Association between weight perception and psychological distress

Ethnic and sexual orientation inequalities in mental health-obesity comorbidity, self-harm, and attempted suicide among British adolescents

PURPOSE

Mental illness and obesity (MH-OB) may co-occur in adolescence and have a strong risk to track into adulthood. Using an intersectional framework, we explored associations between ethnic-sexual identities and MH-OB comorbidity in adolescents. We examined the risk of self-harm (SH) and attempted suicide (AS) by comorbidity status and ethnic-sexual identities.

METHODS

Participants included 9,789 adolescents (aged 17 years) from the UK-wide Millennium Cohort Study with data on self-identified ethnicity and sexuality. Participants were categorised as White-heterosexual, White-sexual minority (SM), Ethnic Minority (EM) heterosexual or EM-SM adolescents. We used multivariable logistic regression to examine associations between 1.dual ethnic-sexual identities and MH-OB comorbidity, 2.risk for self-harm (or attempted suicide) in relation to comorbidity and ethnic-sexual identities (including interactions between the comorbidity and ethnic-sexual identities variables to assess whether risk for self-harm differed by ethnic-sexual identities and comorbidity status).

RESULTS

Comorbidity was higher among White-SM (OR = 3.73, 95%CI 2.42-5.75) and EM-SM (OR = 1.96, 1.03-3.73) adolescents. SM identities (OR = 3.02, 2.41-3.78 for White-SM) and having comorbidity (OR = 2.83, 2.03-3.95) were independently associated with SH or AS. Risk of SH among White-heterosexual individuals was greater among comorbid individuals (40%) relative to non-comorbid individuals (19%). Risk of SH was higher in SM individuals (58% vs. 41% in White-SM and 50% vs. 29% in EM-SM individuals with and without comorbidity, respectively). Risk of AS was 5% and 19% in comorbid and non-comorbid White-heterosexual individuals, respectively; the corresponding figures for White-SM individuals were 14% and 17%.

CONCLUSION

Irrespective of ethnicity, SM adolescents have a significantly greater risk of SH and AS. Comorbidity further amplifies this risk.

Association between weight, weight perception, weight teasing and mental health among adolescents

BACKGROUND

Adolescent mental health problems are becoming increasingly prevalent, and there are correlations between weight-related concerns and adolescent mental health. The aim of this study is to explore the association between three weight-related factors (actual weight, weight perception, and weight teasing) and mental health problems (depressive symptoms, anxiety symptoms, and loneliness) in Chinese adolescents.

METHODS

10,070 adolescents between the ages of 11-18 from schools in Shanghai, China were selected using a stratified random cluster sampling method. Self-reported questionnaires were collected to investigate weight-related factors and mental health problems. Logistic regression analysis was used to examine the relationship.

RESULTS

The prevalence of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms among adolescents were 18.0%, 53.8%, 26.5%, and 12.3%, respectively, with a higher prevalence found in females. After adjusting for weight perception and weight teasing, actual weight had no harmful impact on adolescents' mental health. Adolescents' perception of being overweight increased the risk of depressive symptoms, loneliness, mild anxiety symptoms, and moderate to severe anxiety symptoms, while the perception of being underweight had a similar but more profound impact (depressive symptoms OR = 1.590, 95% CI: 1.342-1.883; loneliness OR = 1.537, 95% CI: 1.353-1.746; mild anxiety symptoms OR = 1.368, 95% CI: 1.178-1.589; moderate to severe anxiety symptoms OR = 1.780, 95% CI: 1.449-2.186). Experiencing weight teasing more than once a year had a greater effect on adolescents' mental health, especially among adolescents with overweight/obesity (depressive symptoms OR = 2.970, 95% CI: 2.325-3.793; loneliness OR = 3.839, 95% CI: 3.119-4.727; mild anxiety symptoms OR = 2.822, 95% CI: 2.236-3.562; moderate to severe anxiety symptoms OR = 5.212, 95% CI: 3.846-7.065).

CONCLUSIONS

The prevalence of mental health problems among adolescents was high, especially loneliness. Weight perception and weight teasing, but not the actual weight, independently influenced adolescent mental health.

A review on linking stress, depression, and insulin resistance via low-grade chronic inflammation

Stress is a disturbance in homeostasis caused by psychological, physiological, or environmental factors. Prolonged reactions to chronic stress can be detrimental, resulting in various metabolic abnormalities, referred to as metabolic syndrome (MS). There is a reciprocal increased risk between MS and major depressive disorder. Recent studies established an association between inflammation and insulin signaling in type 2 diabetes mellitus with depression. In the present review, we discuss chronic low-grade inflammation, pathways of insulin resistance, and brain glucose metabolism in the context of neuroinflammation and depression. Specific attention is given to psychotropic drugs such as bupropion, mirtazapine, and nefazodone, anti-inflammatory drugs like Celecoxib (COX-2 inhibitor), Etanercept, adalimumab, IL-4Ra antagonist, Anti-IL- 17A antibody (Ixekizumab) and lifestyle modifications including exercise, dietary changes, and sleep hygiene. These therapeutic solutions offer potential in treating depression by targeting metabolic conditions like insulin resistance and inflammatory pathways. The article further explains the significance of a nutrition and antioxidants-rich diet, emphasizing the role of omega-3 fatty acids, vitamin D, zinc, and polyphenols, to improve immunity and activate anti-inflammatory signaling pathways.

Socioeconomic position, perceived weight, lifestyle risk, and multimorbidity in young adults aged 18 to 35 years: a Multi-country Study

BACKGROUND

Multimorbidity-risk is established early in life, therefore reducing modifiable risk factors such as overweight or obesity may, in part, tackle the burden of multimorbidity in later life.

METHODS

We made use of a cross-sectional online survey that included young adults (18-35yrs old) from three countries - Kenya, South Africa, and the United Kingdom (n = 3000). Information pertaining to socio-demographic, health, lifestyle, and perceived weight was collected. Additionally, the sum of affirmed morbidities was used to determine a morbidity score. Likewise, a lifestyle risk score was calculated based on information obtained from questions surrounding four unhealthy lifestyle behaviours, namely current smoking, alcohol consumption, physical inactivity, and overweight/obese weight status as a confirmed clinic condition. We further explored differences in socioeconomic position, and the prevalence of perceived weight, multimorbidity, and lifestyle risk factors between the three countries. We also determined the odds ratio of multimorbidity with perceived weight as a main predictor variable. We furthermore performed a generalised structural equation model to determine whether the association between socioeconomic position and multimorbidity was mediated via perceived weight and/or lifestyle risk.

RESULTS

Socioeconomic position, weight perceptions, lifestyle risk, and multimorbidity varied significantly across the different economic countries. Higher morbidity (by > 11.9%) and lifestyle risk (by > 20.7%) scores were observed in those who reported an overweight weight perception when compared to those with an underweight or normal weight perception. In pooled analyses, the odds ratio in developing 2 or more morbidities increased multiple times in those who perceived themselves as overweight (all models: OR ≥ 2.241 [95% CI ≥ 1.693; ≥ 2.966] p < 0.001), showing a larger odds ratio with high significance in those who reported 3 or more morbidities (all models: OR ≥ 3.656 [95% CI ≥ 2.528; ≥ 5.286] p < 0.001). Furthermore, this study showed that an overweight weight perception partially mediated (p ≤ 0.001) the association between socioeconomic position and multimorbidity.

CONCLUSIONS

This study confirmed poorer health outcomes in those who perceived themselves as overweight. The findings from this study further emphasise the importance of targeted intervention strategies directed at raising weight-related awareness and potentiating risk factors, specifically in those who reside in lower economic developed countries.

