How is weight teasing cross-sectionally and longitudinally associated with health behaviors and weight status among ethnically/racially and socioeconomically diverse young people?

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BACKGROUND: Weight stigma is prevalent among young people and harmful to health. The current study used a health equity lens to examine cross-sectional and longitudinal associations between experiencing weight teasing (a form of weight stigma) with a range of weight-related health behaviors and weight status in an ethnically/racially and socioeconomically diverse sample of young people. We also assessed whether ethnicity/race and adolescent socioeconomic status (SES) operated as effect modifiers in these relationships.

METHODS: Adolescents (n = 1568) were enrolled in EAT 2010-2018 (Eating and Activity over Time) and followed into young adulthood. Weight teasing; screen time; moderate-to-vigorous physical activity (MVPA); sleep duration; breakfast frequency; fruit, vegetable, sugar-sweetened beverage (SSB), and fast-food intake; and body mass index (BMI) were assessed at baseline (mean age = 14.4 years) and eight-year follow-up (mean age = 22.2 years). Multivariate linear regression estimated marginal means and 95% confidence intervals. All analyses adjusted for BMI and sociodemographic characteristics.

RESULTS: Weight teasing was cross-sectionally associated with longer screen time, shorter sleep duration, and higher BMI during adolescence; and cross-sectionally associated with shorter sleep duration, lower breakfast frequency, higher fast-food intake, higher SSB intake, and higher BMI during young adulthood. In the longitudinal analyses, weight teasing was not associated with health behaviors but did predict higher BMI (teased: 28.2 kg/m 2, not teased: 26.4 kg/m 2, p < 0.001). White and higher adolescent SES subgroups had higher MVPA, more frequent breakfast intake, lower fast-food intake, and lower BMI than their respective counterparts. The relationships between weight teasing and health behaviors and weight status were largely consistent across ethnic/racial and adolescent SES subgroups.

CONCLUSIONS: Findings add to growing evidence that weight-based mistreatment poses a threat to weight-related health and that young people across ethnic/racial and SES subgroups are vulnerable to the negative effects of weight teasing. Limitations include attrition at follow-up and the self-reported nature of many measures. Results suggest a need for increased attention to existing recommendations to reduce weight stigma in young people from diverse ethnic/racial and socioeconomic backgrounds including training for healthcare providers to better equip them to address the harms of weight teasing and foster more compassionate care to promote health-supporting behaviors in young people.

Original languageEnglish (US)
Article number71
JournalInternational Journal of Behavioral Nutrition and Physical Activity
Issue number1
StatePublished - Dec 2022

Bibliographical note

Funding Information:
This study was supported by grant numbers R01HL127077 and R35HL139853 from the National Heart, Lung, and Blood Institute (PI: Dianne Neumark-Sztainer). Laura Hooper’s time was supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, grant numbers TL1R002493 and UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute, the National Institutes of Health, or the Health Resources and Services Administration.

Publisher Copyright:
© 2022, The Author(s).


  • Adolescent
  • Body mass index
  • Dietary habits
  • Eating behavior
  • Health behavior
  • Obesity
  • Physical activity
  • Social stigma
  • Weight teasing
  • Young adult
  • Body Mass Index
  • Body Weight
  • Cross-Sectional Studies
  • Humans
  • Feeding Behavior
  • Health Behavior
  • Young Adult
  • Health Promotion
  • Adult

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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