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Review of Rebecca Puhl and Jeorg Luedickes Weight Based Victimization Among
Adolescents in the School Setting: Emotional Reactions and Coping Behaviors

Meredith McCrea
Salem College

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Puhl and Luedickes study entitled Weight-Based Victimization Among Adolescents in
the School Setting: Emotional Reactions and Coping Behaviors and published in 2012 in
Youth Adolescence describes numerous types of bullying based on weight as well as the
ways that adolescents respond to that bullying both internally and through external
action. While it is known that bullying and particularly weight directed bullying is
frequent, there is not a great deal known about the emotional responses of teens who
experience this type of victimization and what their coping mechanisms (either positive
or negative) may be to deal with such an event. While this study does have limitations
and the need for broader, more expanded research is evident, Rebecca Puhl and Joerg
Luedicks research enumerates several significant responses and coping mechanisms, and
provides a good starting point for additional psychological investigation.
As the United States has experienced a startling increase in childhood obesity
instances of weight-based bullying have undoubtedly risen. As many as 34% of
adolescents are overweight and 30% of adolescents are obese, (Puhl and Luedicke,
2012) so very high numbers of teens have the potential to be targets of weight directed
bullying. The sheer volume of people who could experience bullying because of this
factor suggests that the psychological effects and coping mechanisms employed by
bullied youth are meaningful topics of study. It would seem to be important for
researchers to understand the immediate and long-term effects of adverse emotional and
physical treatment since it has potential to involve a large amount of the current and
future population of this country. Puhl and Luedicke chose to begin their study with an
initial sample of 1555 students who attended one of two high schools in Connecticut.
(Puhl and Luedicke, 2012) Students completed a significant number of self-report

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studies to determine eligibility and focus of the study. Of the initial 1555 students 394
were considered for the purposes of this particular study as they self-identified as having
experienced weight- based victimization. (Puhl and Luedicke, 2012) Fifty-six percent
were female and 84% were Caucasian. (Puhl and Luedicke, 2012) Students were
categorized as underweight, normal weight, overweight or obese based on their body
mass index (BMI) which was derived from their self-reported height and weight. Those
students who were categorized as underweight were not included any further in the
analysis because so few students met that criterion. Such an extremely small number of
underweight students reported being teased or bullied that those findings would have
proven to not be statistically significant or provided an appropriate, reliable basis for
comparison. (Puhl and Luedicke, 2012)
Students were asked questions broken down into the following five categories:
rate of teasing/bulling incidents, location of such incidents, affect responses to these
incidents, coping strategies, and school related responses to weight-based victimization.
(Puhl and Luedicke, 2012) Students were first asked about 28 different instances that
could be considered bullying and were asked to rate the frequency with which they had
experienced those behaviors on a five point scale ranging from very often to never.
(Puhl and Luedicke, 2012) The answers to all 28 questions were then summed and any
student having a sum answer greater than 1 was considered to have experienced weightbased victimization. Students were then asked to rate on the same 5-point very often to
never scale the frequency with which they experienced weight-based victimization in
eight locations throughout the school building. Those locations included the classroom,
gym, cafeteria, locker room, playground, school bus, bathroom and hallways. (Puhle and

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Luedicke, 2012) The questions about affect responses were used to identify and
categorize the emotional response that students had to teasing/bullying and were
measured by the students level of agreement with particular statements. These included
things like feeling sad, depressed angry or not bothered by teasing. (Puhl and Luedicke,
2012 p.31) Students were also asked to rate the frequency with which they employed 28
different enumerated coping strategies using the same 5-point very often to never
scale used in previous questions. The coping strategies were then parsed out and
redistributed into categories such as avoidance strategies and health behavior
strategies as well as those which centered around increased eating. (Puhl and Luedicke,
2012) Interestingly enough the school-related responses to victimization, which included
things like grades being impacted and rates of skipping class seemed to have much lower
rates of occurrence than other categories of behavior. (Puhl and Luedicke, 2012) Though
these questions were rated on a similar 5-point scale as other categories the responses
could be collapsed into a smaller number of variables given the similarity and
infrequency of responses.
It is also of note that there was a fairly high proportion of non-responses to
various questions, particularly among those students with lower BMIs. (Puhl and
Luedicke, 2012) There could be speculation that this was because students were either
embarrassed by or avoiding certain questions. However, this could not be ascertained
and all non-responses were treated as missing at random. (Puhl and Luedicke, 2012)
Overall, 40-50% of students who felt as though they had suffered weight-based
victimization reported that it made them feel sad, depressed, worse about themselves,
bad about their body and angry. (Puhl and Luedicke, 2012) Even worse, 15% of

