Ethnic differences in perceptions of body satisfaction and body appearance among U.S. schoolchildren: a cross-sectional study

Negative familial weight talk and weight bias internalization in a US sample of children and adolescents

BACKGROUND

Negative familial weight talk may contribute to higher weight bias internalization in pre- and early adolescents (hereafter referred to as children) and may differ by gender, weight status, and race and ethnicity.

OBJECTIVE

Examine the relationship between negative familial weight talk and weight bias internalization and examine differences by gender, weight status, and race and ethnicity.

METHODS

We cross-sectionally analysed 5th-7th graders (10-15 years old) living in Massachusetts (n = 375, 52.3% girls, 21.3% BMI ≥85th percentile, 54.8% non-Hispanic White). Negative familial weight talk frequency during the past 3 months was self-reported and discretized as 'never,' 'occasionally' (1-9 times) and 'often' (>9 times); the Modified Weight Bias Internalization Scale assessed weight bias internalization. Generalized linear models estimated the relationship between negative familial weight talk and weight bias internalization and sub-analyses estimated the relationship across gender, weight status, and race and ethnicity. Results are summarized as ratios of means (RoM).

RESULTS

Children experiencing negative familial weight talk occasionally (RoM = 1.12, p = 0.024) and often (RoM = 1.48, p < 0.001) had significantly higher weight bias internalization than children who never experienced it. In sub-analyses, experiencing negative familial weight talk often was associated with higher weight bias internalization among girls (RoM = 1.66, p < 0.001), boys (RoM = 1.32, p = 0.007), children with BMI <85th percentile (RoM = 1.44, p = 0.007) and BMI ≥85th percentile (RoM = 1.39, p = 0.001), and non-Hispanic White children (RoM = 1.78, p < 0.001), but not Hispanic (RoM = 1.25, p = 0.085) or non-Hispanic Black children (RoM = 1.20; p = 0.31).

CONCLUSIONS

Frequent negative familial weight talk was associated with higher weight bias internalization across gender and weight status and in non-Hispanic White children only.

The association between insulin resistance and depressive symptoms - A national representative cross-sectional study

OBJECTIVE

Increasing evidence suggests a positive association between insulin resistance (IR) and depression. However, whether sex-or body mass index-specific differences exist remains controversial, and only few studies have analyzed specific symptom domains. Thus, the present study aimed to analyze the association between IR and depressive symptom domains and to clarify the effects of sex and body mass index.

METHODS

The study sample comprised 4007 participants, aged 19-79, from the Korea National Health and Nutrition Examination Study 2020. Participants completed health interviews and examinations, providing data on circulating insulin and glucose levels, the Patient Health Questionnaire-9 (PHQ-9), and related covariates. IR was calculated using the homeostasis model assessment of insulin resistance. Associations between IR and PHQ-9 were analyzed using negative binomial regression with adjustments for the complex survey design.

RESULTS

The association between log-transformed IR and PHQ-9 total scores was statistically significant (incidence rate ratio [IRR] = 1.17, 95% confidence interval [CI] = 1.07-1.29, p = 0.001). Only body mass index specific differences were statistically significant, as the association was only significant in those without obesity (IRR = 1.21, 95% CI = 1.06-1.38, p = 0.005). IR was associated with cognitive/affective (IRR = 1.23, 95% CI = 1.08-1.41, p = 0.002) and somatic (IRR = 1.14, 95% CI = 1.04-1.25, p = 0.005) depressive symptom domains. Sensitivity analyses revealed similar results.

CONCLUSIONS

IR was positively associated with cognitive/affective and somatic depressive symptoms in non-obese individuals.

Differences in Perceptual and Attitudinal Body Image Between White and African-American Adults Matched for Sex, Age, and Body Composition

PURPOSE

The purpose of this study was to evaluate the differences in perceptual and attitudinal body image between White and African-American males and females matched for sex, age, BMI, and other body composition components using a combination of 3-dimensional mobile digital imaging analysis (DIA) and the Multidimensional Body-Self Relations Questionnaire-Appearance Scale (MBSRQ-AS).

