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According to a new study, children who bully others are more likely to suffer from eating disorders than their non-bullying counterparts.

Research published this fall in the International Journal of Eating Disorders found that, among children aged nine to 16 who bullied others, 30.8% displayed symptoms of bulimia. That figure fell to 17.6% among those who were not involved in bullying at all.

The study, conducted by scientists from Duke Medicine and the University of North Carolina School of Medicine, uses information gathered by the Great Smoky Mountains Study, a "longitudinal, population-based community survey of children and adolescents in North Carolina." In the paper's abstract, the authors explain that "ten waves of data on 1,420 participants between ages 9 and 25 were used from the prospective population-based Great Smoky Mountains Study." Because the dataset is population-based, the sample of children is not nationally representative.

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Still, the study offers insight into how childhood bullying affects everyone involved. In a statement issued Monday, Duke laid out the detrimental effects of those who either were consistently bullied, consistently bullied others, or spent time doing both, as compared to those who were not bullied and did not bully at all:

Children who were victims of bullying were at nearly twice the risk of displaying symptoms of anorexia (11.2 percent prevalence compared to 5.6 percent of children who were not involved in bullying) and bulimia (27.9 percent prevalence compared to 17.6 percent of children not involved in bullying). Children who were both bullies and victims had the highest prevalence of anorexia symptoms (22.8 percent compared to 5.6 percent of the children not involved in bullying) and also the highest prevalence of binge eating (4.8 percent of children as compared to less than 1 percent of uninvolved children) and vomiting as a way to maintain their weight.

Cynthia M. Bulik, a co-author of the study, explained that, "Sadly, humans do tend to be most critical about features in other people that they dislike most in themselves… the bullies’ own body dissatisfaction could fuel their taunting of others." Sounds about right.

Danielle Wiener-Bronner is a news reporter.