Health Risks of Weight-Based Bullying among LGBTQ Adolescents: Effects of Legislation as a Prevention Strategy

• In Event: Pathways to Adolescent Physical Health Outcomes: Unpacking the Power of Peers

Abstract

Background

Weight-based bullying is the most prevalent form of peer harassment across racial/ethnic groups (Bucchianeri et al., 2013) and carries significant health consequences for adolescents, including increased somatic symptoms (Juvonen et al., 2017), weight gain (Schvey et al., 2019), and disordered eating (Puhl et al., 2017). The health consequences of weight-based bullying are particularly salient among adolescents who identify as a sexual and/or gender minority (SGM; Himmelstein et al., 2019). Thus, to support healthy adolescent outcomes, identifying strategies to reduce weight-based bullying (primary prevention) and its adverse health sequelae (secondary prevention) is a critical public health priority.

Despite the increasing use of legislation to address bullying in schools, there has been limited empirical examination on the efficacy of anti-bullying laws in reducing the prevalence of weight-based bullying and its adverse health sequelae. We tested whether anti-bullying legislation that includes weight as a protected class (i.e., enumeration) was associated with lower rates and health risks of weight-based bullying for SGM adolescents.

Methods

A cross-sectional observational study was conducted using data from the LGBTQ National Teen Survey collected in 2017 (Watson et al., 2019). Participants included 17,082 diverse SGM adolescents in grades 7 through 12 (Mage = 15.57 years, SDage = 1.27). Adolescents reported how often they have experienced weight-based bullying and responded to three indicators of health risk: unhealthy eating behaviors, stress, and self-rated health. Data on anti-bullying legislation were obtained from the U.S. Department of Health and Human Services comprehensive evaluation of state bullying laws and coded based on whether weight was, or was not, enumerated. Multilevel analyses were conducted.

Results

Higher levels of weight-based bullying were associated with more unhealthy eating behaviors (b = 0.19, 95% CI: 0.18 - 0.21), stress (b = 0.31, 95% CI: 0.29 - 0.34), and lower perceived health (b = -0.12, 95% CI: -0.13 – -0.11), even after controlling for relevant sociodemographic (e.g., race/ethnicity) and anthropometric (e.g., body mass index) characteristics. There was substantial variation across states in the rates of weight-based bullying (range = 49% - 86%). Three states had anti-bullying laws that provided special protections for individuals based on weight (i.e., weight enumeration). Weight-based bullying occurred significantly less frequently in states with anti-bullying laws that did, versus did not, enumerate weight. However, weight-based bullying was associated with greater health risk (i.e., more unhealthy eating behaviors, stress, and lower perceived health) in states with anti-bullying laws that enumerated weight.

Conclusions

Weight-based bullying represents a significant health risk for SGM adolescents. The current results suggest that adding weight as a protected class in state anti-bullying laws may be an effective mechanism of reducing weight-based bullying. However, to support healthy outcomes for adolescents who continue to experience weight-based bullying, it is likely critical to simultaneously stimulate victim support also within more proximal contexts (e.g., within schools, families, peer groups).

Authors

• Leah Marie Lessard, University of Connecticut
  Presenting Author

• Ryan J Watson, University of Connecticut
  Non-Presenting Author

• Hannah Schacter, Wayne State University
  Non-Presenting Author

• Christopher W Wheldon, Temple University
  Non-Presenting Author

• Rebecca M Puhl, University of Connecticut
  Non-Presenting Author