METHODS

One-hundred non-Hispanic White (n=50) and non-Hispanic African-American (n=50) adults (M=34, F=66) matched for sex, age, BMI, and body composition components completed this cross-sectional study. Participants underwent several anthropometric assessments, completed the MBSRQ-AS, and rated their perceived appearance, ideal appearance, and the appearance they believed a partner would find societally attractive using a state of the art mobile 3-dimensional DIA produced using broad developmental populations. Body image distortion was measured as the perceived minus actual appearance, and body image dissatisfaction was defined as the ideal appearance and appearance a partner would find attractive minus the perceived appearance.

RESULTS

Using the DIA, only African-American females demonstrated significant body image distortion (p<0.001); reporting perceived appearances significantly lower their than their actual. Further, AA females demonstrated significantly larger differences between their ideal and perceived appearance (p=0.009), perceived larger bodies as more attractive to a potential partner (p=0.009), and reported higher ratings of appearance evaluation (p=0.001) and body area satisfaction (p=0.011) compared to White females.

CONCLUSIONS

After accounting for all anthropometric determinants of body image, perceptual and attitudinal body image differs between White and African-American adults with differences supporting larger body size acceptance for African-American individuals, particularly African-American females.

Comparative Analysis of Body Image Dissatisfaction, Depression, and Health-Related Quality of Life in Adults with Type 1 Diabetes: A Case-Control Study

(1) Objective: This case-control study investigated body image dissatisfaction, depression, and health-related quality of life (HRQoL) in adults with type 1 diabetes. (2) Methods: A total of 35 adults with diabetes and an equal number of age- and gender-matched controls were included. Assessment tools used were the Body Image Disturbance Questionnaire (BIDQ), the Hospital Anxiety and Depression Scale (HADS), and the RAND 36-Item Health Survey. Both quantitative and qualitative data were analyzed. (3) Results: Body image dissatisfaction did not differ significantly between the groups. However, adults with diabetes reported higher levels of depression (p = 0.002) and lower scores for physical health (p = 0.015) and general health (p < 0.001) on the HRQoL measure. Qualitative analysis identified common themes related to physical disturbance, effect on activities, and psychosocial concerns. (4) Conclusions: Despite similar body image dissatisfaction, adults with type 1 diabetes exhibited increased depression and reduced HRQoL. These findings emphasize the need to integrate psychological well-being into type 1 diabetes management. They also support further research into the impact of body image dissatisfaction in T1D and potential interventions to address it.

Perceived Discrimination as a Critical Factor Affecting Self-Esteem, Satisfaction with Physical Appearance and Depression of Racial/Ethnic Minority Adolescents in Korea

The effect of perceived discrimination on adolescents' developmental outcome has long been a topic of research, however, little is known about how it affects their depression especially among the racial/ethnic minority adolescents in Asian countries. In Korea, a country with a relatively short history of immigrant influx, discrimination has become an important social issue affecting a rapidly growing population. This study examines the impact of perceived discrimination on racial/ethnic minority adolescents in Korea, specifically focusing on its impact on depression through self-esteem and satisfaction with physical appearance. The Multicultural Adolescents Panel Study data were used for analyses, and the SPSS Process Macro program was used to test the parallel mediating effects of self-esteem and satisfaction with physical appearance. The findings show that perceived discrimination was a strong predictor of their depression. Self-esteem and satisfaction with physical appearance also had significant mediating effect. There were no distinct gender differences among paths though the male adolescents were found to have more discriminatory experiences than the female adolescents. The findings call for the development of healthy coping strategies for these adolescents to prevent the effect of perceived discrimination, not only for their mental health, but also with their self-perception including physical appearance.

Weight Concerns in Black Youth: The Role of Body Mass Index, Gender, and Sociocultural Factors

Weight concerns are prevalent among Black adolescents and have negative ramifications for well-being. We examined racial identity and racial socialization as potential sociocultural resources that might mitigate the development of weight concerns among Black adolescents, and we evaluated gender differences in these links. Participants were 132 Black youth (45% female; M age = 14.33 years at Time 1) who completed two annual home interviews. Results revealed that for adolescents with high (but not low) body mass indices (BMI), racial identity may be protective against developing weight concerns. Further, fathers' (but not mothers') racial socialization was protective against weight concerns for girls with high BMI. Findings highlight the importance of sociocultural contexts toward refining theory and advancing evidence-based practice.