Body mass index: A determinant of distress, depression, self-esteem, and satisfaction with life amongst recreational athletes from random intermittent dynamic type sports

This study aimed to understand the impact of body mass index on distress, depression, self-esteem, and satisfaction with life amongst recreational athletes from random intermittent dynamic type sports. A cross-sectional study design was selected with 440 recreational athletes to conduct this study. The mean age was 20.34 ± 1.33 years, height was 157.27 ± 5.93 cm, weight was 57.31 ± 13.02 kg, and BMI was 25.82 ± 6.64 kg/m². All the athletes voluntarily participated in this study. Psychological distress was measured with the K10 questionnaire; depression was measured with the PHQ-9 self-reported questionnaire. The Rosenberg self-esteem scale measured self-esteem, and Diener's satisfaction with life scale measured satisfaction with life. The data collection was conducted in the classroom setting. It took 12-15 min to complete the survey. The descriptive statistics were calculated, and the ordinal-scale, qualitative variables and frequency distributions for different categories were determined. The Chi-Square (two-tails) test was applied to find the relationship between the variables. The significant level was set at 0.05 level. The result showed that body mass index was significantly related to distress (X ²  = 27.59, p = .001) and life satisfaction (X ²  = 45.14, p = .001). Whereas depression (X ²  = 15.46, p = .148) and self-esteem (X ²  = 12.02, p = .212) showed an insignificant relationship with body mass index among recreational athletes from random intermittent dynamic sports. The study highlighted the health implications of psychological distress, depression, self-esteem, and satisfaction with life with body mass index among recreational athletes from random intermittent dynamic sports. Future studies are needed to understand better the interaction between psychological variables and body mass index level.

Adverse childhood experiences and mental ill-health - obesity comorbidity among British adolescents - A national cohort study

Background

Mental ill-health and obesity are increasingly prevalent in childhood with both conditions likely to co-occur. Less is known about associations between adverse childhood experiences (ACEs) and mental ill-health and obesity (MH-OB) comorbidity in adolescence. The aim of this study was to examine associations between ACEs and MH-OB comorbidity in adolescents from a national cohort study.

Methods

Participants; 10,734 adolescents (males = 50.3%) from the Millennium Cohort Study with 6 ACEs (for e.g., parental MH, drug/alcohol misuse, physical punishment) collected prospectively between ages 3-11 years. MH-OB comorbidity (binary indicator) was based on objectively measured BMI (for overweight/obesity) and self-reported depression/anxiety at ages 14 and 17. Associations between: 1.total ACE scores (0, 1, 2 or ≥3) and additionally each individual ACE, and MH-OB, were analysed used logistic regression, separately at 14 and 17 years.

Results

At age 14, ACE scores were associated with higher odds for MH-OB comorbidity, with a gradient of increasing odds ratios (OR) with increasing ACEs. Individuals with 1 (OR:1.22[95%CI: 1.1-1.6]), 2 (OR:1.7[1.3-2.3]), or ≥3ACEs (OR:2[1.5-2.6]) had increased odds for MH-OB comorbidity compared to those with 0 ACEs. At age 17, associations between ACE scores and MH-OB were attenuated and observed in individuals with ≥3ACEs (OR:1.54, 1.1-2.3). Parental MH (OR:1.5, 1.2-1.9), intimate-partner violence (OR:1.2, 1.1-1.6), physical punishment (OR:1.3, 1.1-1.6), bullying (OR:2, 1.6-2.5) were associated with MH-OB comorbidity age 14. However, only parental MH (OR:1.5, 1.1-2.1) and bullying (OR:1.6, 1.2-2.1) were associated with MH-OB comorbidity at age 17.

Conclusion

ACEs are associated with increased risk of MH-OB comorbidity in between ages 14 and 17. These findings provide timely opportunity for interventions to reduce risk and are pertinent given that MH and obesity contribute significantly to global burden of disease and track across the lifecourse.

The association between mental health and obesity in postmenopausal women: A systematic review

Postmenopausal women are at great risk of mental health deterioration, which may lead to morbidity and mortality. The decrement of mental health with aging is attributed to hormonal changes, lowered physical activity, sleep disturbances, economic factors, as well as modifiable variables such as smoking and obesity. Studies have shown controversial results on the association between obesity and mental health in postmenopausal women. This study is a systematic review of the evidence available on the association between obesity and mental health in postmenopausal women with the aim to identify the most reliable obesity measure that has been shown in association with mental health as well as the effective measures that have been practiced for improving mental health in postmenopausal obese women. CINAHL, Scopus, Science Direct and PubMed including Medline databases were searched. Out of 3,766 articles, 23 studies of average to good quality were included, out of which 17 were cross-sectional and 6 interventional. Out of the 17 studies, 12 showed a positive association between obesity and deterioration of mental health, 3 showed a negative association and two showed no association. From the interventional studies, 4 showed positive and two not significant impact of the intervention used on obesity and mental health. In conclusion, more studies showed a positive association between obesity, especially visceral obesity, and mental health issues particularly depression, anxiety, and sleep disorders. Combination of caloric restriction and exercise seems to have a better impact on the mental health of the postmenopausal in comparison with other interventions.

Associations between depression, domain-specific physical activity, and BMI among US adults: NHANES 2011-2014 cross-sectional data

Background

Physical activity is associated with depression. However, benefits of physical activity on depression may differ for specific domains of physical activity (i.e., leisure-time, work, and travel). Moreover, the relationship between physical activity and depression could also differ for people in different Body Mass Index (BMI) categories. This study investigated the relationship between domain-specific physical activity and BMI with depression, and the moderation effects of BMI on the relationship between domain physical activity and depression.

Methods

Complex survey data from the NHANES 2011-2014 was used (N=10,047). Depression was measured using the Patient Health Questionnaire (PHQ-9). Participants reported physical activity minutes in each domain using the Global Physical Activity Questionnaire. Demographic characteristics were self-reported. Weight and height were objectively measured and used for calculating BMI. Survey procedures were used to account for complex survey design. As two survey cycles were used, sampling weights were re-calculated and used for analyses. Taylor series linearisation was chosen as a variance estimation method.

Results

Participants who engaged in ≥150 minutes/week of total moderate-vigorous physical activity (MVPA) (adjusted B = 0.83, 95% CI [0.50, 1.16]) and leisure-time MVPA (adjusted B = 0.84, 95% CI [0.57, 1.11]) experienced lower levels of depression compared to those engaging in <150 MVPA minutes/week. Work and travel-related physical activity were not associated with depression. Overweight (adjusted B = -0.40, 95% CI [-0.76, -0.04]) and underweight/normal weight participants (adjusted B = -0.60, 95%CI [-0.96, -0.25]) experienced less depressive symptoms compared to obese participants. BMI did not moderate the relationship between domain-specific physical activity and depression.

Conclusions

Interventions that focus on leisure-time physical activity appear to be best suited to improve depression, however, this needs to be confirmed in purposefully designed intervention studies. Future studies may also examine ways to improve the effectiveness of work and travel physical activity for reducing depression.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14037-4.

Body Mass Index and risk for onset of mood and anxiety disorders in the general population: Results from the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2)

BACKGROUND

Examine the onset of a clinical diagnosis of mood (major depression, dysthymia and bipolar disorder)- and anxiety disorders (panic disorder, agoraphobia without panic disorder, social phobia, specific phobia and generalized anxiety disorder) by Body Mass Index levels at baseline in the general adult population over three years.

METHODS

Data are from NEMESIS-2, a representative psychiatric cohort study in the Netherlands. A total of 5303 subjects aged 18-64 were interviewed with the CIDI (3.0 based on DSM-IV) in two waves, with an interval of three years. The first wave was performed from November 2007 to July 2009, the second wave from November 2010 to June 2012.

RESULTS

Persons with obesity at baseline had a significantly increased risk of the onset of any mood -or anxiety disorder adjusting for covariates compared to persons with a normal Body Mass Index (OR = 1.71; 95% CI: 1.11-2.62). The odds ratio of the underweight category was non-significant. A dose-response effect of the continuous BMI scores on the onset of any mood or anxiety disorder was found (OR = 1.06; 95% CI: 1.02 = 1.10; p < 0.01).

CONCLUSIONS

Obesity at baseline is a risk for the onset of mood -and anxiety disorders at three year follow up.

Pictogram Is a Valid Instrument to Classify At-Risk Adult Population Based on Abdominal Obesity: Results from Pars Cohort Study

BACKGROUND

Abdominal obesity is associated with increased risk of myocardial infarction and death events. Thus, obtaining data on the status of abdominal obesity is important in risk factor assessment and prevention of non-communicable diseases. This study aimed to evaluate the validity of using pictograms to classify abdominal obesity indices (waist circumference [WC], waist-hip ratio [WHR], and waist-height ratio [WHtR]) into normal and at-risk categories and determine the effects of demographic characteristics on this validity.

