects for the shame-related mediators on depression, social anxiety, and externalizing behaviors. Specifically, indirect positive effects for characterological and bodily shame on depression and social anxiety were found, with greater bodily shame linked to higher levels of social anxiety in girls but not boys. In addition, an indirect negative effect for behavioral shame on externalizing problems was found, with higher levels of externalizing problems in victimized boys but not in girls. Finally, an indirect positive effect for shame proneness and externalizing problems was found. To clarify the directionality, three additional mediation models were run with mental health symptoms as predictors of shame and subsequent victimization. Indirect effects for the shame-related mediators were found for all outcomes, specifically bodily shame and shame proneness as mediators between internalizing and externalizing symptoms and victimization. These three models were compared and contrasted with the hypothesized models. In sum, findings support the role of shame as an underlying emotional mechanism of peer victimization, and may guide intervention programs to address the mental health concerns of victimized youth.

Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

Clinical practice guideline for the diagnosis and treatment of pediatric obesity: recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.

Body mass index, peer victimization, and body dissatisfaction across 7 years of childhood and adolescence: Evidence of moderated and mediated pathways

Numerous studies have reported that children and adolescents who are overweight are more likely to get bullied, yet the literature is replete with methodological limitations. We examined the transactional associations between peer victimization and body mass index (BMI), considering potential mediating (body dissatisfaction) and moderating (biological sex) factors. Participants (n = 631) came from the McMaster Teen Study, where students were assessed annually between Grades 5-11, approximately half were girls (53.9%), and the majority were white (76.4%). Peer victimization (from Grade 5) and body dissatisfaction (from Grade 6) were self-reported by students, while parents reported their child's height and weight (from Grade 5). Cascade models were built up sequentially using path analysis across 2-year increments (Grades 5, 7, 9, and 11). The final model had excellent fit to the data (χ²  = 73.961, df = 66, p = 0.234). Grade 5 peer victimization had a direct effect on BMI across a 2-year period in girls (b = 0.59, SE = 0.21, p = 0.005) and boys (b = 0.82, SE = 0.30, p = 0.006), and an indirect effect on BMI via body dissatisfaction across a 4-year period (b = 0.074, 95% CI = 0.012-0.152, p = 0.036). At no point did BMI directly increase risk for peer victimization, yet there were indirect effects via body dissatisfaction among girls but not boys. Peer victimization and body dissatisfaction were proximally and longitudinally related at every time point and there was a transactional association in late-adolescence among girls but not boys. Targeting modifiable factors in the social (peer victimization) and psychological (body dissatisfaction) domains may limit accelerated weight gain and the health risks associated with excess adiposity.

Thin idealization and causal attributions mediate the association between culture and obesity stereotypes: An examination of Chinese and American adolescents

Few studies have examined age or cultural differences in the stereotypes adolescents have of persons with obesity. The present research explored the hypotheses that American adolescents have more negative obesity stereotypes than Chinese adolescents and that the effects of culture are mediated by weight attributions and thin idealization. Participants (N = 335; 181 female; M age = 14.83 years, SD = 1.57 years) completed measures of thin idealization and causal attributions and made generalizations from and attributions of stereotypical personality characteristics to obese figures. Not only did stereotypes differ between countries, but generalizations of negative characteristics from obese figures increased with age. In addition, American adolescents more firmly endorsed the 'thin ideal' and were more likely to attribute obesity to internal causes that Chinese adolescents. As anticipated, between-country differences in stereotyping were mediated by thin idealization and causal attributions. Findings are discussed in terms of the 'doctrine of the mean', social identity theory, and dual-process theories. Statement of Contribution The development of obesity stereotypes has been the subject of a number of recent studies. Although scarce, research on adolescents' obesity stereotypes indicates that the strength of these stereotypes increases with age and that these increases are mediated by thin idealization and causal attributions. The current research adds to this growing literature that differences between Chinese adolescents' and American adolescents' obesity stereotypes - in terms of the assignment of stereotypical traits to people with obesity and the generalization of negative traits from an individual person with obesity to people with obesity as a group - are mediated by thin idealization and attributions about obesity's causes. The research also indicates that (1) age differences in obesity stereotyping vary as a function of the method used to measure stereotypes, (2) Chinese adolescents are less likely than American adolescents to attribute obesity to characterological flaws, and (3) American adolescents idealize thinness more than Chinese adolescents.