Black adolescents' appearance concerns, depressive symptoms, and self-objectification: Exploring the roles of gender and ethnic-racial identity commitment

There is a dearth of research examining Black adolescents' body image, with even less work examining gender differences or the influence of ethnic-racial identity (ERI) commitment. It is critical to understand how culturally relevant aspects of appearance-beyond commonly measured ideals such as thinness and muscularity-are particularly relevant to Black adolescents. The present study of Black youth (n = 252; 55% girls, 45% boys, ages 13-18, M_age = 15.5) explored the roles of gender and ERI commitment in the associations between skin tone, hair, and facial satisfaction and appearance esteem, depressive symptomatology, and self-objectification. With a few exceptions, satisfaction with skin tone, hair, and face were significantly associated with higher appearance esteem and lower self-objectification and depressive symptoms, even when controlling for weight and muscle tone satisfaction. Findings were similar across genders, with some associations stronger among Black girls relative to boys. Among youth with higher ERI commitment, associations were stronger between skin tone, hair, and facial satisfaction and some indicators of wellbeing. Findings elucidate the role of culturally relevant appearance concerns of Black adolescents and the potential benefits of ERI commitment. This work can inform culturally sensitive research practices and therapeutic interventions related to Black youth's body image experiences.

Type 1 diabetes youth with disordered eating: Is there a disproportionate impact on ethnic minorities and indigenous peoples?

Adolescents with type 1 diabetes mellitus consistently have suboptimal glycaemic control and worse outcomes, and this is especially true for adolescents from indigenous communities and ethnic minorities. It is increasingly recognised that disordered eating is common in adolescents and likely causes a disproportionate impact on glycaemic outcomes and psychological morbidity. Eating disorders may be even more common in indigenous and ethnic minority populations and be another reason why it is harder to achieve recommended glycaemic targets in this group. In this viewpoint, we explore the issues around disordered eating in this vulnerable group, the difficulties in diagnosis and the challenges in management. We focus in particular on the outcomes in the more disadvantaged adolescents with type 1 diabetes, especially indigenous groups and ethnic minorities, an area where there have been few publications and generally less recognition to date.

The relation between satisfaction with appearance and race and ethnicity: A National Institute on Disability, Independent Living, and Rehabilitation Research burn model system study

Research supports that people of color in the U.S. have poorer outcomes after burn injury compared to White individuals. The current study sought to explore burn health disparities by testing the relationship between racial and ethnic minority status, a proxy for systemic discrimination due to race and ethnicity, with two key constructs linked to functional outcomes, satisfaction with appearance and social community integration. Participants included 1318 burn survivors from the Burn Model System National Database (mean age = 40.2, SD = 12.7). Participants completed measures of satisfaction with appearance and social community integration at baseline, 6-, 12-, and 24-months after burn injury. Linear regressions revealed that racial and ethnic minority status significantly related to lower satisfaction with appearance and social community integration compared to White individuals at all time points. In addition, satisfaction with appearance continued to significantly relate to greater social community integration even while accounting for race and ethnicity, age, sex, burn size, and physical disability at 6-, 12-, and 24-month time points. Overall, the study supports that racial and ethnic minority burn survivors report greater dissatisfaction with their appearance and lower social community reintegration after burn injury.

