Associations of weight- or shape-related bullying with diverse disordered eating behaviors in adolescents

Determinants of Disordered Eating Behaviours (DEBs) among Adolescent Female School Students in Riyadh, Saudi Arabia: A Qualitative Study

The risk of DEB is more prevalent in girls, particularly during adolescence. The onset of DEB can be triggered by many inter-related factors, including biological, social, parental, and psychosocial. To date, very little is known about the determinants of DEBs in Saudi adolescent girls. Using a qualitative analysis, this study explored potential determinants of DEB among adolescent girls in Riyadh. Eighteen semi-structured interviews were carried out with adolescent girls (mean age = 14.06, SD = 0.87) who reported a high risk of DEB (EAT-26 ≥ 20) in intermediate and secondary schools in Riyadh. The mean weight was 51 kg (SD = 11.8) with BMI ranging from 14.18 kg/m2 to 27.51 kg/m2. EAT-26 scores ranged from 21 to 42 (M = 26.8, SD = 5.6). Data were transcribed and revised, then themes and sub-themes were assigned using MAXQDA 24. The most common DEBs reported were dieting and binging, followed by induced vomiting. Major themes were related to negative cognitions, conscious imitation/copying behaviours, bullying, comparisons, and negative comments. Some participants identified the possibility of biological and familial factors in increasing the likelihood of DEB. Our findings provide a framework that could be used to increase understanding of DEB and inform the development of interventions to address underlying causes of DEB in Saudi adolescent girls.

Screen time, social media use, and weight-related bullying victimization: Findings from an international sample of adolescents

Screen time, social media, and weight-related bullying are ubiquitous among adolescents. However, little research has been conducted among international samples. Therefore, the aim of this study was to determine the association between screen time, social media use, and weight-related bullying victimization among an international sample of adolescents from six countries. Data from the 2020 International Food Policy Study Youth Survey were analyzed (N = 12,031). Multiple modified Poisson regression models were estimated to determine the associations between weekday hours of five forms of screen time, and total screen time, and use of six contemporary social media platforms and weight-related bullying victimization. Analyses were conducted among the overall sample, and stratified by country (Australia, Canada, Chile, Mexico, United Kingdom, United States). Greater hours of weekday screen time and use of each of the six social media platforms were associated with weight-related bullying victimization among the sample. Each additional hour of social media use was equivalent to a 13% (confidence interval [CI] 1.10-1.16) increase in the prevalence of weight-related bullying victimization. The use of Twitter was associated with a 69% (CI 1.53-1.84) increase in the prevalence of weight-related bullying victimization. Associations between hours of weekday screen time, use of six social media, and weight-related bullying victimization differed by country. Findings underscore the associations between screen time, social media, and weight-related bullying among a sample of adolescents from six medium- and high-income countries. Country-specific and global public health and technology efforts are needed to address this burgeoning social problem.

A systematic review of weight stigma and disordered eating cognitions and behaviors

Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.

Impact of a Web-Based Nutrition Intervention on Eating Behaviors and Body Size Preoccupations among Adolescents

We aimed to evaluate the impact of a web-based school nutrition intervention on eating behavior traits, body weight concern, body size perception and body size dissatisfaction in adolescents. Ten classes of secondary students in Canada (13.6 ± 0.8 years) were randomized into an intervention (n = 162 students) or control group (n = 75 students). Adolescents in the intervention, conducted between 2011 and 2013, participated in an online nutrition challenge to increase their consumption of vegetables, fruits and dairy products using a web-based platform over six weeks. Measurements were taken at baseline (PRE) and post-intervention (POST). No significant negative changes were observed between the intervention and control groups for eating behavior traits, body weight concern, body size perception and dissatisfaction. However, results suggest a trend for a positive effect of the intervention on susceptibility to hunger in boys (group × time interaction, p = 0.10). Specifically, boys experienced a reduction in their susceptibility to hunger in response to the intervention (PRE: 6.1 ± 3.8, POST: 4.8 ± 3.7, p = 0.009). An intervention aimed at improving the eating habits of adolescents did not negatively influence body size preoccupations. In response to the intervention, boys tended to show a lower susceptibility to hunger, which might help them to prevent overeating and adopt healthy eating habits.