Perceived Weight and Bullying Victimization in Boys and Girls

BACKGROUND

Research suggests that perceived weight poses separate risks from objective weight on adolescents' risks of being bullied. We examined if the prevalence of bullying victimization differed by perceived and objective weight status, and how these associations varied by sex.

METHODS

Data were analyzed for 6716 8th and 11th graders from the School Physical Activity and Nutrition project, a Texas statewide survey of public school students. Participants reported demographics, bullying victimization, and weight perceptions. Height and weight were measured.

RESULTS

In the last 6 months, 10.8% of students reported being bullied. Nearly 70% of normal weight and overweight and 50% of obese adolescents perceived themselves as weighing the right amount. Perceiving oneself as weighing too little or too much was significantly associated with increased bullying victimization (p < .05 for both), whereas objective weight was not. Statistical interactions between perceived weight and sex were significantly associated with victimization (p < .05) among boys only; boys who perceived themselves as weighing too little had higher predicted probabilities of victimization.

CONCLUSIONS

Perceived weight may play a greater role in bullying victimization than objective weight, especially among boys. Interventions to prevent bullying should consider adolescents' self-perceptions of weight to effectively identify those at greater risk for victimization.

Poor Health and Experiences of Being Bullied in Adolescents: Self-Perceived Overweight and Frustration with Appearance Matter

OBJECTIVE

To examine the associations between body image (actual and self-perceived weight status; feelings about appearance) and health outcomes (overall health, life satisfaction, and mental health) and between body image and experiences of being bullied.

METHODS

Participants included 8,303 children from 7th to 10th grade in the Health Behavior of School-Aged Children (HBSC) 2009-2010 data set, a large-scale sample in the United States. Several multiple linear regressions (with health outcomes as dependent variables) and multivariate logistic regressions (with being bullied or not as dependent variable) were conducted to investigate the associations between each dependent variable and the following independent variables: relationship with parents, frustration with appearance, and actual and self-perceived weight status.

RESULTS

Self-perceived underweight, self-perceived overweight (OW), and frustration with appearance were positively associated with being bullied. Frustration with appearance was a risk factor, while good relationship with parents was a protective factor, especially for psychological health outcomes. Self-perceived OW had a stronger association with the experience of being bullied than actual OW. The relationship between actual OW and being bullied might be attenuated when self-perceived OW is simultaneously considered.

CONCLUSIONS

Body image may be an important factor in the association between weight status and the experience of being bullied.

Systematic Review: Bullying Involvement of Children With and Without Chronic Physical Illness and/or Physical/Sensory Disability-a Meta-Analytic Comparison With Healthy/Nondisabled Peers

Objective

To compare levels of victimization and perpetration associated with bullying among children and adolescents with and without chronic physical illnesses and/or physical or sensory disabilities.

Methods

In total, 107 studies were identified using a systematic search in electronic databases and cross-referencing. A random-effects meta-analysis was computed.

Results

Children and adolescents with chronic physical illness or disability were more likely to be victims of bullying in general (odds ratio [OR] = 1.65), particularly physical bullying (OR = 1.47), relational bullying (OR = 1.47), verbal bullying (OR = 1.67), cyberbullying (OR = 1.39), and illness-specific teasing (OR = 5.29). They were also more likely to be bullies in general (OR = 1.28), as well physical (OR = 1.38) and relational bullies (OR = 1.13). The effect sizes varied across different illnesses and disabilities and, in part, by visibility of the disease, school type, and year of assessment.

Conclusions

Although most between-group differences tend to be small, some form of intervention is needed to reduce bullying among children and adolescents with chronic physical illnesses and/or physical or sensory disabilities, and illness-specific weight- and appearance-related teasing in particular.

Adolescent Desire for Cosmetic Surgery: Associations with Bullying and Psychological Functioning

BACKGROUND

Adolescent bullying may be a key driver of interest in cosmetic surgery. This study examined the extent of such interest and whether any effect was sex-specific, and examined psychological functioning as a potential mechanism through which bullying involvement may lead to a wish for cosmetic surgery.