Self-regulatory processes in early childhood as predictors of Hispanic children's BMI z-scores during the elementary school years: Differences by acculturation and gender

Over the last decade, longitudinal research has shown that children's general, top-down self-regulation during early childhood is negatively associated with children's weight status in elementary school. The samples in these previous studies have been primarily White, and no study to date has examined this issue in a sample of Hispanic children from low-income families-a population at high risk for childhood obesity. The present study followed 130 Hispanic children over a time period of three to just under five years, examining the degree to which multiple measures of general, top-down self-regulation, along with a measure of appetite regulation (eating in the absence of hunger), predicted children's BMI z-scores in the early elementary school years. Results showed that children's ability to delay gratification in the preschool years was negatively associated with later BMI z-scores and that children's eating in the absence of hunger was positively associated. In separate models by gender, these relationships were significant only for girls. Moreover, analyses run separately for children of mothers low or high on acculturation showed that the relationship between delay of gratification and later BMI z-scores was significant only for children whose mothers were low on acculturation. Possible socialization and environmental factors contributing to these findings are considered.

Sports Participation from Childhood to Adolescence is Associated with Lower Body Dissatisfaction in Boys-A Sex-Specific Analysis

OBJECTIVES

This study aimed to analyze the association between body dissatisfaction and sports participation from childhood to adolescence in a school-based sample of adolescents, according to sex.

METHODS

A total of 1011 adolescents of 13.1 ± 2.3 years of age were evaluated. Body dissatisfaction was assessed by the Silhouettes Scale and sports participation for at least one consecutive year was retrospectively assessed by closed specific questions related to childhood and adolescence periods. Body mass index (BMI) and abdominal obesity were objectively measured. Habitual practice of physical activity (PA), socioeconomic status (SES), and ethnicity were assessed through questionnaires.

RESULTS

Sports participation from childhood to adolescence was observed in 55.1% of boys and in 41.2% of girls. Boys with body dissatisfaction showed lower habitual PA in leisure time (Baecke score = 4.38 ± 2.27 vs. 5.15 ± 2.25, p < 0.05) and in total (Baecke score = 9.34 ± 2.64 vs. 9.96 ± 2.68, p < 0.05) than those who were satisfied. No differences were observed among girls. Sports participation from childhood to adolescence was associated with 42% less chance of having body dissatisfaction in boys (OR = 0.58 [95%CI = 0.36-0.94]). No significant association was observed among girls.

CONCLUSIONS FOR PRACTICE

Sports participation from childhood to adolescence was negatively associated with body dissatisfaction in boys. The continuity of physical activity during youth may be an important modifiable factor to reduce body dissatisfaction.

Racial-Ethnic Disparities in Obesity and Biological, Behavioral, and Sociocultural Influences in the United States: A Systematic Review

For a comprehensive understanding of high-level obesity in the USA, we studied the trends of obesity prevalence since 2007, and related biological, behavioral, and sociocultural factors in obesity racial/ethnic disparities. We searched PubMed, Embase, and national data archives for the studies using national survey data and published in English from January 1, 2007 to September 11, 2020. Forty-seven studies met the inclusion criteria and were systematically reviewed. After a short leveling-off during 2009-2012, the US national prevalence of obesity has steadily increased. Although women had higher racial/ethnic disparities in obesity and severe obesity than men, it decreased due to the significant drop in non-Hispanic black (NHB) women in the last 10 y. However, obesity and severe obesity prevalence increased in Mexican-American (MA) men, MA boys, and MA girls and became similar to or surpassing NHB groups. Substantial racial/ethnic disparities remained in the past decade. Even at the same level of BMI, MAs and non-Hispanic Asians had a higher percent of body fat and metabolic syndrome than other ethnic/racial groups. NHB's cultural preference for a large body significantly associated weight misperception and lower weight control practices. In addition to socioeconomic status, health behaviors, neighborhood environments, and early childhood health factors explained substantial racial/ethnic differences in obesity. Differences in biological, behavioral, and sociocultural characteristics should be considered in future public health intervention efforts to combat obesity in the USA.

