Children and teenagers who are ridiculed about their weight end up gaining more weight in the long run than youngsters who aren’t teased, according to a new study from the National Institutes of Health.

The study was conducted by researchers with the Uniform Services University of the Health Sciences, Bethesda, Md., the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Diabetes and Digestive and Kidney Diseases. It was published Thursday in the journal Pediatric Obesity.

The context

Childhood and youth overweight and obesity are at epidemic proportions in the United States and are associated with numerous health problems, including type 2 diabetes, hypertension, sleep apnea and orthopedic complications. In addition, weight-based teasing is one of the most common reasons for bullying cited among youngsters in the U.S. According to previous research, 90 percent of high school students have witnessed their peers made fun of for their weight, and 60 percent of overweight youngsters have reported being teased about their weight by peers and family members. Teachers, coaches and healthcare providers have also been found to engage in fat shaming, as well.

However, few longitudinal studies have assessed the impact of weight stigma on weight gain and body composition, and those that did tended to focus on adults. But, the researchers noted, children who are overweight or obese are at risk of becoming adults with excess weight.

The data

The study involved 110 youths who were an average age of 11.8 years when they were enrolled. The participants were either overweight, with a body mass index (BMI) at or above the 85th percentile, or were considered at risk for excess weight because they had two parents who were overweight or obese. When they joined the study, they completed a six-item questionnaire about whether they had been teased about their weight. They were invited to participate in annual follow-up visits for the next 15 years.

Fifty-five percent of these youngsters were girls. Of the 110 participants, 53 percent were overweight and 47 percent were considered at risk. Altogether, 43 percent of all the participants reported at least one incident of weight-based teasing.

The results

Youngsters who reported high levels of weight-based teasing experienced a 33 percent greater gain in BMI per year compared to youth who did not experience weight-based teasing. That amounted to an average weight gain of .44 pounds more per year for the youths who experienced a high level of teasing compared to those who did not. Those who experienced high levels of teasing also experienced a 91 percent greater gain in body fat per year than the youth who didn’t get teased about their weight.

Weight-based teasing appeared to worsen the risk for excess weight, instead of motivating a young person to attempt to control their weight. The researchers theorized, based on past studies, that ridicule about excess weight made youths more likely to engage in unhealthy coping behaviors like binge eating and avoiding exercise. Another possible explanation for the study outcomes was the stress of being teased could have sparked the release of the hormone cortisol, which can stimulate appetite and lead to weight gain.

The caveats

The study’s limitations include the relatively small study sample size, and the participants were all non-Hispanic black and white youngsters.

Next steps

The authors say more research is needed to explore these findings, including the unique effects of different kinds of weight stigmatizing, such as cyberbullying and social exclusion.

In addition, the researchers said, continued efforts should be made to educate people about the potentially harmful impacts of weight-based teasing.