Association of bullying victimization with overweight and obesity among adolescents from 41 low- and middle-income countries

Background: Data on the association between overweight/obesity and bullying victimization among adolescents are scarce from low- and middle-income countries. Objectives: We assessed the associations between overweight/obesity and bullying victimization in 41 low- and middle-income countries. Methods: Cross-sectional data from the Global School-based Student Health Survey were analyzed. Data on past-30 day bullying victimization (including type) and body mass index based on measured weight and height were collected. The 2007 WHO Child Growth reference was used to define overweight and obesity. Multivariable logistic regression (multinomial and binary) and meta-analyses based on country-wise estimates were conducted. Data on 114 240 adolescents aged 12-15 years were analyzed [mean age (SD) 13.8 (1.0) years; 48.8% girls]. Results: Among girls, compared to normal weight, overweight (OR=1.08; 95%CI=1.02-1.16; between-country heterogeneity I2=0.0%) and obesity (OR=1.20; 95%CI=1.07-1.34; I2=0.0%) were associated with significantly higher odds for any bullying victimization but no significant association was observed among boys. However, overweight and obesity were both associated with significantly increased odds for bullying by being made fun of because of physical appearance among both sexes [obesity (vs. normal weight): girls OR=3.42 (95%CI=2.49-4.71); boys OR=2.38 (95%CI=1.67-3.37)]. Conclusions: Effective strategies to reduce bullying of children with overweight/obesity are needed in low- and middle-income countries.