Body dissatisfaction and its association with domains of physical activity and of sedentary behavior in a sample of 15,632 adolescents

Objectives Body image is widely related to behavioral factors in adolescents and negative levels has been associated to poor physical and mental health. This study analyzed the association of physical activity and sedentary behavior with body dissatisfaction in adolescents. Methods Data from 15,632 adolescents between 11 and 17 years from the Brazilian National Scholar Health Survey - PeNSE 2015 were analyzed. Body dissatisfaction was self-reported. Sedentary behavior was assessed by hours in television (TV) viewing and in overall sitting behaviors. Physical activity was assessed by amount of time in domains of active commuting, physical education classes at school, and physical activities outside the school. Analyses were adjusted by age, ethnicity, body mass index, and scholarity of mother. Results Body dissatisfaction prevalence was 18.5%, being higher in girls than boys (24.2 vs. 12.7%, p < 0.001). Female gender (OR = 2.35), higher age-group (OR = 1.64), high scholarity of mother (OR = 1.43), and had overweight/obesity (OR = 2.38/4.81) were positively related to body dissatisfaction. Higher sedentary time was associated with body dissatisfaction in adolescents when compared to less than 2 h/day of sedentary time (OR varying from 1.45 to 2.14). Physical activity was negatively associated with adolescent body dissatisfaction in all assessed domains, with odds ratio varying from 0.66 to 0.89. Conclusions Body dissatisfaction showed an independent association of with total sedentary behavior (positively) and with different domains of physical activity (negatively) in a large scholar sample of Brazilian adolescents.

Longitudinal bidirectional relations between body dissatisfaction and depressive symptoms among Black adolescents: A cross-lagged panel analysis

Objective

To assess the variation in body dissatisfaction and depressive symptoms by weight status and the bi-directional relations between body dissatisfaction and depressive symptoms by weight status among Black adolescents.

Methods

A sample of 153 Black adolescents aged 12–13 years, either overweight/obese (n = 57, 37%) or healthy weight (n = 96, 63%), were recruited and evaluated three times over two years (T1, T2 and T3). Measured weight and height were converted to age and sex-specific BMI z-score; body dissatisfaction was measured with silhouettes, and depressive symptoms were measured with the Beck Depression Inventory (BDI-I). Bidirectional relations were assessed with cross-lagged panel analyses, accounting for stability over time and contemporary correlations.

Results

Body dissatisfaction was higher among the overweight/obese group than the healthy weight group. No significant differences were found for depressive symptoms by weight status. Among the overweight/obese group, there were bidirectional relations: antecedent body dissatisfaction predicted subsequent depressive symptoms (T1-T2: β = 0.42, SE = 0.11, p<0.001; T2-T3: β = 0.36, SE = 0.09, p<0.001) and antecedent depressive symptoms predicted subsequent body dissatisfaction (T1-T2: β = 0.25, SE = 0.10, p = 0.012; T2-T3: β = 0.17, SE = 0.08, p = 0.045). Among the healthy weight group, there was no relation in either direction.

Conclusions

Elevated body dissatisfaction among the overweight/obese group supports weight-based stigma as a stressor among Black adolescents. The bidirectional relations between body dissatisfaction and depressive symptoms among the overweight/obese group support the internalization of thinness idea and negative self-appraisal associated with depressive symptoms. Prevention of both body dissatisfaction and depressive symptoms may be mutually beneficial among Black adolescents with overweight/obesity.

Study of the Relationship between Body Mass Index, Body Image, and Lifestyle Behaviors: A Community Survey in Fiji

Introduction:

Public health promotion efforts aimed at overweight and obesity prevention often proceed from the premise that the first step should be losing weight. Appropriate perceptions of body image may be important for improving weight loss awareness. Therefore, we aimed to examine the relationship between body mass index and body image perception in Fiji, where increasing obesity is currently the most important health-related issue.

Methods:

Using the resident register based on the governmental census, one household member, aged between 18 and 69 years, was randomly selected from each household in two areas. There were 1,014 participants in the study. The questionnaire items were related to body image, dietary behaviors, physical activity, smoking habits, and alcohol consumption habits. Moreover, information regarding height, weight, blood pressure, and hemoglobin A1c were measured, and questions about social status (age, ethnicity, education, marital status, and employment), and subjective living status were asked. A multivariate logistic regression analysis was performed to analyze the relationship between body mass index (BMI) and body image perception.

