Teens with eating disorders can find themselves bullied

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.”