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students reported feeling afraid as a result of weight based victimization. (Puhl and
Luedicke, 2012) It is of particular concern that girls experience significantly more
negative affect in response to weight based teasing than boys. (Puhl and Luedicke, 2012
p.31) As a society this means that an entire upcoming generation of women is being told
from an early age that their value is attached to their weight. It only furthers the negative
body image and potentially destructive behaviors and self-doubt that teens typically deal
with regardless of their weight. While school based responses like getting worse grades
and skipping class were less prevalent than other responses or coping mechanisms there
were still important and significant effects in that area. Specifically, the odds of
students reporting that their grades were harmed because of being victimized about their
weight increased by approximately 5% per teasing incident. (Puhl and Luedicke, 2012)
Given the fact that students reported as many as 74 individual incidents of weight-based
victimization this impact is alarming. Additionally, the odds of students skipping school
increased almost 5% per teasing incident. (Puhl and Luedicke, 2012) While boys
experienced negative affect most strongly from being teased in the classroom, girls were
likely to have negative emotions stemming from both classroom and gym class
victimization. (Puhl and Luedicke, 2012) Most importantly, girls were much more likely
to employ avoidance strategies if they had been teased in gym class than anywhere else.
(Puhl and Luedicke, 2012)

Students not being able to fulfill their academic potential

and missing valuable classroom instruction creates an additional problem of these

students not being as college and career ready as their peers in addition to the potential
for stifled emotional stability and psychological fortitude. While it was not clear that any
particular factors influenced girls using binge eating or increased food intake as a coping

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strategy, boys who were specifically teased in more private locations (locker rooms for
example) did more often employ those strategies. (Puhl and Luedicke, 2012) Puhl and
Luedicke also found that girls use more positive coping strategies than boys (2012),
which suggests that boys have not developed positive strategies or they do not feel they
are able to use them in response to these situations. Overall, while there is no clear
predictor either by location or type of teasing, it is safe to say that students who were
victimized at any point did response more frequently with avoidance and increased food
intake strategies. (Puhl and Luedicke, 2012.) Overall this study suggests that the
conditions and responses created by weight-based bullying may have far reaching and
multifaceted, negative implications as this generation ages.
Because the proportion of young adults struggling with being overweight and
obese has increased so dramatically and rapidly over the last 20 years the potential
dangers both physical and psychological of this epidemic merit swift and considerable
critical research. While the physical implications both short and long term of this weight
crisis are fairly apparent even to a cursory observer, the psychological effects are less
clear. There are many reasons to be concerned with the emotional and mental effects of
being overweight or obese and this is particularly true for adolescents. The young adult
years have been labeled formative for a reason. If people experience negative
emotional, psychological and social experiences related to weigh as teens, a period of
time in which they are developing a sense of self, and identity and many of the coping
skills they will employ as adults, this has the potential to have long lasting and far
reaching impact on their abilities to function positively as adults. As a society and a
country our future leaders would theoretically have less positive coping skills, rely more

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heavily on negative coping skills including avoidance, and suffer the ill effects of
continually feeling shamed, not worthy and embarrassed. This scenario does not paint a
picture of a thriving, emotionally fulfilled populous in years to come. Given the high
stakes outcomes that these types of occurrences present for the future of this country, this
topic is certainly worth studying in greater depth and scope. Obviously this study was
limited in a number of ways and further investigation would be necessary in order to
generalize results and potentially affect change in societal thinking and healthcare
funding allotment. Because this study was limited to only two schools both within the
same general geographic area, it would be important for future research to expand to
multiple locations throughout the country. Though not exactly the same limitation, the
location of the schools studied also creates a significantly narrowed pool of study
participants when trying to examine how students of color or with less socioeconomically
advantaged backgrounds respond to these types of occurrences. Because the school
locations were in areas that were primarily white and affluent, the study is limited by only
examining attitudes of a particular geographical subset and also only examining the
attitudes of mostly white and generally well off students. Without further diverse studies
that include a greater cross-section of all walks of American life it is not wise to expand
the conclusions of this study to apply to the greater population of overweight and obese
teens.

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References

Puhl, R., & Luedicke, J. (2012). Weight Based Victimization Among Adolescents in the
School Setting: Emotional Reactions and Coping Behaviors. Journal of Youth
Adolescence, 41, 27-40.