Fatty, Fatty, Two-by-Four: Weight-Teasing History and Disturbed Eating in Young Adult Women

摘要

Objective. We investigated the long-term effect of weight teasing during childhood. Methods. Young adult women (n?=?1533; aged 18–26 years) from 3 large universities participated in a survey (Fall 2009 to Spring 2010) that assessed disturbed eating behaviors; weight status at ages 6, 12, and 16 years; and weight-teasing history. Results. Nearly half of the participants were weight-teased as a child. Participants who experienced childhood weight teasing were significantly more likely to have disturbed eating behaviors now than non–weight-teased peers. As the variety of weight teasing insults recalled increased, so did disturbed eating behaviors and current body mass index. Those who recalled their weight at ages 6, 12, or 16 years as being heavier than average endured weight teasing significantly more frequently and felt greater distress than their lighter counterparts. Conclusions. Weight teasing may contribute to the development of disturbed eating and eating disorders in young women. Health care professionals, parents, teachers, and other childcare givers must help shift social norms to make weight teasing as unacceptable as other types of bullying. To protect the health of children, efforts to make weight teasing unacceptable are warranted. Nearly one quarter of the population is subjected to taunts and jeers, such as “chubby,” “tubby,” and “fatso,” during their lifetimes. 1 Weight-related teasing is especially prevalent during childhood and adolescence, 2,3 and may be on the rise with the increasing rates of overweight and obesity in youths. 4 At greatest risk for being teased are those who have “violated” social norms. 5 Social norms, a construct of the Theory of Reasoned Action and Theory of Planned Behavior, 6 are “written and unwritten rules that define ‘appropriate’ thoughts, feelings, and behaviors of a culture and exert pressure on people to believe and behave in a certain way.” 7 (p152) In fact, overweight youths are the targets of weight-related teasing more often than their average-weight peers—about one fifth of average-weight girls and nearly half of overweight girls report being teased about their weight at least a few times each year. 2 Females are at greater risk for weight-teasing insults than males, 8 perhaps because of greater societal pressures to achieve the “thin ideal” body type. 9,10 According to Haines et al., “Despite increased media and research attention on bullying and hate speech, weight-related teasing and the biased weight-related norms that influence such behaviors do not appear to be abating.” 11 (pS23) The prevalence and persistence of weight teasing is troubling because of the pernicious effects it can have on physical and emotional health. 12 Weight-related teasing can lead to poorer overall health, diminished social well-being, and body dissatisfaction. 13 Even more worrisome are longitudinal research findings linking weight teasing insults to disturbed eating behaviors. 14,15 Disturbed eating includes unhealthy or extreme weight-control behaviors, such as self-induced vomiting and medication misuse (e.g., laxatives), and binge eating. 16,17 These practices can escalate into a full-blown eating disorder. 16,17 Longitudinal data indicate that disturbed eating behaviors are common in adolescence and track into young adulthood, thereby placing youths at an increased eating-disorder risk. 18 Little is known about the long-term effects of weight teasing during childhood on eating behaviors. In addition, previous investigations of weight-related teasing and disturbed eating practices did not use instruments that assessed the full array of eating disorder diagnostic criteria elucidated in the Diagnostic Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) . 19 Previous weight-teasing research also has neglected exploration of other salient disturbed eating behaviors, such as emotional eating, disinhibited eating, and dichotomous thinking with regard to food. Increased emotional eating (i.e., eating in response to a mood) and disinhibited eating (i.e., uncontrolled eating) are common among dieters and binge eaters. 20,21 Although identified as a common factor among those who have eating disorders, 22 dichotomous thinking (i.e., rigid, “black and white” cognitive thinking style) remains an understudied psychological construct. 22,23 The rigid dietary “rules” in dichotomous thinking (e.g., good food vs bad food) may help maintain disturbed eating behaviors and increase the frequency of behaviors (e.g., binge eating, purging) following any breach of dietary rules. 24 This “all or nothing” attitude toward eating may place an individual at risk for eating disorders. The goal of this research was to expand our understanding of the long-term effect of weight teasing during childhood on a broad array of current disturbed eating behaviors of healthy young adult women. A second goal was to explore relationships among recollections of body weight durin