METHODS

This cross-sectional study used data from Pars Cohort Study (PCS). Participants chose the most similar pictogram scores to their body size at 15, 30 years, and current age. Optimal normal/at-risk cut-off values for pictograms were calculated using sensitivity/specificity plots. Receiver operating characteristic curves were used to evaluate the validity of pictograms. Validity measures were analyzed across different subgroups of demographic characteristics.

RESULTS

A total of 9263 participants (46% males) were included in the study. The estimated area under the curves were 84% for WC, 77% for WHR, and 89% for WHtR in males, and 84% for WC, 73% for WHR, and 90% for WHtR in females. Optimal pictogram cutoffs to classify central obesity for WC, WHR, and WHtR were 4, 4, and 5 in males and 4, 4, and 6 in females, respectively. The majority of demographic characteristics were not associated with the validity of pictograms.

CONCLUSION

Using pictograms to determine normal and at-risk categories of abdominal obesity indices is valid among adult population with a wide range of demographic characteristics. However, the results need to be interpreted with caution in those with a positive history of weight fluctuation.

Body weight perception and physical activity among young adults: Analysis from the national longitudinal study of adolescent to adult health

ObjectiveTo identify the young adults' perception of their weight and examine the associations between young adults' weight perception and physical activities. Participants: A total of 4,882 participants' responses were derived from the Add Health, Wave III. Method: Chi-square tests were used to examine the weight perception and multinomial logistic regression used to assess the association between weight perception and physical activities. Results: Perceived weight and weight management among male participants were significantly different from female participants (p<.001, p<.001, respectively). Young adults with self-perception of being "slightly overweight" and "very overweight" were more likely of participating in physical activities such as gymnastic/weight lift/strength (OR = 0.91, p <.001 and OR = 0.77, p<.001) and walking (OR = 1.08, p<.001 and OR = 1.13, p<.001). Conclusion: The study showed that physical activities significantly increased the probability of accurate perceived weight. Steps should be taken to implement interventions that increase accurate weight perception and promote physical activity among young adults.

Cross-sectional study of BMI, weight concern, body size perception, dieting and mental distress in adolescents: The HUNT Study

OBJECTIVE

We examined the associations between body mass index (BMI), weight concern, body size perception, dieting and mental distress in a population-based study of 7350 adolescents.

DESIGN

Cross-sectional.

SETTINGS

Data from a Norwegian population-based cohort, The Young-HUNT3 (2006-2008) from the county of Nord-Trøndelag, Norway.

PARTICIPANTS

A total of 7350 adolescents (13-19 years) who had both self-reported questionnaire data and anthropometric measures.

PRIMARY OUTCOME MEASURES

Odds for mental distress given sex, BMI, weight concern, body size perception and dieting. Analyses were performed in binomial logistic regression models.

RESULTS

Compared with being overweight/obese, having weight concern, irrespective of BMI, was associated with higher OR for mental distress (MD) among boys and girls. Body size overestimation was associated with an increase in the OR for MD, in participants who were overweight/obese, had weight concern or dieted. This effect was more pronounced in boys.

CONCLUSIONS

Weight concern and body-size estimation are strongly associated with mental health in adolescent boys and girls. Routine assessment of adolescents' attitudes towards their weight and body size is advised.

Overweight in mood disorders: Effects on morbidity and treatment response

OBJECTIVE

As it is not clear how body-mass index (BMI) may relate to diagnosis, symptom-severity, illness-course, and treatment-response among psychiatric patients, we related BMI to psychiatric diagnosis and to selected clinical and demographic factors in major affective disorder subjects.

METHODS

We analyzed mean BMI levels vs. diagnosis, and evaluated selected risk factors for association with overweight and obesity among subjects with DSM-5 major affective disorders.

RESULTS

In 1884 subjects, BMI ranged from 23.4 kg/m² with anxiety disorders to 27.6 with psychotic disorders, and averaged 24.1 among 1469 affective disorder subjects. Mood-disorder subjects with BMI ≥ 25 (overweight/obese) were more likely: men, older, married, with more children and siblings, less education, lower socioeconomic status, engaged less in physical exercise, smoked more, and lived in less densely populated areas. They also were more likely to have: BD than MDD, familial mood disorders, no co-occurring ADHD, higher serum triglyceride levels, more time depressed and less improvement in depression ratings with treatment.

CONCLUSIONS

Risk of being overweight or obese was greatest with psychoses, least with anxiety, personality, and minor depressive disorders, and intermediate with major mood disorders. Several plausible risk factors for high BMI were identified in mood disorder subjects, including male sex and with BD > MDD. Striking were selectively greater prospective morbidity and decreased treatment-response for depression vs. mania with BMI ≥ 25.

Artificial neural network and decision tree models of post-stroke depression at 3 months after stroke in patients with BMI ≥ 24

OBJECTIVE

Previous studies have shown that excess weight (including obesity and overweight) can increase the risk of cardiovascular, cerebrovascular and other diseases, but there is no study on the incidence of post-stroke depression (PSD) and related factors in patients with excessive weight. The main purpose of this study was to find related factors of PSD at 3 months after stroke in patients with excessive weight and construct artificial neural network (ANN) and decision tree (DT) models.

METHODS

This is a prospective multicenter cohort study (Registration number: ChiCTR-ROC-17013993). Five hundred and three stroke patients with Body Mass Index(BMI) ≥ 24 were included in this study. The diagnostic criteria of PSD is according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) diagnostic criteria for depression due to other medical conditions and the HAMD-17 scores > 7 at 3 months after stroke was used as the primary endpoint. The χ² test, Mann-Whitney U test or t-test were used to check for statistical significance.

RESULTS

Our study found that sleeping time < 5 h, CHD, physical exercise, BI score, N dimension(EPQ) and subjective support(SSRS) were associated with PSD in patients with excessive weight. Physical exercise(odd ratio [OR] = 0.49, p = 0.001, 95%CI [confidence interval]: 0.32-0.75) and BI score(OR = 0.99, p < 0.001, 95%CI: 0.98-0.99) were protective factors; sleeping time < 5 h(OR = 2.86, p < 0.001, 95%CI: 1.62-5.04), CHD(OR = 2.18, p = 0.018, 95%CI: 1.14-4.15), N dimension(OR = 1.08, p = 0.001, 95%CI: 1.03-1.13) and subjective support(OR = 1.04, p = 0.022, 95%CI: 1.01-1.07) were risk factors.

CONCLUSION

This study found several factors related to the occurrence of PSD at 3 months in patients with excessive weight. Meanwhile, ANN and DT models were constructed for clinicians to use.

Multimorbidity of overweight and obesity alongside anxiety and depressive disorders in individuals with spinal cord injury

OBJECTIVE

To compare the prevalence of anxiety/depression and overweight/obesity (Aim 1) and the multimorbidity of these conditions (Aim 2) in a sample of adults with and without spinal cord injury (SCI). Aim 3 was to examine whether overweight/obese individuals with SCI differ on the prevalence of anxiety/depressive disorders compared to non-overweight/obese individuals with SCI.

DESIGN

Retrospective cohort study.

PARTICIPANTS

Individuals ≥16 years old who had patient encounters between January 1, 2011, and February 28, 2018. In total, 761 598 individuals were included, of which 3136 had SCI.

MAIN OUTCOME MEASURES

Individuals were identified as diagnosed with SCI, anxiety and/or depressive disorders, and overweight/obesity using the International Classification of Diseases.

RESULTS

Age-adjusted odds ratios (ORs) were calculated using logistic regression. In contrast to non-SCI individuals, those with SCI had increased odds of anxiety disorders (OR: 3.58, 95% CI [3.29-3.90]), depressive disorders (OR: 4.33, 95% CI [3.95-4.74]), and overweight/obesity (OR: 3.08, 95% CI [2.80-3.38]). Pertaining to multimorbidity, individuals with SCI had increased odds of having overweight/obesity alongside anxiety disorders (OR: 4.30, 95% CI [3.71-4.98]) and overweight/obesity alongside depressive disorders (OR: 4.69, 95% CI [4.01-5.47]) compared to those without SCI. Individuals with SCI who were diagnosed as overweight/obese had increased odds of having anxiety disorders (OR: 2.54, 95% CI [2.06-3.13]), and depressive disorders (OR: 2.70, 95% CI [2.18-3.36]), relative to non-overweight/obese individuals with SCI.