Results:

Data from 391 men and 537 women were analyzed. Men within higher BMI quartiles smoked less (p = 0.0004) and drank less alcohol (p = 0.042). Women in higher BMI quartiles engaged in less physical activity (p = 0.022). Among the assessed data, both men and women in the higher BMI quartiles underestimated their body image compared with their actual physique (p < 0.0001). The higher BMI was associated with underestimated body image (men: odds ratio [OR] = 3.22, 95% confidence interval [CI], 1.94–5.35; p < 0.0001; women: OR = 18.11, 95% CI, 10.10–32.47; p < 0.0001).

Conclusions:

Higher BMI is strongly associated with underestimated body image among Fiji residents. Health-related counseling should be included within programs that aim to increase recognition of one’s actual physical size.

Does dissatisfaction with, or accurate perception of overweight status help people reduce weight? Longitudinal study of Australian adults

BACKGROUND

With studies around the world suggesting a large proportion of people do not recognise that they are overweight (or feel satisfied with being overweight), this fuels the view that such 'misperceptions' need to be 'corrected'. However, few longitudinal studies have examined the consequences of under-perceived weight status, nor over-perceived weight status (when a person feels overweight when they are not) and weight-related satisfaction on trajectories in body mass index (BMI).

METHODS

Five-year BMI trajectories were examined among 8174 participants in an Australian nationally representative cohort. Each person was classified into groups according to their neighbourhood socioeconomic circumstances, baseline BMI and answers to "how satisfied are you with your current weight?" and "do you consider yourself to be… acceptable weight / underweight / overweight?" Gender-specific multilevel linear regressions were used to examine five-year BMI trajectories for people in each group, adjusting for potential confounders.

RESULTS

At baseline, weight-related dissatisfaction and perceived overweight were generally associated with higher mean BMI for men and women, regardless of whether they were classified as 'normal' or overweight by World Health Organization (WHO) criteria. Mean BMI did not decrease among people classified as overweight who perceived themselves as overweight, or expressed weight-related dissatisfaction, regardless of where they lived. Among men and women with 'normal' BMI at baseline but expressing weight-related dissatisfaction, mean BMI increased disproportionately among those living in disadvantaged areas compared to their counterparts in affluent areas. Similarly, mean BMI rose disproportionately among people in disadvantaged areas who felt they were overweight despite having a 'normal' BMI by WHO criteria, compared to people with the same over-perceptions living in affluent areas. These differences exacerbated pre-existing socioeconomic inequities in mean BMI.

CONCLUSIONS

No evidence was found to suggest accurate recognition of overweight or expressing weight-related dissatisfaction leads to a lower BMI. However, there was evidence of an increase in mean BMI among people who felt dissatisfied with, or over-perceived their 'normal' weight, especially in socioeconomically disadvantaged areas. Correction of under-perceptions may not drive weight loss, but circumstances contributing to over-perception and dissatisfaction with weight status may contribute to increased weight gain and exacerbate socioeconomic inequities in BMI.

Baseline Body Mass Predicts Average Depressive Symptoms over the Next Two Decades for White but Not Black Older Adults

Background: Although obesity and depression have a bidirectional association, this link may vary based on race. The current study tested racial variation in bidirectional links between depressive symptoms and body mass index (BMI) over 24 years of follow-up in older adults over the age of 50 in the United States. We hypothesized weaker bidirectional links in Blacks compared to Whites. Methods: Data came from waves 1 to 12 (1990 to 2014) of the Health and Retirement Study (HRS), an ongoing state-of-the-art national cohort. The study followed a representative sample of Americans (n = 15,194; 2,200 Blacks and 12,994 Whites) over the age of 50. Dependent variables were average depressive symptoms and BMI over 24 years, based on measurements every other year, from 1990 to 2014. Independent variables included baseline depressive symptoms and BMI. Covariates included age, gender, marital status, veteran status, and activities of daily living. Structural equation models were fitted to the data for data analysis. Results: In the pooled sample, bidirectional associations were found between BMI and depressive symptoms as baseline BMI predicted average depressive symptoms over time and baseline depressive symptoms predicted average BMI over 24 years. Racial differences were found in the bidirectional association between BMI and depressive symptoms, with both directions of the associations being absent for Blacks. For Whites, baseline BMI predicted average depressive symptoms over the next 24 years. Conclusion: Reciprocal associations between BMI and depressive symptoms over a 24-year period among individuals over the age of 50 vary for Blacks and Whites. As these associations are stronger for Whites than Blacks, clinical and public health programs that simultaneously target comorbid obesity and depression may be more appropriate for Whites than Blacks.

