Teens who engage in especially controlling and unhealthy eating behaviors face a heightened risk of being bullied by their peers, a new study finds. And that, in turn, can lead to certain mental illnesses, such as depression, data from the study show.
Bullying used to be seen as a harmless rite of passage. “It turns out that’s complete bunk,” says William Copeland. “Being bullied isn’t something that makes kids stronger down the road,” he points out. Copeland is a psychologist at Duke University in Durham, N.C.
Bullying can have lasting impacts on mental and physical health. That’s what emerging data by Copeland and others show. Such health problems can include things like anxiety and depression. Previous data had shown that bullied students are more likely to develop eating disorders. Researchers in Canada now find hints that the opposite also might be true.
“In some kids, disordered eating might lead to bullying,” notes Tracy Vaillancourt. A psychologist in Canada, she works at the University of Ottawa in Ontario. Her studies focus on the links between bullying, eating disorders and depression. Understanding how these may relate is important, she says. It could help to prevent dangerous adolescent behaviors.
Along with Ottawa colleague Kirsty Lee, Vaillancourt focused on a group of more than 600 students. All were part of a Canadian study on mental health and bullying. Once each year, between grades 7 and 11, the students took part in a survey. They reported how often they had been bullied. They also answered questions about their moods. The survey sought to find out whether they often felt sad or anxious.
Other questions asked about unhealthy eating habits. How often did the students eat in secret, for instance? Did they ever vomit in secret — and on purpose — right after eating?
True eating disorders, a type of mental illness, tend to be fairly rare. They afflict only about one in every 50 people. Among the best known of these are anorexia (starving oneself) and bulimia (vomiting after eating). Answers to the new survey couldn’t diagnose whether someone had an actual eating disorder. However, they could point to certain behaviors — known as disordered eating — that can precede full-blown eating disorders. Traits of disordered eating include taking an overly controlling approach to eating. This might include exercising excessively after eating, to burn off calories. Or it could include secretly overeating, known as binging. Some people simply eat very, very little.
These behaviors are common. Half of high school girls engage in at least one of these behaviors, a large study found. One in three boys do, too.
In the new study, such unhealthy habits appeared before symptoms of depression at every time point, Vaillancourt and Lee report. Disordered eating also preceded bullying at two times (between grades 8 and 9 and between grades 10 and 11). This pattern held up in both boys and girls. However, disordered eating and depression were more tightly linked in girls, the data showed.
Lee and Vaillancourt published their findings online April 11 in JAMA Psychiatry.
A new risk factor
Disordered eating could be a new risk factor for bullying, the new data suggest. A risk factor is something that increases the chance that some other thing will occur.
The researchers don’t yet know why teens with disordered eating were more likely to be bullied the next year. “It’s possible they already are dealing with mental health difficulties,” says Vaillancourt. And that, she adds, may have made them “more vulnerable to bullying.”
Her team also can’t pinpoint why some kids develop unhealthy eating patterns in the first place. However, they note, it’s certainly possible that bullying before grade 7 — when this study began — might have played some role.
Problems at home also might have set the stage. The new study did not ask questions about a student’s home life. Still, notes Sue Swearer, “Being neglected or maltreated at home, or having a parent who is struggling with a mental illness, can put kids at risk for disordered eating and depression.” Swearer is an educational psychologist. She works at the University of Nebraska-Lincoln. Although she studies bullying, she did not take part in the new research.
The new findings might help to identify kids who may need a little extra support, Swearer suspects. That could be useful for school counselors, she adds. Their efforts to identify teens with unhealthy eating behaviors might become one step toward preventing future problems with bullying and depression, she explains.
Sometimes classmates may know about an eating problem before adults do. That’s why Copeland recommends that “if you have a friend struggling with disordered eating, step up and say something to a school counselor or other adult who can help.”