CONCLUSIONS

This work is among the first to find evidence that individuals with SCI are at heightened odds of overweight/obesity alongside anxiety and/or depressive disorders. This early work holds clinical implications for treating these interrelated comorbidities in SCI.

The effects of relative body weight on socioemotional and schooling outcomes among female adolescents in the United States

RATIONALE

An extensive literature has shown that individuals, especially women, with higher body mass index (BMI) face a range of negative life outcomes. Most previous studies rely on absolute measures of body weight, such as BMI and obesity status, to estimate the social impact of body weight. Using absolute measures of body weight, however, is inconsistent with social-psychological theories that explain the effects of body weight because they conflate the social effects of body weight with biological processes of body weight.

OBJECTIVE

This study extends the literature by utilizing a relative measure of body weight, or a student's BMI rank within her relevant peer group, to examine the impact of body weight on youth outcomes.

METHODS

Using data from the National Longitudinal Study of Adolescent to Adult Health and leveraging a quasi-experimental research design, this study examines the association between relative BMI and socioemotional and schooling outcomes among female adolescents in the United States.

RESULTS

Results show that female students with high relative BMI are more likely to experience a decrease in self-esteem and an increase in depressive symptoms, even after adjusting for absolute BMI and weight perceptions. These effects are partially explained by lower levels of school attachment (∼26% for self-esteem and ∼15% for depressive symptoms). This study also finds that relative BMI is associated with an increased risk of high school dropout, but not college attainment and completed years of schooling. The association between relative BMI and high school dropout is partially explained by a combination of lowered self-esteem (∼7%), increased depressive symptoms (∼12%), as well as a decline in academic achievement (∼33%) and aspirations (∼12%).

CONCLUSION

We argue that to better understand how body weight affects one' life outcomes, it is essential to take into consideration the social contexts in which one is embedded.

Frequency of physical activity and stress levels among Brazilian adults during social distancing due to the coronavirus (COVID-19): cross-sectional study

BACKGROUND

The COVID-19 pandemic may be having many psychological impacts on people, at both an individual and a community level.

OBJECTIVE

To ascertain the relationship between the weekly frequency of physical activity and levels of stress among Brazilian adults during social distancing due to the coronavirus (COVID-19), and the interaction of sex in this association.

DESIGN AND SETTING

Cross-sectional study with a descriptive approach conducted at a public university in Curitiba (PR), Brazil.

METHODS

2,000 Brazilian adults (average age 36.4 years; 59.6% women) were recruited according to convenience through digital media. They filled out a questionnaire in electronic format that asked for sociodemographic information, health data, food consumption data, weekly frequency of physical activity and stress levels on the 10-item Kessler psychological distress scale. Descriptive statistics and regression analyses were used to evaluate the data.

RESULTS

Associations were observed for the following correlations: male sex * no physical activity (odds ratio (OR): 4.35; 95% confidence interval (CI): 1.14-16.67); female sex * physical activity 4 or 5 times a week (OR: 7.86; 95% CI: 2.28-27.05); female sex * physical activity 3 times a week (OR: 7.32; 95% CI: 2.09-25.58); female sex * physical activity 1 or 2 times a week (OR: 14.57; 95% CI: 4.28-49.57); and female sex * no physical activity (OR: 24.17; 95% CI: 7.21-80.97).

CONCLUSION

The lower the weekly frequency of physical activity during the period of social distancing was, the greater the chances of having stress levels were, especially for women.

Body mass index, subjective body shape, and suicidal ideation among community-dwelling Korean adults

Background

Previous studies have not investigated in depth the combination of objective body weight and subjective body shape and its association with suicidal ideation among different age groups. Therefore, this study aimed to examine the abovementioned association among Korean adults, stratified by developmental stages.

Methods

We used nationally representative data from the 2017 Korean Community Health Survey, and included 222,037 participants aged 19 years or older in our study. Suicidal ideation was considered as the dependent variable (1 = yes, 0 = no). Along with body mass index (BMI) and subjective body shape measures, seven categories were created (1 = underweight-skinny, 2 = underweight-normal/fat, 3 = healthy weight-skinny, 4 = healthy weight-normal, 5 = healthy weight-fat, 6 = overweight-skinny/normal, 7 = overweight-fat). Multivariate logistic regression was conducted for each age group.

Results

Adjusted for covariates, young adults who were overweight-fat (OR = 1.18, p < .01), middle-aged adults who were underweight-skinny (OR = 1.32, p < .05), and older adults who were healthy weight-fat (OR = 1.19, p < .05) were more likely to have suicidal ideation than their healthy weight-normal counterparts.

Conclusions

The results suggest that the association between the combination of objective body weight and subjective body shape and suicidal ideation differs according to the developmental stage. Therefore, this difference should be considered when developing suicide prevention interventions based on the developmental stages.

Do weight perception and bullying victimization account for links between weight status and mental health among adolescents?

Background

The purpose of this study was to explore whether the way youth perceive their weight and their experiences of bullying victimization account for the increased risk of depression and anxiety symptoms, and poor psychosocial well-being, associated with overweight/obesity in a large sample of Canadian secondary school students. We also explored if associations differed by gender.

Methods

We used cross-sectional survey data from year 7 (2018–19) of the COMPASS study. The sample included 57,059 students in grades 9–12 (Secondary III-V in Quebec) at 134 Canadian secondary schools (Alberta, British Columbia, Ontario, Quebec). First, multiple regression models tested associations between body mass index (BMI) classification and mental health outcomes (anxiety [GAD-7] and depression [CESD-10] symptoms, and psychosocial well-being [Diener’s Flourishing Scale]). Second, weight perception and bullying victimization were added to the models. Models were stratified by gender and controlled for sociodemographic covariates and school clustering.

Results

When weight perception and bullying victimization were added to the models, obesity BMI status no longer predicted internalizing symptoms and flourishing scores relative to normal-weight BMIs. Students with ‘overweight’ or ‘underweight’ perceptions, and experiences of bullying victimization in the past month, reported higher anxiety and depressive symptomatology, and lower flourishing levels, in comparison to students with ‘about right’ weight perceptions and without experiences of bullying victimization, respectively, controlling for BMI status. Results were largely consistent across boys and girls.

Conclusions

Results suggest perceptions of weight and experiences of bullying independently contribute to differences in mental health outcomes by weight status among youth. Continued efforts targeting weight-based bullying and weight bias, and the promotion of body size acceptance and positive body image, may help reduce the risk of mental illness and poor mental health among adolescents.

The role of the FTO gene in the relationship between depression and obesity. A systematic review

Depression and obesity are major global health problems that frequently co-occur. The FTO gene has one of the strongest links with obesity and high body mass index (BMI) in humans. Besides, this gene is highly expressed in the brain, may play a role in the nervous system, and could confer risk for depression, although scarce literature is available in this respect. We perform a systematic review of the relationship between FTO and both conditions. We selected original articles with observational design or reviews, where depression was assessed with ICD-10, DSM-5 or previous versions, published from 2012 (when the first related paper was published) to November 2020, performed in adults, in English or Spanish and having an optimal methodological quality (evaluated with SIGN checklist). Five original studies were finally included. The results regarding the role of FTO in depression-obesity comorbidity were inconclusive. This leads us to endorse further research covering the role of this gene on both conditions, emphasising a more precise characterization of depression, in order to confirm this role.

COVID- 19 outbreak: Does confinement have any impact on weight change perception?

Purpose

This study aimed to evaluate the relationship between factors related to COVID-19 confinement (i.e., fear of COVID-19, anxiety, anger, boredom, eating disorders, and duration of confinement) and weight perception in a sample of the Lebanese population.

Methods

A cross-sectional web-based survey carried out at a one-time point between April 3 and 18, 2020, enrolled 407 participants. Due to the imposed lockdown, respondents self-reported their weight and height. One dichotomized question (positive/negative) assessed the perception of weight change (yes = change perception, and no = no change perception). The variation in BMI was calculated by subtracting the estimated weight during confinement from the estimated weight before.

Results

No significant variation in BMI was detected before and during the confinement (p = 0.40), while a perceived weight change was found in 212 (52.1%) participants. The regression analysis showed that higher fear of COVID-19 score (ORa = 0.96) and higher self-reported weight change (ORa = 0.47) were associated with lower weight change perception. However, longer confinement duration (ORa = 1.07), higher anxiety (ORa = 1.05), and high eating concerns (ORa = 1.81) were associated with higher weight change perception.

