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February 22, 2026BMC Public Health0 citationsOpen Access

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

NMNermine N. MahfouzMEMona A. ElabdAEAzza Abd El-Shaheed

Key Points

  • This research aims to evaluate body image perception and its relationship with obesity and bullying experiences in Egyptian children.
  • Conducted a case-control study involving 86 children aged 5 to 10 years.
  • Used a structured questionnaire and clinical examination for data collection.
  • Compared obesity group (44 children) to control group (42 children) regarding bullying and body image perceptions.
  • Obese children experienced higher rates of bullying (36.4%) compared to controls (11.9%).
  • Family bullying prevalence was significantly higher in obese children (40.9%) versus controls (7.1%).
  • Obese children reported significantly more feelings of sadness (56.8%) compared to controls (11.9%).
  • Higher rates of low self-esteem and sadness were observed among females, particularly concerning family denial.

Abstract

Abstract Background 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. Aim To assess body image perception among bullied obese children in Egypt and to examine the relationship between obesity, bullying experiences, and body image dissatisfaction. Methods 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. Results 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. Conclusion 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.

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Cite This Study

Mahfouz et al. (2026) studied this question.

synapsesocial.com/papers/699a9e00482488d673cd4595https://doi.org/10.1186/s12889-026-26346-z
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