Bullying is a type of repeated, aggressive behaviour intended to harm another person. It involves a real or perceived power imbalance between the person (or group of people) who bullies and those who are bullied. Bullying can take many forms, including verbal aggression, physical violence, relational bullying, and online abuse.

Bullying is relatively common among school-aged children. In the UK, 1 in 4 adolescents between the ages of 12 and 18 experience bullying each year (Ditch the Label, 2020). Research has shown that bullying can cause lasting harm to a young person’s well-being, increasing the risk of physical health problems, anxiety, depression, psychosis, and low school achievement. 

Several studies have also found a link between bullying and eating disorders. They show that young people who experience bullying are more likely to develop symptoms of different eating disorders, including bulimia nervosa and anorexia nervosa (Copeland et al. 2015).

With as many as one in five children experiencing disordered eating globally (López-Gil et al., 2023), their research is more important than ever. Understanding the causes of eating disorders is crucial to their prevention and treatment, making a difference in young people’s physical and mental well-being worldwide.

In this article, we look at the relationship between bullying and eating disorders, outlining the results of several key studies and exploring some of the theoretical explanations underneath.

We also touch on how our understanding of the relationship can help to both prevent and treat eating disorders.

What Are Eating Disorders?

Eating disorders (EDs) affect the way that a person relates to and behaves with food. There are lots of different types of eating disorders, but they usually involve using food to cope with difficult emotions or situations.

Eating disorders are serious mental health conditions that deserve immediate care and professional support.

Eating disorders can look very different from one person to another and can affect anyone, regardless of age, background, gender, ethnicity, or other identities. Someone with an eating disorder may:

• use food to cope with difficult emotions
• experience body dissatisfaction 
• value themselves primarily on their body shape or weight
• be scared of gaining weight
• feel out of control when they’re eating

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes several types of eating disorders, each with specific criteria. Sometimes, a person’s eating behaviours may not match one of these types, meaning they do not receive a diagnosis.

It’s important to remember that eating problems can be very serious even without a diagnosis and it’s vital that every individual can access the support that they need.

Some of the eating disorders laid out in the DSM-5 are:

• Anorexia nervosa, when someone isn’t eating enough food to stay healthy
• Bulimia nervosa, characterised by cycles of binging and purging
• Binge eating disorder, involving episodes of loss of control over eating
• Other specified feeding and eating disorder, when someone experiences emotions, behaviours, or body changes related to eating disorders but don’t meet all the criteria for one of the above disorders

Eating disorders are usually diagnosed during adolescence, although younger children may also struggle with disordered eating. Younger and older adults can also develop eating disorders and some eating disorders can continue for a long time. 

With treatment and support, most people can recover from eating disorders.

What Is the Relationship Between Bullying and Eating Disorders?

Eating disorders can have many different causes. While researchers are still not sure exactly how and why eating disorders develop, they likely result from a combination of different biological, personal, and environmental factors.

For some people, experiences of trauma may play an important role in the development of eating disorders. Research has found that the experience of trauma, including a variety of forms of abuse and neglect, is a risk factor for eating disorders in children, adolescents, and adults.

Trauma is also associated with eating disorder co-morbidity, where an individual lives with both an eating disorder and another mental health condition (Brewerton, 2007).

Bullying is one particular form of abuse that can affect young people. Studies show that both bullies and people who are bullied are at an increased risk of developing eating disorders

In 2015, Copeland et al. published a study that conducted 10 waves of interviews with 1420 young people between the ages of 9 and 25.

They explored the relationship between ‘bullies’, ‘victims’, and ‘bully-victims’ (young people who were both bullies and had been bullied) and symptoms of anorexia nervosa and bulimia nervosa. They found that:

• Children and adolescents who had been bullied were more likely to show symptoms of anorexia and bulimia, even when taking into account other mental health concerns and experiences of childhood adversity
• Bullies were more likely to show symptoms of bulimia and bully-victims showed higher levels of anorexia

Other studies have presented similar findings. A 2021 study found that individuals with a history of eating disorders were significantly more likely to have experienced bullying during childhood or adolescence, particularly verbal, indirect, and digital bullying (SØ. Lie et al, 2021).