METHODS

A two-stage design was used. In the first stage, 2782 adolescents (aged 11 to 16 years) were screened for bullying involvement using self-reports and peer nominations. In the second stage, 752 adolescents who were bullies, victims, bully-victims, or uninvolved in bullying reported their desire for cosmetic surgery. Psychological functioning was constructed as a composite of self-esteem and emotional problems (assessed at stage 1) and body-esteem scores (assessed at stage 2).

RESULTS

Adolescents involved in bullying in any role were significantly more interested in cosmetic surgery than uninvolved adolescents. Desire for cosmetic surgery was greatest in adolescents who were bullied (victims and bully-victims) and girls. Desire for cosmetic surgery was highest in girls, but sex did not interact with bullying role. Being victimized by peers resulted in poor psychological functioning, which increased desire for cosmetic surgery. In contrast, desire for cosmetic surgery in bullies was not related to psychological functioning, which was in the normal range.

CONCLUSIONS

Bullying victimization is related to poor psychological functioning, and both are related to a greater desire for cosmetic surgery in adolescents. Cosmetic surgeons should screen candidates for psychological vulnerability and may want to include a short screening questionnaire for a history of peer victimization.

The Interplay among BMI z-Score, Peer Victmization, and Self-Concept in Outpatient Children and Adolescents with Overweight or Obesity

BACKGROUND

Research has provided evidence that obesity is associated with peer victimization and low levels of self-concept. No study has examined the relationship between BMI z-score, self-concept in multiple domains, and peer victimization.

METHODS

The aim of the research was to investigate the interplay between BMI z-score, self-concept in multiple domains (physical, athletic, social), and peer victimization, testing direct, mediated, and moderated associations. Eighty hundred fifteen outpatient children and adolescents were consecutively recruited in 14 hospitals distributed over the Italian country. The sample consisted of 419 males and 396 females; mean age 10.91 ± 1.97 years (range 6-14 years) and mean BMI z-score 1.85 ± 0.74 (range -0.97 ± 3.27). Peer victimization and self-concept were assessed with a revised Olweus Bully/Victim Questionnaire and with the Self-Perception Profile for Children. A structural equation model approach was used to determine the associations among variables, testing two competing models.

RESULTS

In both models, path analysis revealed that BMI z-score was directly associated with peer victimization and self-concept in multiple domains. In the first model, peer victimization mediated the relationship between BMI-score and self-concept, whereas in the alternative model, self-concept mediated the relationship between BMI z-score and peer victimization. Interaction analyses revealed that social competence moderated the relationship between BMI z-score and peer victimization and that peer victimization moderated the relationship between BMI z-score and physical appearance.

CONCLUSIONS

Higher levels of BMI z-score are a risk factor for peer victimization and poor self-concept. When high levels of BMI z-score are associated with a negative self-concept, the risk of victimization increases. Preventive and supportive interventions are needed to avoid negative consequences on quality of life in children and adolescents with obesity.

Intra-gastric balloon as an adjunct to lifestyle support in severely obese adolescents; impact on weight, physical activity, cardiorespiratory fitness and psychosocial well-being

BACKGROUND

Severe adolescent obesity (body mass index (BMI) >99.6th centile) is a significant public health challenge. Current non-invasive treatments, including community-based lifestyle interventions, are often of limited effectiveness in this population, with NICE guidelines suggesting the use of bariatric surgery as the last line of treatment. Health professionals are understandably reluctant to commission bariatric surgery and as an alternative, the use of an intra-gastric balloon as an adjunct to a lifestyle programme might offer a reversible, potentially safer and less invasive option.

OBJECTIVES

Explore the use of an intra-gastric balloon as an adjunct to a lifestyle support programme, to promote weight loss in severely obese adolescents. Outcomes included weight loss, waist and hip measurements, psychosocial outcomes including health-related quality of life (HRQoL) and physical self perceptions, physical activity and cardiorespiratory fitness.

METHOD

Non-randomised pilot study.