Conclusion

Our results revealed that both the fear of COVID-19 and self-reported weight change were negatively associated with weight change perception, while higher anxiety and a longer duration of confinement correlated with a higher weight change perception. Further studies are necessary to confirm our findings.

Cognitive insight is associated with perceived body weight in overweight and obese adults

Background

Accurate perception of body weight is necessary for individuals with a high body mass index (BMI) to initiate strategies to improve their health status. Furthermore, identifying factors that influence accurate body weight perception can assist in designing appropriate educational and weight management programs. We therefore aimed to investigate whether levels of cognitive functioning and insight influence the ability to correctly judge body weight.

Methods

One hundred and eighty four overweight and obese adults who participated in a cross- sectional case-control study and were controls in the aforementioned study were included. The study was conducted in Cape Town, South Africa. Demographic, weight-related, neuropsychiatric, neurocognitive and cognitive insight measures were administered. Regression analysis was conducted to determine the factors associated with correct weight perception.

Results

The final regression model explained 52.3% of variation in accurate perception of body weight and was significant (p ≤ 0. 001). The model correctly classified 79.3% of individuals who were able to correctly and incorrectly judge their weight. Adults with higher BMI, and lower self-certainty, those who reported that they had gained weight in the previous year and those who were told by a healthcare professional to lose or maintain a healthy weight were more likely to correctly judge their weight.

Conclusion

Some aspects of cognitive insight (self-certainty) but not cognitive functioning were associated with perception of body weight in this sample. Awareness of recent weight changes, higher BMI and advice from of health care professionals were also significantly associated with perception of body weight, while demographic variables were not. Understanding the factors that contribute to the correct perception of weight is important in identifying appropriate health interventions that may address the burden of associated non-communicable diseases in overweight and obese individuals.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10559-5.

Preliminary evidence of acylated ghrelin association with depression severity in postmenopausal women

We have previously shown increased depression and anxiety scores in postmenopausal overweight women, when compared to overweight premenopausal women. The mechanisms responsible for these alterations are not understood. Although ghrelin involvement in mood modulation has been suggested, its role is still ambiguous and has not been evaluated in postmenopause. Here we investigated the association of ghrelin with depression and anxiety symptoms in postmenopausal women. Fifty-five postmenopausal women with depression symptoms, who were not in use of hormones or antidepressants, were included in the study. Depression symptoms were evaluated by Beck's Depression Inventory (BDI) and Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms were evaluated by Beck's Anxiety Inventory (BAI). Women were allocated into three groups, according to BDI classification of mild, moderate, or severe depression symptoms. Anthropometric, biochemical and hormonal parameters were analyzed. Total and acylated ghrelin levels were higher in the severe depression than in the mild depression group. Multivariate regression analyses showed positive associations of BDI scores with acylated ghrelin and BMI, and of PHQ-9 scores with acylated ghrelin and homeostasis model assessment of insulin resistance (HOMA-IR). BAI scores associated positively with waist-to-hip ratio. To the best of our knowledge, this is the first demonstration of an association between acylated ghrelin and the severity of depression symptoms in postmenopausal women. This association may reflect either a physiological response aimed at fighting against depression symptoms or a causal factor of this mental disorder.

Associations between binge eating, depressive symptoms and anxiety and weight regain after Roux-en-Y gastric bypass surgery

BACKGROUND

Weight regain (WR) after bariatric surgery (BS) is frequent.

OBJECTIVE

The aim of this study was to evaluate whether the occurrence of psychiatric disorders would be associated with short- and long-term WR after BS.

METHODS

Ninety-six patients (77.6% female, age 40.2 ± 10.1 years, BMI of 50 ± 8.2 kg/m²) from the Obesity and Bariatric Surgery Outpatient Clinic of the Universidade Federal São Paulo completed the Questionnaire on Eating and Weight Patterns-Revised, the Beck Depression Inventory and an anxiety inventory to assess the occurrence of binge eating, depressive symptoms (DS) and anxious symptoms (AS) before and after short-term and long-term BS.

RESULTS

Twenty-four months after BS, the prevalence of binge eating, depression and anxiety decreased from 100 to 13%, 100 to 15% and 43 to 4%, respectively. The mean WR of 35.2 ± 17.3% of weight loss occurred in nine patients after 24 months and was associated with binge eating (p = 0.002) but not with DS or AS. At long-term follow-up (12 ± 1.5 years), 67% had a mean WR of 50.3 ± 24.9%. The prevalence of binge eating, DS and AS were 48%, 46% and 63%, respectively, in this group, and significant associations were observed between WR and binge eating (p = 0.001), DS (p = 0.029) and AS (p = 0.001). Furthermore, the number of psychiatric disorders was inversely associated with the percentage of weight loss (p < 0.05) and positively associated with WR (p < 0.05).

CONCLUSION

Weight regain was associated with the occurrence of binge eating in the short and long term after BS, whereas the occurrence of depressive and anxious symptoms was associated with WR only in the long term.

LEVEL III

Evidence obtained from well-designed cohort or case-control analytic studies.

Gaining "The Quarantine 15:" Perceived versus observed weight changes in college students in the wake of COVID-19

OBJECTIVE

Amidst restrictions to reduce the spread of COVID-19, jokes have surfaced regarding weight gain during the pandemic. The current study documents perceived changes since COVID-19 and compares these to observed longitudinal changes in reported weight, BMI, and how college students described their weight from January to April 2020.

METHOD

Undergraduates (N = 90; 88% female) completed on-line assessments before and after students were required to leave campus due to COVID-19. Time 1 and Time 2 surveys collected demographic information, height, weight, and a Likert-scale rating to describe perceived weight, ranging from 1 = very underweight to 5 = very overweight (weight description). Time 2 surveys added questions for perceived changes since COVID-19 in body weight, eating, physical activity, various forms of screen time, and concerns about weight, shape, and eating.

RESULTS

Time 2 surveys indicated perceived increases in body weight, eating, and screen time, and decreases in physical activity along with increased concerns about weight, shape and eating since COVID-19. Longitudinal data indicated no significant change in weight, body mass index (BMI), or BMI category, but how participants described their weight changed significantly from January to April 2020. Compared to longitudinal changes in BMI category, students' weight description was significantly more likely to fall into a higher category from Time 1 to Time 2.

DISCUSSION

Shifts in how body weight is experienced in the wake of COVID-19 that do not align with observed changes in reported weight may reflect cognitive distortions that could increase risk for disordered eating in some individuals.

Careful conversations: an educational video to support parents in communicating about weight with their children

BACKGROUND

Parents may struggle to initiate healthy weight-related conversations with their children. Educational videos may be an effective tool for improving parents' knowledge and self-efficacy on this topic. The aim of this pilot study was to develop an educational video to assist parents in weight-related conversations with their child, and to assess changes in parents' self-efficacy on this topic.

METHODS

Video development was based on a scoping review and semi-structured interviews with parents. Respondent demographics and user satisfaction were assessed at pre- and post- video, and 4-6 months later. Self-efficacy scores were compared between parent groups based on weight concerns over time.

RESULTS

Fifty-seven parents participated in the video questionnaires, and 40 repeated measures 4-6 months later. Significant improvements in self-efficacy in "raising the issue of weight" and "answering questions or concerns" were found after watching the video (p ≤ 0.002) compared to baseline, and scores 4-6 months post baseline remained slightly elevated, but non-significant. Parents with concerns about their child being overweight had significantly lower perceived self-efficacy scores compared to parents with no concerns about their child's weight (p = 0.031). The video was found to be positively received and of relevance to parents across a number of different domains.

CONCLUSION(S)

Preliminary findings suggest an educational video about initiating weight-related conversations may be an effective tool for increasing parents' perceived self-efficacy in the short term. Further work is needed to validate findings in a randomized controlled trial, and with diverse parent populations.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03664492 . Registered 10 September 2018 - Retrospectively registered.