School absenteeism and impairment associated with weight bullying

INTRODUCTION

Many children experience weight-based bullying (WB), when individuals are treated poorly or demeaned because of weight. WB has negative mental and physical health consequences. The current study examined how children's experiences of different forms of WB (verbal, social, physical, cyber) were associated with impaired functioning in school, social life, and family life.

METHODS

Data were collected in Spring 2021. Participants (N = 224) were parents of a school-aged child and lived in the United States. Sixty percent of parents were mothers and 72% of parents self-identified as White. They completed surveys regarding weight, eating, and bullying.

RESULTS

Social and cyber WB were associated with clinically significant impairment for both children and parents. Children who experienced social and physical WB were more likely to skip school, whereas physical and cyber WB were associated with skipping a particular class. All forms of bullying were associated with skipping gym class. Social and cyber WB were associated with isolating. Cyber WB was associated with all disordered eating behaviors. In addition, physical WB was associated with binge eating, social WB was associated with purging, and verbal WB was associated with secretive eating.

DISCUSSION

Victims of WB experience impairment in school, social life, and family life, absenteeism, and disordered eating. It is essential to develop approaches to address WB in its various forms to identify strategies for reducing and preventing WB across various levels of influence, including peer groups, schools, and families.

Development of transdiagnostic clinical risk prediction models for 12-month onset and course of eating disorders among adolescents in the community

OBJECTIVE

To develop and internally validate risk prediction models for adolescent onset and persistence of eating disorders.

METHODS

N = 963 Australian adolescents (11-19 years) in the EveryBODY Study cohort completed online surveys in 2018 and 2019. Models were built to predict 12-month risk of (1) onset, and (2) persistence of a DSM-5 eating disorder.

RESULTS

Onset Model. Of the n = 687 adolescents without an eating disorder at baseline, 16.9% were identified with an eating disorder after 12 months. The prediction model was based on evidence-based risk factors for eating disorder onset available within the dataset (sex, body mass index percentile, strict weight loss dieting, history of bullying, psychological distress, weight/shape concerns). This model showed fair discriminative performance (mean AUC = .75). The most important factors were psychological distress, weight and shape concerns, and female sex. Diagnostic Persistence Model. Of the n = 276 adolescents with an eating disorder at baseline, 74.6% were identified as continuing to meet criteria for an eating disorder after 12 months. The prediction model for diagnostic persistence was based on available evidence-based risk factors for eating disorder persistence (purging, distress, social impairment). This model showed poor discriminative performance (mean AUC = .65). The most important factors were psychological distress and self-induced vomiting for weight control.

DISCUSSION

We found preliminary evidence for the utility of a parsimonious model for 12-month onset of an eating disorder among adolescents in the community. Future research should include additional evidence-based risk factors and validate models beyond the original sample.

PUBLIC SIGNIFICANCE

This study demonstrated the feasibility of developing parsimonious and accurate models for the prediction of future onset of an eating disorder among adolescents. The most important predictors in this model included psychological distress and weight and shape concerns. This study has laid the ground work for future research to build and test more accurate prediction models in diverse samples, prior to translation into a clinical tool for use in real world settings to aid decisions about referral to early intervention.

Outcomes of a Cluster Randomized Controlled Trial of the SoMe Social Media Literacy Program for Improving Body Image-Related Outcomes in Adolescent Boys and Girls

Although the negative effect of social media use among youth on body image and eating concerns has been established, few classroom-based resources that can decrease these effects through targeting social media literacy skills have been developed. This study aimed to test the efficacy of SoMe, a social media literacy body image, dieting, and wellbeing program for adolescents, through a cluster randomized controlled trial. Participants (n = 892; M_age = 12.77, SD = 0.74; range 11–15; 49.5% male) were randomized by school (n = 8) to receive either weekly SoMe (n = 483) or control sessions (lessons as usual; n = 409) over 4 weeks in their classroom. Participants completed surveys at four timepoints (baseline, 1-week post-intervention, and 6- and 12-month follow-up) assessing body dissatisfaction, dietary restraint, strategies to increase muscles (primary outcomes), self-esteem and depressive symptoms (secondary outcomes), and internalization of appearance ideals and appearance comparison (exploratory outcomes). Modest positive intervention effects were found in dietary restraint and depressive symptoms at 6-month follow-up in girls but few positive effects emerged for boys. The findings provide only preliminary support for a social media literacy intervention, but suggest the usefulness of both identifying those who benefit most from a universally delivered intervention and the need to refine the intervention to maximize intervention effects.