Another study from the same year found that school-aged adolescents in Columbia who had medium to high exposure to bullying were at an increased risk of developing eating disorders (Quintero-Jurado et al., 2021). The following year, a study among 5208 young people in Brazil also found that being bullied predicted eating disorder behaviours (de Oliveira Galvão et al., 2022).

A meta-analysis of 22 studies found that people with eating disorders were two to three times more likely to have been bullied or teased about their appearance than those without (SØ. Lie et al, 2019).

Why Does Bullying Affect Eating Disorder Symptoms?

Researchers have suggested several different explanations for why bullying and bullying make eating disorder symptoms more likely. It’s likely that multiple different pathways may play a role.

Being Bullied, Anxiety and Depression

One possible pathway from bullying to eating disorders involves feelings of anxiety and depression. Being bullied is linked with subsequent increases in anxiety, depression, withdrawal, loneliness, and other difficult mental states.

These symptoms can also make it more likely that young people are bullied, causing a vicious cycle of increased peer victimisation and greater emotional distress (Reijintjes et al., 2010). 

Anxiety, depression, and eating disorders are also linked. Symptoms of anxiety and depression are more common among people with eating disorders, and people with anxiety or depressive disorders are more likely to engage in eating disorder behaviours (Garcia et al. 2020).

In their study, Copland et al. (2015) found that anxiety and depression constituted an indirect path from bullying to eating disorders. Their results supported the theory that individuals who are bullied may experience more anxiety and depression, in turn making the development of eating disorder symptoms more likely. 

Bullying and Eating Disorder Symptoms

Research has shown that bullying others is linked with symptoms of eating disorders, even when taking into account pre-existing symptoms (Copland et al., 2015). While the association between being bullied and eating disorders isn’t surprising, the link between bullies and eating disorders is less expected.

Some experts have suggested that disorder eating behaviours, such as diet restriction or weight loss, may be a strategy to maintain the social control necessary for – and acquired through – bullying. Restrictive eating disorder behaviours might represent another way of seeking control over themselves and the world around them.

Alternatively, young people who bully other people about their weight or body shape may become more conscious of their own weight and body in the process. Or, bullies may experience feelings of guilt and regret as a result of their actions and use food as a way of coping with their emotional distress.

Weight and Body-Related Teasing and Body Dissatisfaction

Bullying can take many forms, including verbal, physical, and relational abuse. Some young people are bullied or teased about their weight or their bodies.

Unsurprisingly, research suggests that weight and body-related teasing may increase body dissatisfaction among young people, affecting the way they perceive their bodies.

For many people with eating disorders, body dissatisfaction underlies their thought patterns and behaviours, causing them to restrict or change their diet to have a different body shape.

A meta-analysis found that both appearance and weight-based teasing are linked with body dissatisfaction. Weight-based teasing was also associated with dietary restraint and bulimic behaviours (Menzel et al. 2010). 

Bullying may affect a child’s self-esteem and body image from a very young age. One study among 10-year-olds found that social exclusion affected their perceptions of their general appearance and weight, as well as their beliefs about how others viewed their appearance. The study also found that appearance teasing was linked to body self-esteem (Lunde et al., 2006).

Moving Forward: Preventing and Treating Eating Disorders

Looking forward, it’s important to prioritise the prevention of bullying in schools. While stopping bullying would not prevent all young people from developing eating disorders, it could go some way to reducing their prevalence among teenagers and adolescents, as well as the prevalence of other mental health disorders.

The most effective strategies for reducing bullying usually involve improved supervision by parents and school staff alongside a clear, collective understanding that bullying of any form is not accepted.

At the same time, young people who are receiving treatment for eating disorders should be asked about their experiences with bullying.

Psychiatrists, psychologists and other professionals can work with young people to address these experiences and how they may have affected their present thoughts, feelings, and behaviours.

Cognitive-behavioural therapy techniques may help young people identify their emotional and cognitive responses to these experiences and change them into more positive ones.