The role of weight perceptions and their impact on health and well-being: A multiple mediation model

The present study analyses the role of weight distortion and weight self-criticism in explaining the relationship between actual weight and perceived health, well-being, body satisfaction and emotional eating. Eight hundred and six individuals were selected from a national study on nutrition. They were divided into two groups according to self-reported dieting. A questionnaire measuring the outcome variables was implemented. Weight distortion and self-criticism were calculated using actual, estimated and desired BMI. A multiple mediation model was estimated using structural equation modelling. A valid model was obtained in which weight self-criticism is a partial mediator of the relationship between weight and body satisfaction and a full mediator of the relationship between weight and emotional eating for the non-dieter group. For the dieter group, full mediation of weight self-criticism is observed in the relationships between weight and health, well-being and body satisfaction. For weight distortion, no mediation effect is found in either group. The results highlight the importance of weight perceptions in understanding the influence of body weight on several aspects of health and well-being. The type of weight perception is also relevant. A critical attitude towards weight is more determinant than the distortion in weight appraisal.

Predictors of Persistent Body Weight Misclassification from Adolescence Period to Adulthood: A Longitudinal Study

This study examined whether body weight misclassification continues from adolescence to adulthood and the associated predictors behind that misclassification. Data are from a sample of a longitudinal Australian birth-cohort study. Data analyses were restricted to 2938 participants whose measured and perceived body weights were recorded during their adolescence and adulthood follow-ups. To identify misclassification, we objectively compared their measured and perceived body weights at each follow-up. Potential predictors during early life or adolescence periods were included in data analyses. At each follow-up, underestimation was recorded more often among overweight and obese participants, whereas overestimation was mostly recorded among underweight ones. Over 40% males and females were able to correctly estimate their body weight at one follow-up, whereas almost 30% males and 40% females were able to do so in more than one follow-ups. One-third females and 45% males underestimated their body weight at one follow-up, whereas 13% females and a quarter of males were able to do so in more than one follow-ups. Being female, dieting, being overweight, having an overweight mother, and having poor mental health were the most significant predictors for more than one follow-up misclassifications. Further studies are needed to evaluate the impact of persistent misclassification on population health benefits.

Age and leptinemia association with anxiety and depression symptoms in overweight middle-aged women

OBJECTIVE

The aim of the study was to investigate the effect of menopause and of postmenopausal stages on depression and anxiety symptoms, and whether these symptoms associate with anthropometric, metabolic, and hormonal parameters in midlife women.

METHODS

Postmenopausal women (age 50-65), either at early (EPM, n=33) or late (LPM, n = 23) postmenopause, and 23 premenopausal controls (PreM, age 40-50), matched for BMI with the PM groups, were studied. Blood biochemical and hormonal determinations, bioimpedance anthropometry, and depression and anxiety symptoms (Beck's depression [BDI] and anxiety [BAI] inventories) were conducted.

RESULTS

The BAI score was higher in both PM groups than in the PreM group. In contrast, only the LPM group showed a significantly elevated BDI score. All groups presented overweight and abdominal obesity, having similar BMI and waist/hip ratio values. Both PM groups showed insulin resistance, whereas only the LPM group presented decreased skeletal muscle mass and basal metabolic rate. Correlation analysis, including all 79 middle-aged women, showed age, percentage body fat, waist/hip ratio, and leptinemia to correlate positively with the anxiety and depression scores. Multivariate regression showed leptin and age to associate positively with depressive- and anxious-like symptoms.

CONCLUSIONS

Postmenopausal women presented impaired body composition, energy expenditure, insulin sensitivity, and mental symptoms, in comparison to similarly overweight premenopausal women. Among all the overweight midlife women, these symptoms were more strongly associated with age and leptin levels than with reproductive aging itself. The data indicate that, among overweight middle-aged women with abdominal obesity, the aging process and the development of leptin resistance are associated with impairment of mental health.

A new anthropometric index to predict percent body fat in young adults

OBJECTIVE

To propose a new anthropometric index that can be employed to better predict percent body fat (PBF) among young adults and to compare with current anthropometric indices.

DESIGN

Cross-sectional.

SETTING

All measurements were taken in a controlled laboratory setting in Seoul (South Korea), between 1 December 2015 and 30 June 2016.

PARTICIPANTS

Eighty-seven young adults (18-35 years) who underwent dual-energy x-ray absorptiometry (DXA) were used for analysis. Multiple regression analyses were conducted to develop a body fat index (BFI) using simple demographic and anthropometric information. Correlations of DXA measured PBF (DXA_PBF) with previously developed anthropometric indices and the BFI were analysed. Receiver operating characteristic curve analyses were conducted to compare the ability of anthropometric indices to identify obese individuals.

RESULTS

BFI showed a strong correlation with DXA_PBF (r = 0·84), which was higher than the correlations of DXA_PBF with the traditional (waist circumference, r = 0·49; waist to height ratio, r = 0·68; BMI, r = 0·36) and alternate anthropometric indices (a body shape index, r = 0·47; body roundness index, r = 0·68; body adiposity index, r = 0·70). Moreover, the BFI showed higher accuracy at identifying obese individuals (area under the curve (AUC) = 0·91), compared with the other anthropometric indices (AUC = 0·71-0·86).

CONCLUSIONS

The BFI can accurately predict DXA_PBF in young adults, using simple demographic and anthropometric information that are commonly available in research and clinical settings. However, larger representative studies are required to build on our findings.

Association Between Weight Misperception and Some Mental Health-Related Characteristics in Korean Adolescents

BACKGROUND

Obesity in adolescents is associated with their mental as well as physical health. Adolescents tend to have negative or distorted perceptions about their body weight; however, the effects of such weight misperception on mental health remain unclear. This study investigated the association between weight misperception and mental health in Korean adolescents.

METHODS

The analysis was based on the Korea Youth Risk Behavior web-based survey 2017 dataset, which included data from 62,276 middle and high school students at 800 schools throughout Korea. The students were divided into three groups according to whether they overestimated their body weight, underestimated it, or had no misperception. The mental health characteristics of the overestimation and no misperception groups were compared through multiple logistic regression analysis.

RESULTS

Based on their body mass index, male adolescents were more likely to be overweight than female adolescents (p < 0.001) and less likely to have weight misperception. The female adolescents were more likely to overestimate their body weight and less likely to underestimate it (p < 0.001). The male adolescents and female adolescents who overestimated their body weight had significantly lower levels of subjective happiness than their peers had and were more likely to experience subjective stress, sadness/despair, suicidal ideation, and suicide planning. Compared with their peers who have no misperception, male adolescents with overestimation were less likely to drink alcohol (odds ratio [OR], 0.903) or smoke (OR, 0.871), whereas female adolescents with overestimation were more likely to drink alcohol (OR, 1.107) and smoke (OR, 1.130).

CONCLUSION

Male and female adolescents who overestimated their body weight experienced more psychological problems. Thus, interventions to assist adolescents to gain realistic weight perception may be beneficial. Particularly, more attention needs to be given to female adolescents, who are more likely to overestimate their body weight compared with their male counterparts.

The moderator effect of age in the association between mood and adiposity in the elderly is specific for the subcutaneous adipose compartment: An MRI study

The positive association between obesity and depressive mood in young- and middle-age individuals is a phenomenon with major clinical implications in public health. Interestingly, the trend of this association in older individuals is not clear, given the conflicting results of multiple studies. Since aging is accompanied by changes in body fat distribution, we questioned whether age is a modulator of such association. This study explores the role of age in the association between mood and general (body mass index [BMI]) and abdominal adiposity (waist circumference [WC]) in older adults characterizing the different abdominal adipose tissue compartments (subcutaneous adipose tissue [SAT] and visceral adipose tissue [VAT]) with magnetic resonance imaging (MRI) techniques.

METHODS

One hundred twenty aged community-dwelling individuals (≥50 y of age) were assessed regarding depressive mood (Geriatric Depression Scale) and adiposity (BMI and WC). From these, 96 were assessed for SAT and VAT using MRI.

RESULTS

Using multiple linear regression models, depressive mood was positively associated with BMI, WC, and VAT. Age was a significant moderator of the association between depressive mood and BMI, WC, and SAT: positive in younger participants and null or negative in older participants. On the other hand, higher VAT was significantly associated with a more depressive mood, independently of age.

CONCLUSIONS

This study identifies age as a relevant moderator in the association between depressive mood and adiposity in the elderlies. Furthermore, the body fat compartment analysis revealed that the effect of age is specific for the SAT, suggesting its protective role in depressive mood.