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adolescent Someone in that transitional stage of physical and psychological development that begins at the onset of puberty, typically between the ages of 11 and 13, and ends with adulthood.
anorexia Short for anorexia nervosa. It's a serious eating disorder that involves self-starvation (often accompanied by excessive exercise) to lose weight.
anxiety A nervous reaction to events causing excessive uneasiness and apprehension. People with anxiety may even develop panic attacks.
behavior The way something, often a person or other organism, acts towards others, or conducts itself.
bulimia Short for bulimia nervosa. It's an eating disorder that involves overeating followed by purging (deliberately vomiting up a meal).
bullying (v. to bully) A group of repeated behaviors that are mean-spirited. They can include teasing, spreading rumors about someone, saying hurtful things to someone and intentionally leaving someone out of groups or activities. Sometimes bullying can include attacks using violence (such as hitting), threats of violence, yelling at someone or abusing someone with violent language. Much bullying takes place in person. But it also may occur online, through emails or via text messages. Newer examples including making fake profiles of people on websites or posting embarrassing photos or videos on social media.
calorie The amount of energy needed to raise the temperature of 1 gram of water by 1 degree Celsius. It is typically used as a measurement of the energy contained in some defined amount of food.
colleague Someone who works with another; a co-worker or team member.
data Facts and/or statistics collected together for analysis but not necessarily organized in a way that gives them meaning.
depression (in medicine) A mental illness characterized by persistent sadness and apathy. Although these feelings can be triggered by events, such as the death of a loved one or the move to a new city, that isn’t typically considered an “illness” — unless the symptoms are prolonged and harm an individual’s ability to perform normal daily tasks (such as working, sleeping or interacting with others). People suffering from depression often feel they lack the energy needed to get anything done. They may have difficulty concentrating on things or showing an interest in normal events. Many times, these feelings seem to be triggered by nothing; they can appear out of nowhere.
diagnose To analyze clues or symptoms in the search for their cause. The conclusion usually results in a diagnosis — identification of the causal problem or disease.
disordered eating An unhealthy pattern of very controlled eating behaviors that often precedes full-blown eating “disorders.” Such behaviors may include exercising excessively to burn off calories, secretly overeating or secretly restraining food intake to the point that it resembles intentional starvation. It often develops in people who have a poor body image (they may feel too fat) or who feel unable to control other events in their lives.
eating disorder An illness of the mind involving dangerously unhealthy patterns of eating and weight loss or gain.
high school A designation for grades nine through 12 in the U.S. system of compulsory public education. High-school graduates may apply to colleges for further, advanced education.
link A connection between two people or things.
mental health A term for someone’s emotional, psychological and social well-being. It refers to how people behave on their own and how they interact with others. It includes how people make choices, handle stress and manage fear or anxiety. Poor mental health can be triggered by disease or merely reflect a short-term response to life’s challenges. It can occur in people of any age, from babies to the elderly.
online (n.) On the internet. (adj.) A term for what can be found or accessed on the internet.
peer (noun) Someone who is an equal, based on age, education, status, training or some other features. (verb) To look into something, searching for details.
psychiatry (adj. psychiatric) A field of medicine where doctors study and treat diseases of the human mind. Treatments may consist of talking therapies, prescription drugs or both. People who work in this field are known as psychiatrists.
psychologist A scientist or mental-health professional who studies the human mind, especially in relation to actions and behaviors.
risk The chance or mathematical likelihood that some bad thing might happen. For instance, exposure to radiation poses a risk of cancer. Or the hazard — or peril — itself. (For instance: Among cancer risks that the people faced were radiation and drinking water tainted with arsenic.)
survey (v.) To ask questions that glean data on the opinions, practices (such as dining or sleeping habits), knowledge or skills of a broad range of people. Researchers select the number and types of people questioned in hopes that the answers these individuals give will be representative of others who are their age, belong to the same ethnic group or live in the same region. (n.) The list of questions that will be offered to glean those data.
symptom A physical or mental indicator generally regarded to be characteristic of a disease. Sometimes a single symptom — especially a general one, such as fever or pain — can be a sign of any of many different types of injury or disease.
trait A characteristic feature of something. (in genetics) A quality or characteristic that can be inherited.
Journal: K.S. Lee and T. Vaillancourt. Longitudinal associations among bullying by peers, disordered eating behavior, and symptoms of depression during adolescence. JAMA Psychiatry. Vol. 75, June 2018, p. 605. doi: 10.1001/jamapsychiatry.2018.0284.