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(Reuters Health) - For overweight adolescents, experiencing discrimination or bullying in the first year of middle school may contribute to emotional issues seen in the third year by worsening loneliness and anxiety, a U.S. study suggests.

"We know that heavier youth are likely to be dissatisfied with their bodies at any one time," said lead author Jaana Juvonen of the University of California, Los Angeles.

"However, we were surprised at our longitudinal findings: that we can predict emotional problems during the last year in middle school (8th grade) based on youth's BMI during the first year (6th grade) in middle school when taking into account whether they have been mistreated by peers because of their weight," Juvonen told Reuters Health by email.

The researchers used data from a larger long-term study of 26 California middle schools, where data on body mass index (BMI), a measure of weight relative to height, was collected for about 5,000 kids in the spring semester of sixth grade - their first year in middle school - and again in seventh grade and eighth grade, the final year of middle school.

The kids, who were racially and ethnically mixed and about 52 percent female, also answered questions each year about their own emotional health, including body dissatisfaction, social anxiety and loneliness. They rated their experiences of bullying on questionnaires including items on exclusion, disrespectful treatment, threats or name calling by their peers because of their weight.

At each grade level, almost a quarter of kids were overweight or obese based on BMI categories, and one third of the entire group said they'd experienced at least one weight-based discrimination in seventh grade.

Researchers found that individual kids' perceptions of weight-based discrimination in seventh grade were a better predictor than actual BMI of their body dissatisfaction, social anxiety and loneliness in eighth grade, according to the report in Journal of Clinical Child and Adolescent Psychology.

For girls, this was also true for so-called somatic (physical) symptoms of emotional issues, such as headaches and nausea.

The results document an important process by which being overweight potentially leads to poorer mental health, said Joseph P. Allen of the University of Virginia in Charlottesville, who was not part of the new study. "Even after accounting for where they started, adolescents who experienced discrimination were more symptomatic two years later," he said by email.

"With non-experimental research, we can never prove causality," Juvonen said. "And we can obviously not randomly assign heavy youth to conditions where some get discriminated by their peers and others do not."

Still, "when no one wants to sit with Skyler, or Skyler never gets invited to parties or is publicly humiliated in front of others, it is easy to see why Skyler feels lonely or socially anxious," Juvonen said.

"Not only do we see peer discrimination predicting loneliness and social anxiety over time for both boys and girls, but we also see that girls who report such discrimination feel increasingly sick," she said. "Feeling physically sick, lonely, and socially anxious are likely to make youth withdraw from social situations."

Some body dissatisfaction can happen without peer discrimination, she noted. "Social comparisons to others (e.g., Facebook pictures, magazine photos) are likely to increase body dissatisfaction especially among girls because they compare themselves to (thin) ideals," Juvonen said. "If looks are important to them, they may also have low self-esteem or feel depressed."

Bullying shapes social norms by indicating what is not accepted or tolerated, and may extend even to kids in the healthy weight range, she said.

"Explicit efforts to address weight and body shape issues might be needed especially in middle school when bodies change at different rates and ways due to pubertal maturation," she said.

Adults should let students know just why making a "harmless" joke at someone else's expense reflects badly on the students using it, Allen told Reuters Health.

SOURCE: bit.ly/2cTOZhE Journal of Clinical Child and Adolescent Psychology, online September 12, 2016.

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Weight discrimination may worsen young teens' emotional problems

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(Reuters Health) - For overweight adolescents, experiencing discrimination or bullying in the first year of middle school may contribute to emotional issues seen in the third year by worsening loneliness and anxiety, a U.S. study suggests.

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One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a 'personal weakness' still exist.

A person who is considered 'mentally healthy' is someone who can cope with the normal stresses of life and carry out the usual activities they need to in order to look after themselves; can realise their potential; and make a contribution to their community. However, your mental health or sense of 'wellbeing' doesn't always stay the same and can change in response to circumstances and stages of life.

Everyone will go through periods when they feel emotions such as stress and grief, but symptoms of mental illnesses last longer than normal and are often not a reaction to daily events. When these symptoms become severe enough to interfere with a person's ability to function, they may be considered to have a significant psychological or mental illness.

Someone with clinical depression, for example, will feel persistent and intense sadness, making them withdrawn and unmotivated. These symptoms usually develop over several weeks or months, although occasionally can come on much more rapidly.

Mental health problems are defined and classified to help experts refer people for the right care and treatment. The symptoms are grouped in two broad categories - neurotic and psychotic.

Neurotic conditions are extreme forms of 'normal' emotional experiences such as depression, anxiety or obsessive compulsive disorder (OCD). Around one person in 10 experiences these mood disorders at any one time. Psychotic symptoms affect around one in 100 and these interfere with a person's perception of reality, impairing their thoughts and judgments. Conditions include schizophrenia and bipolar disorder.

Mental illness is common but fortunately most people recover or learn to live with the problem, especially if diagnosed early.

How common are mental illnesses in the UK?

Anxiety will affect 10% of the population

Bipolar disorder will affect one in 100

One in every 150 15-year-old girls will get anorexia, and one in every 1000 15-year-old boys

20% of people will become depressed at some point in their lives

OCD will affect 2%

Personality disorder will affect one in 10, though for some it won't be severe

Schizophrenia will affect one in 100

Source: Royal College of Psychiatrists

The exact cause of most mental illnesses is not known but a combination of physical, psychological and environmental factors are thought to play a role.

Many mental illnesses such as bipolar disorder can run in families, which suggests a genetic link. Experts believe many mental illnesses are linked to abnormalities in several genes that predispose people to problems, but don't on their own directly cause them. So a person can inherit a susceptibility to a condition but may not go on to develop it.

Psychological risk factors that make a person more vulnerable include suffering, neglect, loss of a parent, or experiencing abuse.

Difficult life events can then trigger a mental illness in a person who is susceptible. These stressors include illness, divorce, death of a loved one, losing a job, substance abuse, social expectations and a dysfunctional family life.

A mental illness can not be 'tested' by checking blood or body fluids. Instead it is diagnosed, usually by an experienced psychiatrist or clinical psychologist, after studying a patient's symptoms and monitoring them over a period of time.

How ICD-10 classifies bipolar affective disorder:

'A disorder characterized by two or more episodes in which the patient's mood and activity levels are significantly disturbed, this disturbance consisting on some occasions of an elevation of mood and increased energy and activity (hypomania or mania) and on others of a lowering of mood and decreased energy and activity (depression). '

Many different mental illnesses can have overlapping symptoms, so it can be difficult to tell the conditions apart.

To diagnose a mental health condition, psychiatrists in the UK may refer to the World Health Organisation's International Classification of Diseases ( ICD) system. This lists known mental health problems and their symptoms under various sub-categories. It is updated around every 15 years.

Some experts argue that the current system relies too strongly on medical approaches for mental health problems. They say it implies the roots of emotional distress are simply in brain abnormalities and underplay the social and psychological causes of distress.

They argue that this leads to a reliance on anti-depressants and anti-psychotic drugs despite known significant side-effects and poor evidence of their effectiveness.
For symptoms and more information, visit NHS Choices

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When does your mental health become a problem?

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One in four people are expected to experience a mental health problem, yet stigma and discrimination are still very common. Myths such as assuming mental illness is somehow down to a 'personal weakness' still exist.