Dieting for weight-control among older adults: The role of perceived health and perceived overweight status

BACKGROUND

Despite the ever-growing literature on weight-control diets, data about dieting among older adults are scarce.

PURPOSE

To describe the prevalence of weight-control dieting across age groups and weight statuses (from healthy-weight to overweight and obese). To identify cross-sectional associations of perceived health and perceived overweight status with dieting among older adults.

METHODS

Secondary analyses of the second and third waves of the Midlife in the US study (MIDUS). Sample included 2588 participants (40-93 years old, 54.5% females, age = 64.4 ± 11.1 years, BMI = 28.3 ± 5.9 kg/m²). Logistic regressions were used to predict dieting across age groups (independent variables: BMI, perceived health, perceived overweight status; covariates: BMI change, education, age, race).

RESULTS

As many as 15% of participants had reported dieting during the previous year. Older age was associated with less dieting among healthy weight (p = .02) and overweight (p < .001) participants, but not among participants with obesity (p = .36). Among participants younger than 75, overweight perception (vs. healthy-weight perception) was linked with higher likelihood for dieting (40-55 years: OR = 3.94[1.70-9.1]; 55-65 years: OR = 4.11[1.91-8.82]; 65-75 years: OR = 4.50[1.90-10.65]). Nevertheless, among participants older than 75, excellent (vs. good/fair/poor) perceived health was linked with higher likelihood of dieting (good vs. excellent: OR = 0.29[0.09-0.87]; fair/poor vs. excellent: OR = 0.12[0.03-0.54]).

CONCLUSIONS

Older age is associated with less weight-control dieting among people without obesity. Although overweight perception may have a stronger impact on dieting during younger age, health perception may have a stronger impact on dieting during older age, suggesting that the motivation behind weight-control diets may potentially change throughout the adult lifespan.

Are weight status and weight perception associated with academic performance among youth?

BACKGROUND

Emerging evidence suggests perceptions of being overweight account for many of the psychosocial consequences commonly associated with obesity. Previous research suggests an obesity achievement gap, yet limited research has explored weight perception in association with academic performance. Moreover, underweight perceptions have typically been excluded from research. The current study examined how BMI classification and weight perception relate to academic performance in a large cohort of youth.

METHODS

We used cross-sectional survey data from 61,866 grade 9-12 students attending the 122 Canadian schools that participated in Year 6 (2017/2018) of the COMPASS study. Mixed effect regression models were used to examine associations between students' BMI classification and weight perceptions and their math and English/French course grades. All models were stratified by sex and adjusted for sociodemographic covariates and school clustering.

RESULTS

For English/French grades, males and females with overweight or underweight perceptions were less likely to achieve higher grades than their peers with perceptions of being at "about the right weight", controlling for BMI and covariates. For math grades, females with overweight perceptions, and all students with underweight perceptions, were less likely to achieve higher grades than their peers with "about the right weight" perceptions. All students with BMIs in the obesity range were less likely to report grades of 60% or higher than their peers with "normal-weight" BMIs, controlling for weight perception and covariates. Overweight BMIs were predictive of lower achievement in females for English/French grades, and in males for math grades, relative to "normal-weight" BMIs. Results for students that did not respond to the weight and weight perception items resembled those for obesity BMI and overweight/underweight perceptions, respectively.

CONCLUSIONS

Overall, this study demonstrates that an obesity achievement gap remains when controlling for students' perceptions of their weight, and that both underweight and overweight perceptions predict lower academic performance, regardless of BMI classification. Results suggest barriers to academic success exist among youth with larger body sizes, and those with perceptions of deviating from "about the right weight".

Prevalence and correlates of depressive symptoms in secondary school children in Dhaka city, Bangladesh

Objectives: Depression is a leading contributor to the global burden of disease, and often starts at a young age. Depression in young people can increase the risk of unhealthy lifestyle behaviour and can lead to substantial disability, social problems, poor health, and suicide. Other research has examined depressive symptoms among adult populations in Bangladesh, but little is known about other age groups. The aim of this study was to assess the prevalence and socio-demographic correlates of depressive symptoms among secondary school children of Dhaka city, Bangladesh.Design: A self-completed questionnaire was administered to 898 students from eight secondary schools of Dhaka, the capital City of Bangladesh. Of the respondents, 755 (372 males, 383 females; average age 14.26 years; SD 1.15) completed the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). A score of 10 or more was used to indicate depressive symptoms. Parents completed a separate questionnaire to provide individual and household/family-level data. Generalized Estimating Equations (GEE) was used to assess sociodemographic and lifestyle factors associated with adolescent depressive symptoms.Results: Among the responding adolescents, 25% reported depressive symptoms with prevalence more common among females than males (30% vs. 19%). Factors significantly associated with symptoms of depression included being female, aged 15-16 years, self-perception of non-normal weight, feeling unsafe at school, sleep disturbance, low life satisfaction, high intake of sugary drinks, and regularly skipping breakfast.Conclusion: Depressive symptoms are prevalent among secondary school children in urban Bangladesh. Interventions for adolescents with depressive symptoms could focus on lifestyle practices such as weight management, personal safety, sleep hygiene and healthy eating.

Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study

Objectives

Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents.

Methods

This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight.

Results

The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66).

Conclusion

Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.

The brain-adipocyte-gut network: Linking obesity and depression subtypes

Major depressive disorder (MDD) and obesity are dominant and inter-related health burdens. Obesity is a risk factor for MDD, and there is evidence MDD increases risk of obesity. However, description of a bidirectional relationship between obesity and MDD is misleading, as closer examination reveals distinct unidirectional relationships in MDD subtypes. MDD is frequently associated with weight loss, although obesity promotes MDD. In contrast, MDD with atypical features (MDD-AF) is characterised by subsequent weight gain and obesity. The bases of these distinct associations remain to be detailed, with conflicting findings clouding interpretation. These associations can be viewed within a systems biology framework-the psycho-immune neuroendocrine (PINE) network shared between MDD and metabolic disorders. Shared PINE subsystem perturbations may underlie increased MDD in overweight and obese people (obesity-associated depression), while obesity in MDD-AF (depression-associated obesity) involves more complex interactions between behavioural and biomolecular changes. In the former, the chronic PINE dysfunction triggering MDD is augmented by obesity-dependent dysregulation in shared networks, including inflammatory, leptin-ghrelin, neuroendocrine, and gut microbiome systems, influenced by chronic image-associated psychological stress (particularly in younger or female patients). In MDD-AF, behavioural dysregulation, including hypersensitivity to interpersonal rejection, fundamentally underpins energy imbalance (involving hyperphagia, lethargy, hypersomnia), with evolving obesity exaggerating these drivers via positive feedback (and potentially augmenting PINE disruption). In both settings, sex and age are important determinants of outcome, associated with differences in emotional versus cognitive dysregulation. A systems biology approach is recommended for further research into the pathophysiological networks underlying MDD and linking depression and obesity.

Prevalence of comorbid major depressive disorder in Type 2 diabetes: a meta-analysis of comparative and epidemiological studies

AIMS

To examine the average point prevalence of major depressive disorder in people with Type 2 diabetes and its associated factors in a comprehensive meta-analysis.

METHODS

Two researchers independently conducted a systematic literature search of PubMed, EMBASE, PsycINFO and Cochrane databases. Studies reporting the prevalence of major depressive disorder in people with Type 2 diabetes were identified and analysed using a random-effects model.

RESULTS

A total of 26 studies meeting the inclusion criteria were included in the study. The point prevalence of major depressive disorder was 14.5% (95% CI 7.9-25.3; I²=99.65). People with Type 2 diabetes were more likely to have major depressive disorder compared with the general population (odds ratio 1.73, 95% CI 1.38-2.16). Subgroup and meta-regression analyses showed that study site, study type, diagnostic criteria and age significantly moderated the prevalence of major depressive disorder.

CONCLUSIONS

In this meta-analysis, the average point prevalence of major depressive disorder in people with Type 2 diabetes was high. Routine screening and more effective interventions should be implemented for this population.

[Climb on the scale! Weight in consultations and adult patient's experiences: Exploratory study in general practice]

BACKGROUND

Overweight patients feel stigmatized and are reluctant to talk about weight. Physicians question the efficiency of weight management. This work explored how the weight topic was initiated in GP consultations and the experience of patients about this action, whatever their weight or reason for consultation.