Exploration of body perception and body dissatisfaction in young adults with intellectual disability

BACKGROUND

People with intellectual disability (ID) are more likely to be overweight or obese. Research has shown that body dissatisfaction is a key factor in influencing unhealthy eating behaviour. More evidence is needed relating to how people with ID perceive their bodies in order to provide effectively targeted weight management programmes.

AIMS

This study aimed to investigate whether people with ID have concepts for underweight, overweight and healthyweight, and whether they can apply these concepts to themselves. It also aimed to explore body perception bias through comparison of perceived self to independent figure ratings, and body dissatisfaction through perceived-ideal body discrepancy measurement and a series of open-ended questions.

METHOD

Mixed methodology was used to explore body perception and body dissatisfaction in 40 young adults with ID compared to 48 individuals without ID. The Stunkard Figure Rating Scale assessed how participants would like to look, and their concepts of weight categories.

RESULTS

Young adults with ID tend to hold positive beliefs about their bodies. Females with ID were likely to underestimate their body size. Individuals with ID understood what is meant by 'overweight', 'healthy-weight' and 'underweight' although these concepts were different to those without ID. Individuals with ID were unable to accurately apply these body size categories to themselves.

CONCLUSION

These findings suggest that individuals with ID will first need support to understand how concepts of body size apply to themselves in order to facilitate weight management.

A Healthy Person: The Perceptions of Indonesian and Scandinavian Nursing Students

The purpose of this exploratory study was to investigate how nursing students in Indonesia and Scandinavia characterize a healthy person. Two hundred thirty-two nursing students from Indonesia, 50 students from Sweden, and 119 students from Norway participated by answering an open-ended question. Qualitative content analysis was used to identify patterns of health in a cultural and national context. The characteristics of a healthy person were summarized in the theme “external and inner balance,” which are intertwined because of the wholeness of self-image and appearance. The subcategories were having a strong and positive body image, feeling well and having inner harmony, following the rules of life, coping with challenges, and acting in unison with the environment. There were more similarities than differences between the Indonesian and Scandinavian nursing students’ understanding of being a healthy person. The difference is that the Scandinavian students mentioned individuality, whereas the Indonesian students referred to collective values.

Perceived Physical Appearance: Assessing Measurement Equivalence in Black, Latino, and White Adolescents

Objective

This aim of this study was to examine whether the construct of physical appearance perception differed among the three largest racial/ethnic groups in the United States using an adolescent sample.

Methods

Black (46%), Latino (31%), and White (23%) adolescents in Grade 10 from the Healthy Passages study ( N  = 4,005) completed the Harter's Self-Perception Profile for Adolescents-Physical Appearance Scale (SPPA-PA) as a measure of physical appearance perception.

Results

Overall, Black adolescents had a more positive self-perception of their physical appearance than Latino and White adolescents. However, further analysis using measurement invariance testing revealed that the construct of physical appearance perception, as measured by SPPA-PA, was not comparable across the three racial/ethnic groups in both males and females.

Conclusions

These results suggest that observed differences may not reflect true differences in perceptions of physical appearance. Measures that are equivalent across racial/ethnic groups should be developed to ensure more precise measurement and understanding.

Factors related to obesity and overweight among Black adolescent girls in the United States

In the United States, Black adolescents have the highest prevalence of pediatric obesity and overweight among girls. While Black girls are disproportionately affected, the reasons for this health disparity remain unclear. The authors conducted a systematic review to investigate the factors related to obesity and overweight among Black adolescent girls. The authors searched four databases for relevant English-language publications using all publication years through 2015. Fifty-one studies met the inclusion criteria and were used for this review. Using a configuration approach to synthesis, three categories were identified, paralleling the bioecological theory of human development: (1) individual, (2) interpersonal, and (3) community and societal factors. A description of each factor's association with obesity among Black adolescent girls is presented. From this review, the authors identified a diverse and vast set of individual, interpersonal, and community and societal factors explored for their relationship with obesity and overweight. Given the insufficient repetition and limited significant findings among most factors, the authors believe that multiple gaps in knowledge exist across all categories regarding the factors related to obesity and overweight among Black adolescent girls. To improve the quality of research in this area, suggested research directions and methodological recommendations are provided.