RESULTS

Twelve severely obese adolescents (5 males, 7 females; mean age 15 years; BMI >3.5 s.d.; puberty stage 4 or more) and their families were recruited. Mean weight loss at 12 months (n=9) was 3.05 kg±14.69; d=0.002, P=0.550, and a BMI Z-score (n=12) change of 0.2 s.d.; d=0.7, P=0.002 was observed at 6 months with a large effect, but was not sustained at 12 months (mean change 0.1 s.d.; d=0.3, P=0.146). At 24 months (n=10), there was a weight gain from baseline of +9.9 kg±1.21 (d=0.4; P=0.433). Adolescent and parent HRQoL scores exceeded the minimal clinical important difference between baseline and 12 months for all domains but showed some decline at 24 months.

CONCLUSION

An intra-gastric balloon as an adjunct to a lifestyle support programme represents a safe and well-tolerated treatment approach in severely obese adolescents, with short-term effects on weight change. Improvements in psychosocial health, physical activity and cardiorespiratory fitness were maintained at 12 months, with varying results at 24 months.

Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline

COSPONSORING ASSOCIATIONS

The European Society of Endocrinology and the Pediatric Endocrine Society. This guideline was funded by the Endocrine Society.

OBJECTIVE

To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity.

PARTICIPANTS

The participants include an Endocrine Society-appointed Task Force of 6 experts, a methodologist, and a medical writer.

EVIDENCE

This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The Task Force commissioned 2 systematic reviews and used the best available evidence from other published systematic reviews and individual studies.

CONSENSUS PROCESS

One group meeting, several conference calls, and e-mail communications enabled consensus. Endocrine Society committees and members and co-sponsoring organizations reviewed and commented on preliminary drafts of this guideline.

CONCLUSION

Pediatric obesity remains an ongoing serious international health concern affecting ∼17% of US children and adolescents, threatening their adult health and longevity. Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence. Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns. Pediatric comorbidities are common and long-term health complications often result; screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result. Genetic screening for rare syndromes is indicated only in the presence of specific historical or physical features. The psychological toll of pediatric obesity on the individual and family necessitates screening for mental health issues and counseling as indicated. The prevention of pediatric obesity by promoting healthful diet, activity, and environment should be a primary goal, as achieving effective, long-lasting results with lifestyle modification once obesity occurs is difficult. Although some behavioral and pharmacotherapy studies report modest success, additional research into accessible and effective methods for preventing and treating pediatric obesity is needed. The use of weight loss medications during childhood and adolescence should be restricted to clinical trials. Increasing evidence demonstrates the effectiveness of bariatric surgery in the most seriously affected mature teenagers who have failed lifestyle modification, but the use of surgery requires experienced teams with resources for long-term follow-up. Adolescents undergoing lifestyle therapy, medication regimens, or bariatric surgery for obesity will need cohesive planning to help them effectively transition to adult care, with continued necessary monitoring, support, and intervention. Transition programs for obesity are an uncharted area requiring further research for efficacy. Despite a significant increase in research on pediatric obesity since the initial publication of these guidelines 8 years ago, further study is needed of the genetic and biological factors that increase the risk of weight gain and influence the response to therapeutic interventions. Also needed are more studies to better understand the genetic and biological factors that cause an obese individual to manifest one comorbidity vs another or to be free of comorbidities. Furthermore, continued investigation into the most effective methods of preventing and treating obesity and into methods for changing environmental and economic factors that will lead to worldwide cultural changes in diet and activity should be priorities. Particular attention to determining ways to effect systemic changes in food environments and total daily mobility, as well as methods for sustaining healthy body mass index changes, is of importance.

Online Social Support for Young People: Does It Recapitulate In-person Social Support; Can It Help?

As social media websites have grown in popularity, public concern about online victimization has grown as well; however, much less attention has focused on the possible beneficial effects of online social networks. If theory and research about in-person social networks pertain, then online social relationships may represent an important modern source of or vehicle for support. In a study of 231 undergraduates, three major findings emerged: (1) for people with weaker in-person social support, social media sites provide a source of social support that is less redundant of the social support they receive in person; (2) in ways that were not redundant of each other, both online and in-person social support were associated with lower levels of depression-related thoughts and feelings, and (3) the beneficial effects of online social support (like in-person social support) offset some of the adverse effects of peer victimization. The study suggests that augmenting social relations via strategic use of social media can enhance young people's social support systems in beneficial ways.