METHODS

Mixed method study conducted in parallel with direct observation of GPs' consultations by trainees (with a standardized observation grid) and semi directive interview (with guide) after the consultation. Analyses were descriptive on quantitative data, and thematic on verbatim (double blind coding).

RESULTS

187 consultations were observed and 81 patients interviewed. In consultation, GPs initiated the majority of the weight discussions, with three types of approach: discussion alone, discussion and/or weighing, and weighing alone. GP's demands of weighing were very directive and sometimes seemed to make patients feel uncomfortable. The discussion about weight without weighing seemed to enhance a reflection on a possible change of patient's behavior.The joint analysis questions the scale's role in consultation since the discussion approach to the weight debate led to more patient mobilization and, according to them, "the weight is seen". For the patient, the eye appeared as a tool to measure weight, especially since the doctor could see variations.

CONCLUSION

Comparing the results of the two exploratory studies, in order to better understand this little studied phenomenon, allowed for the emergence of hypotheses and questions the role of the scale in consultations.

Body shape trajectories and incidence of depression in the "Seguimiento Universidad de Navarra" (SUN) prospective cohort

BACKGROUNDS AND AIM

The association between trajectories of body-shape from early childhood to early adulthood (first 40 years of life) and subsequent depression risk has not been explored before. We assessed this association in a prospective cohort of university graduates.

METHODS

We used a group-based modeling approach to assess the body shape trajectories from age 5 to 40 years, among 3888 women and 4124 men of the "Seguimiento Universidad de Navarra" (SUN) cohort study. All participants were free of depression at the beginning of the follow-up, and the occurrence of a new medical diagnosis of depression was evaluated every two years.

RESULTS

Four distinct trajectories for women and men were found ("lean-moderate increase", "medium-stable", "heavy-medium" and "heavy-marked increase" for women and "lean-marked increase", "medium-marked increase", "medium-stable" and "heavy-stable" for men). Among 78,475 person-years of follow-up a total of 351 incident cases of depression were identified. Among women, compared to those who maintained a medium body shape during life span ("medium-stable" trajectory), women who were heavy at childhood and had a marked increase in their body shape during early adult life ("heavy-marked increase" trajectory) showed significantly higher risk of a new-onset depression [HR = 1.92 (1.18-3.13)]. No association was observed in men between body-shape trajectories and subsequent risk of depression.

CONCLUSIONS

Our results suggest that in a Mediterranean cohort, women who were heavy at early childhood and showed marked increases in body shape during early adulthood were at higher risk of developing depression later in life.

A secondary analysis examining the concordance of self-perception of weight and actual measurement of body fat percentage: The CRONICAS Cohort Study

BACKGROUND

Individuals' self-perceptions of weight often differ from objective measurements of body fat. This study aimed to 1) measure agreement between self-perceptions of weight and objective measurement of body fat by bioelectric impedance analysis (BIA) among Peruvian adults; and 2) quantify the association between body fat and a) baseline self-perceptions of weight and b) whether a participant underestimated their weight status.

METHODS

Longitudinal data from the CRONICAS Cohort Study of 3181 Peruvian adults aged 35-years and older were used. BIA measurements of body fat were categorized across four nominal descriptions: low weight, normal, overweight, and obese. Kappa statistics were estimated to compare BIA measurements with baseline self-perceptions of weight. To quantify the association between body fat over time with both baseline self-perceptions of weight and underestimation of weight status, random effects models, controlling for socioeconomic and demographic covariates, were employed.

RESULTS

Of the 3181 participants, 1111 (34.9%) were overweight and 649 (20.4%) were obese at baseline. Agreement between self-perceived and BIA weight status was found among 43.1% of participants, while 49.9% underestimated and 6.9% overestimated their weight status. Weighted kappa statistics ranged from 0.20 to 0.31 across settings, suggesting poor agreement. Compared to perceiving oneself as normal, perceiving oneself as underweight, overweight, or obese was associated with - 4.1 (p < 0.001), + 5.2 (p < 0.001), and + 8.1 (p < 0.001) body fat percentage points, respectively. Underestimating one's weight status was associated with having 2.4 (p < 0.001) body fat percentage points more than those not underestimating only after adjusting for demographic and socioeconomic covariates.

CONCLUSIONS

Half of study participants were overweight or obese. There was poor agreement between self-perceptions of weight with BIA measurements of body fat, indicating that individuals often believe they weigh less than they actually do. Underestimating one's weight status was associated with having more body fat percentage points, but was only statistically significant after adjusting for demographic and socioeconomic characteristics. Further research should be conducted to investigate how self-perceptions of weight can support clinical and public health interventions to curb the obesity epidemic.

Is obesity associated with depression in children? Systematic review and meta-analysis

OBJECTIVES

To compare the odds of depression in obese and overweight children with that in normal-weight children in the community.

DESIGN

Systematic review and random-effect meta-analysis of observational studies.

DATA SOURCES

EMBASE, PubMed and PsychINFO electronic databases, published between January 2000 and January 2017.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Cross-sectional or longitudinal observational studies that recruited children (aged <18 years) drawn from the community who had their weight status classified by body mass index, using age-adjusted and sex-adjusted reference charts or the International Obesity Task Force age-sex specific cut-offs, and concurrent or prospective odds of depression were measured.

RESULTS

Twenty-two studies representing 143 603 children were included in the meta-analysis. Prevalence of depression among obese children was 10.4%. Compared with normal-weight children, odds of depression were 1.32 higher (95% CI 1.17 to 1.50) in obese children. Among obese female children, odds of depression were 1.44 (95% CI 1.20 to 1.72) higher compared with that of normal-weight female children. No association was found between overweight children and depression (OR 1.04, 95% CI 0.95 to 1.14) or among obese or overweight male subgroups and depression (OR 1.14, 95% CI 0.93 to 1.41% and 1.08, 95% CI 0.85 to 1.37, respectively). Subgroup analysis of cross-sectional and longitudinal studies separately revealed childhood obesity was associated with both concurrent (OR 1.26, 95% CI 1.09 to 1.45) and prospective odds (OR 1.51, 95% CI 1.21 to 1.88) of depression.

CONCLUSION

We found strong evidence that obese female children have a significantly higher odds of depression compared with normal-weight female children, and this risk persists into adulthood. Clinicians should consider screening obese female children for symptoms of depression.

BACKGROUND

Childhood mental illness is poorly recognised by healthcare providers and parents, despite half of all lifetime cases of diagnosable mental illness beginning by the age of 14 years. ¹ Globally, depression is the leading cause of disease burden, as measured by disability-adjusted life years, in children aged 10-19 years. ² Untreated, it is associated with poor school performance and social functioning, substance misuse, recurring depression in adulthood and increased suicide risk, which is the second leading cause of preventable death among young people. ^3-6 The resulting cost to the National Health Service of treating depression is estimated at over £2 billion, and the wider social and economic impact of depression is likely to be considerable. ⁷.

Perceived weight and barriers to physical activity in parent-adolescent dyads

OBJECTIVE

Family-based physical activity interventions have the potential to reduce obesity, but more information is needed regarding physical activity in the family context. This study used an actor-partner interdependence model to estimate the dyadic association between perceived weight status and barriers to physical activity in dyads of adults and their adolescent children. It was hypothesized that greater perceived weight would be associated with greater barriers perceived by both one's self and one's partner.

METHOD

Data from 1,568 dyads in the Family Life, Activity, Sun, Health, and Eating study were used to examine the dyadic association between perceived weight status (i.e., greater perceived weight category) and barriers to physical activity. Models were stratified by actual weight (an overweight or obese dyad member vs. two normal weight dyad members) and adjusted for parent education, parent and adolescent age, gender, and race.

RESULTS

Among dyads with at least 1 overweight/obese member, greater perceived weight status was positively associated with one's own perceived barriers (significant actor effects, βs = 1.17 and 1.03, ps < 0.01) and one's partner's perceived barriers (significant partner effects, βs = 0.38 and 0.62, ps < 0.01). No statistically significant relationships were found for dyads with only normal weight members.

CONCLUSIONS

Among dyads with at least 1 overweight or obese member, significant partner effects for parents and adolescents demonstrate that the weight perception of 1 dyad member correlates with the barriers of the other member. These dyadic associations highlight the potential importance of family-based interventions for physical activity. (PsycINFO Database Record