Weight-based teasing, body dissatisfaction, and eating restraint: Multilevel investigation among primary schoolchildren

Objective: Weight-based teasing is a form of weight-based stigmatization that is especially prevalent in middle childhood, and is associated with undesired health outcomes, including body dissatisfaction and eating restraint. To date, this relation has been mainly investigated at individual level only. This study aimed to examine whether body dissatisfaction and eating restraint among primary schoolchildren relate not only to personal experiences of weight-based teasing, but also to the prevalence of weight-based teasing episodes in the classroom. Method: A sample of 744 primary schoolchildren (52.04% girls; M-age = 9.82 +/- .95) from 84 classes completed a survey regarding weight-based teasing, body dissatisfaction and eating restraint. Parent-reported anthropometric data were used to compute standardized Body Mass Index (zBMI). Results: Multilevel structural equation models highlighted that, at the individual level, weight-based teasing is indirectly associated with body dissatisfaction and eating restraint through weight-based teasing. A contextual effect of weight-based teasing at the classroom level also emerged in relation to eating restraint, but not to body dissatisfaction. Specifically, the prevalence of weight-based teasing in the classroom is associated with children's eating restraint-above and beyond personally experienced teasing episodes. Conclusions: Findings showed that weight-based teasing may be negatively associated with health and psychological wellbeing not only among children who experience weight-based teasing episodes, but also among other members of a class in which weight-based teasing is more prevalent. Programs to reduce weight-based stigma in middle childhood should consider the classroom as a primary target of intervention.