Body image as a target of victimization by peers/parents: Development and validation of the Body Image Victimization Experiences Scale

This study developed and established the psychometric properties of the Body Image Victimization Experiences Scale (BIVES). The BIVES retrospectively assesses the frequency (Part A-frequency) and effect (Part B-impact) of victimization experiences pertaining to body image, perpetrated by peers and parents/caregivers in childhood and adolescence. Distinct samples of Portuguese women were recruited in 2013-2014: two nonclinical samples of the general population (n = 1,177), aged 18-60 years, and a clinical sample of patients with Binge Eating Disorder (BED; n = 73), aged 19-59 years. An exploratory factor analysis was conducted in 632 participants. A confirmatory factor analysis (CFA) and the scale's psychometric properties were tested in 545 participants. The ability of the BIVES to discriminate the clinical from a nonclinical sample was examined. The scale presented two factors indicating the sources of the victimization-peers and parents. CFA results confirmed the scale's structure. The BIVES presented very good internal consistency, construct and discriminant validity, good test-retest reliability, and was associated with related constructs, body image shame, and eating psychopathology. The scale adequately discriminated between the clinical sample and a nonclinical sample. The BIVES is a valid and reliable measure that allows for a comprehensive assessment of body image-related victimization experiences.

What Makes Them More Vulnerable Than Others? Obesity, Negative Emotions, and Peer Bullying Victimization

Negative impacts resulting from peer bullying victimization include psychological stress, emotional and academic maladjustment, decreased self-esteem, relational problems with peers, and may also lead to suicidal ideation and behavior. Therefore, efforts have been concentrated toward identifying characteristics of victims and perpetrators of bullying to allocate resources for preventive strategies. The current study adds to this ongoing research by using a nationally representative sample of adolescents to identify health-related correlates (obesity and negative emotions) of students vulnerable to peer bullying victimization, as well as exploring individual and school-related characteristics. Findings suggest that negative emotions are related to peer bully victimization, but a relationship between obesity and victimization is not clear. In addition, students attending schools with bullying prevention programs were more likely to report physical victimization. Discussion is offered regarding these findings and suggestions for future research in this area.

Stand-Biased Versus Seated Classrooms and Childhood Obesity: A Randomized Experiment in Texas

OBJECTIVES

To measure changes in body mass index (BMI) percentiles among third- and fourth-grade students in stand-biased classrooms and traditional seated classrooms in 3 Texas elementary schools.

METHODS

Research staff recorded the height and weight of 380 students in 24 classrooms across the 3 schools at the beginning (2011-2012) and end (2012-2013) of the 2-year study.

RESULTS

After adjustment for grade, race/ethnicity, and gender, there was a statistically significant decrease in BMI percentile in the group that used stand-biased desks for 2 consecutive years relative to the group that used standard desks during both years. Mean BMI increased by 0.1 and 0.4 kilograms per meter squared in the treatment and control groups, respectively. The between-group difference in BMI percentile change was 5.24 (SE = 2.50; P = .037). No other covariates had a statistically significant impact on BMI percentile changes.

CONCLUSIONS

Changing a classroom to a stand-biased environment had a significant effect on students' BMI percentile, indicating the need to redesign traditional classroom environments.

Doubly Disadvantaged? Bullying Experiences among Disabled Children and Young People in England

Bullying among school-aged children and adolescents is recognised as an important social problem, and the adverse consequences for victims are well established. However, despite growing interest in the socio-demographic profile of victims, there is limited evidence on the relationship between bullying victimisation and childhood disability. This article enhances our understanding of bullying experiences among disabled children in both early and later childhood, drawing on nationally representative longitudinal data from the Millennium Cohort Study and the Longitudinal Study of Young People in England. We model the association of disability measured in two different ways with the probability of being bullied at ages seven and 15, controlling for a wide range of known risk factors that vary with childhood disability. Results reveal an independent association of disability with bullying victimisation, suggesting a potential pathway to cumulative disability-related disadvantage, and drawing attention to the school as a site of reproduction of social inequalities.

