# Body image among bullied obese children: an Egyptian case-control study

## TL;DR

This study examines how bullying affects body image in obese Egyptian children, finding higher rates of bullying and emotional distress among them.

## Contribution

The study provides insights into the psychological impact of bullying on obese children in Egypt, linking it to body image dissatisfaction and emotional distress.

## Key findings

- Obese children experienced higher rates of school and family bullying compared to healthy controls.
- Obese children showed significantly higher sadness and lower self-esteem, especially among females.
- Family denial and negative school interactions were linked to increased emotional distress and bullying.

## Abstract

Childhood obesity is a rising worldwide health issue with significant physical, psychological, and social implications. Beyond physical health, obesity has profound psychological effects, particularly on body image perception and self-esteem, which can be exacerbated by bullying and social stigmatization.

To assess body image perception among bullied obese children in Egypt and to examine the relationship between obesity, bullying experiences, and body image dissatisfaction.

This case-control study was conducted on 86 Egyptian children aged 5 to 10 years who attended the outpatient nutrition and immunity clinic at the Medical Research Centre of Excellence (MRCE). A comprehensive, structured questionnaire and clinical examination were used and analyzed to assess participants.

The study included 86 children; 40 males and 46 females. Out of 86 children, 44 children were obese with mean of age (8.16 ± 1.78 y) and 42 were healthy children as controls with mean of age (7.69 ± 1.8. 55 y). A total of 27 children (34.6%) in the study population displayed acanthosis nigricans. Students in the obesity group reported higher rates of school bullying (36.4%) as compared to controls (11.9%). The family bullying was significantly higher in the obesity group at 40.9% compared to the control group at 7.1% (p = 0.001). A significant difference (p = 0.000) in sadness feeling was reported in obese children (56.8%) as compared with controls (11.9%). Children with family refusal showed statistically significant higher occurrences of expressing low self-esteem by refusing to be photographed (50%) and showing sadness (75%), especially in females.

This study highlights the obesity and its association with obesity-related health risks and emotional distress. School refusal was strongly linked to bullying and academic pressure. Negative school interactions affected family relationships, while family denial increased bullying and emotional distress. Females showed greater vulnerability to sadness than males.

The online version contains supplementary material available at 10.1186/s12889-026-26346-z.