Obese Chinese Primary-School Students and Low Self-Esteem: A Cross-Sectional Study

Objectives

The aim of this study was to examine several factors related to low self-esteem among obese Chinese primary-school students.

Methods

A cross-sectional study was conducted between June 2009 and June 2010. A total of 1,410 primary-school students (China grades 4 - 6) in Changsha city were divided into normal weight (n = 1,084), overweight (n = 211), and obese groups (n = 115) according to world health organization (WHO) growth standards for body mass index (BMI). The students were assessed using the self-esteem scale (SES) and a general situation questionnaire. Caregivers completed questionnaires about their child’s weight status. Self-esteem levels were explored; any factors related to low self-esteem were analyzed using logistic regression analysis.

Results

The average self-esteem score among overweight or obese primary-school students was found to be lower than that of normal-weight students. The proportion of students with low self-esteem in the obese group was more than that in the normal-weight and overweight groups. Multiple logistic regression analysis showed that obesity status (odds ratio [OR], 3.74; 95% confidence interval [CI], 2.25 - 6.22), overweight status (OR, 2.60; 95% CI, 1.71 - 3.95), obesity considered by children’s grandparents (OR, 1.76; 95% CI, 1.05 - 2.96), dissatisfaction with height (OR, 1.55; 95% CI, 1.11 - 2.18), and dissatisfaction with weight (OR, 1.45; 95% CI, 1.05 - 2.01) were the risk factors for low self-esteem for primary-school students, while satisfaction with academic performance was a protective factor (OR, 0.22; 95% CI, 0.07 - 0.71).

Conclusions

For Chinese primary-school students, low self-esteem is associated with higher weight status and self-perceived body shape and academic performance. In addition, grandparental opinion of a child’s weight also contributes to low self-esteem.

Do body-related shame and guilt mediate the association between weight status and self-esteem?

Individuals who are overweight or obese report body image concerns and lower self-esteem. However, little is known about the mechanisms underpinning these associations. The objective of this study was to test body-related shame and guilt as mediators in the association between weight status and self-esteem. Young adult participants (n = 790) completed assessments of self-esteem and body-related guilt and shame, and weight status indicators were measured by trained technicians. Findings from multiple mediation analyses suggest that body-related shame mediates the relationship between weight status and self-esteem. If replicated in longitudinal studies, these findings suggest that reducing body-related emotions may have important implications for improving self-esteem in clinical weight management.

Overweight, perceived overweight and involvement in bullying in middle adolescence

Overweight is reportedly a risk factor for being bullied, and body image may mediate this association. Research on associations between overweight and bullying has so far only focused on children and early adolescents. We explored associations between actual and perceived overweight at age 15 and involvement in bullying at ages 15 and 17. A total of 2070 Finnish adolescents responded to a survey at ages 15 and 17. Self-reported weight and height, perceived weight and involvement in bullying were elicited. Being overweight at age 15 was not associated with being bullied or with being a bully at age 15 or 17. Perceived overweight among girls was associated with subsequent involvement in bullying as a bully and in feeling shunned. Weight related bullying may decrease from pre- and early adolescence to middle adolescence. The associations between perceived overweight and self-identification as a bully, and those between perceived overweight and feeling isolated may be explained by the phenomena representing psychological dysfunction.

Weight-based bullying and compromised peer relationships in young adult bariatric patients

The experience of weight-based bullying in young adult bariatric patients has not yet been examined. Thirteen young adults (age, 18-24) that were seeking or had undergone bariatric surgery participated in semi-structured in-depth interviews. A thematic analysis informed by grounded theory principles was conducted. Analysis revealed the following three major themes: (1) being the biggest kid, (2) coping through avoidance, and (3) compromised peer and intimate relationships. Victims of weight-based bullying often avoid and withdraw socially in response to persistent verbal abuse. The decision to pursue bariatric surgery at a relatively young age adds another dimension of difficulty when navigating peer relationships.

Weight status and body image perceptions in adolescents: current perspectives

Adolescence represents a pivotal stage in the development of positive or negative body image. Many influences exist during the teen years including transitions (eg, puberty) that affect one’s body shape, weight status, and appearance. Weight status exists along a spectrum between being obese (ie, where one’s body weight is in the 95th percentile for age and gender) to being underweight. Salient influences on body image include the media, which can target adolescents, and peers who help shape beliefs about the perceived body ideal. Internalization of and pressures to conform to these socially prescribed body ideals help to explain associations between weight status and body image. The concepts of fat talk and weight-related bullying during adolescence greatly contribute to an overemphasis on body weight and appearance as well as the development of negative body perceptions and dissatisfaction surrounding specific body parts. This article provides an overview of the significance of adolescent development in shaping body image, the relationship between body image and adolescent weight status, and the consequences of having a negative body image during adolescence (ie, disordered eating, eating disorders, and dysfunctional exercise). Practical implications for promoting a healthy weight status and positive body image among adolescents will be discussed.

Is subjective perception of negative body image among adolescents associated with bullying?

Adolescents' body image dissatisfaction has an adverse effect on peer relationships. It may lead to changes in behaviour (aggressive or passive) and consequently to bullying behaviour. Our aim was to assess the association between body image dissatisfaction and involvement in bullying and whether this differs by gender. We used data from the Slovak part of the 2010 Health Behaviour in School-aged Children study. The final sample comprised 8050 adolescents aged 11 to 15 years old (mean age 13.57), less than half of whom were boys. The association between self-reported body image and involvement in bullying was determined using multinomial logistic regression. We found a significant association between body dissatisfaction and involvement in bullying. Adolescents dissatisfied with their bodies because due to feeling overweight were more likely to become passive or reactive victims. Self-reported thinness was found to be significantly associated with bully-victims only in boys.

CONCLUSION

Adolescent body dissatisfaction is strongly associated with bullying behaviour. Our findings point out the importance of incorporating at schools different types of intervention programmes supporting positive self-perceptions of adolescents and reducing bullying behaviour.

'I just don't want to get bullied anymore, then I can lead a normal life'; Insights into life as an obese adolescent and their views on obesity treatment

BACKGROUND

Adolescent obesity is a complex condition involving social, emotional, behavioural and cultural issues.

DESIGN

One-to-one interviews and small focus groups with overweight and obese young people were conducted. Qualitative research is an appropriate method to explore the complexity of this issue.

SETTING AND PARTICIPANTS

Overweight and obese adolescent's attending a community weight management intervention in South Yorkshire.

MAIN VARIABLES STUDIED

Interviews aimed to explore the experiences of obese adolescents and their perspectives towards obesity treatment.

RESULTS

Adolescent's provided detailed accounts of their perspectives on weight gain, alluding to disordered patterns of eating and overeating, reported as being triggered by social and emotional factors, and in particular, bullying. Avoidance of bullying and a desire to integrate socially with peers were key drivers to seek treatment. Young people reported what they should do to lose weight, yet responsibility for successful weight loss and lifestyle change was repeatedly attributed to the treatment received, as opposed to viewing this as a combination of self-motivation coupled with support provided by friends and family.

CONCLUSION

Weight loss programmes need to consider the complex experience of obese young people in their design, focusing on how to implement long-term lifestyle changes.

Developmental associations between victimization and body mass index from 3 to 10 years in a population sample

In the current prospective study, we investigated (1) whether high and low BMI in early childhood puts a child at risk of victimization by their peers, and (2) whether being victimized increases BMI over the short- and long-term, independent of the effect of BMI on victimization. We also examined whether gender moderated these prospective associations. Participants were 1,344 children who were assessed yearly from ages 3 to 10 years as part of the Québec Longitudinal Study of Child Development (QLSCD). BMI predicted annual increases in victimization for girls aged 6 years and over; for boys aged 7 and 8 years of age, higher BMI reduced victimization over the school year. Further, victimization predicted annual increases in BMI for girls after age 6 years. When these short-term effects were held constant, victimization was also shown to have a three and 5-year influence on annual BMI changes for girls from age 3 years. These short- and long-term cross-lagged effects were evident when the effects of family adversity were controlled. The findings support those from previous prospective research showing a link between higher BMI and victimization, but only for girls. Further, being victimized increased the likelihood that girls would put on weight over time, which then increased future victimization. The implications of these prospective findings for interventions are considered. Aggr. Behav. 42:109-122, 2015. © 2015 Wiley Periodicals, Inc.