Sustained Obesity and Depressive Symptoms over 6 Years: Race by Gender Differences in the Health and Retirement Study

Background: Although obesity and physical activity influence psychosocial well-being, these effects may vary based on race, gender, and their intersection. Using 6-year follow-up data of a nationally representative sample of adults over age of 50 in the United States, this study aimed to explore race by gender differences in additive effects of sustained high body mass index (BMI) and physical activity on sustained depressive symptoms (CES-D) and self-rated health (SRH).

Methods: Data came from waves 7, 8, and 10 (2004–2010) of the Health and Retirement Study (HRS), an ongoing national cohort started in 1992. The study enrolled a representative sample of Americans (n = 19,280) over the age of 50. Latent factors were used to calculate sustained high BMI and physical activity (predictors) and sustained poor SRH and high depressive symptoms (outcomes) based on measurements in 2004, 2006, and 2010. Age, education, and income were confounders. Multi-group structural equation modeling (SEM) was used to test the additive effects of BMI and physical activity on depressive symptoms and SRH, where the groups were defined based on race by gender.

Results: Group differences were apparent in the direction and significance of the association between sustained high BMI and depressive symptoms. The association between sustained high BMI and depressive symptoms was positive and significant for White women (B = 0.03, p = 0.007) and non-significant for White men (B = −0.03, p = 0.062), Black men (B = −0.02, p = 0.564) and Black women (B = 0.03, p = 0.110). No group differences were found in the paths from sustained physical activity to depressive symptoms, or from physical activity or BMI to SRH.

Conclusion: Sustained high BMI and high depressive symptoms after age 50 are positively associated only for White women. As the association between sustained health problems such as depression and obesity are not universal across race and gender groups, clinical and public health interventions and programs that simultaneously target multiple health problems may have differential effects across race by gender groups.

Urban Neighborhood Features and Longitudinal Weight Development in Girls

INTRODUCTION

The literature on environment and obesity is characterized by studies that are often cross-sectional and lack racial diversity. This study examined associations between neighborhood features and BMI development over 6 years in an urban sample of 2,295 girls (56% African American; mean age at baseline, 11.2 years) in 2004. Analyses were conducted in 2011-2015.

METHODS

Girls, caregivers, and study staff completed annual neighborhood questionnaires. Linear mixed-effects modeling examined annual changes in neighborhood features and BMI and assessed whether baseline neighborhood features modified BMI growth over time.

RESULTS

At baseline, 40% of participants were overweight/obese. Participants' neighborhoods had few neighborhood problems, moderate levels of safety issues and inconvenient features, low levels of neighborhood disorder, few cases of loitering youth, and substantial traffic volume. Adverse neighborhood features were more common for African American than white participants. Neighborhood features were relatively stable over the follow-up period. African American girls with helpful neighbors had lower annual BMI growth (-0.09 kg/m(2)) than others. For white girls, BMI increased more for girls with helpful neighbors (+0.09 kg/m(2) annually). Regardless of race, living in a U.S. Census tract with low levels of educational achievement was linked with higher BMI growth (an additional 0.07 kg/m(2) annually). Girls living in Census tracts with high (versus low) levels of poverty gained an additional 0.08 kg/m(2) gain annually.

CONCLUSIONS

Social environment features are associated with BMI change in white and African American urban girls and may be helpful for identifying girls at risk for early adolescent weight gain.

Weight perceptions, misperceptions, and dating violence victimization among U.S. adolescents

Dating violence is a major public health issue among youth. Overweight/obese adolescents experience peer victimization and discrimination and may be at increased risk of dating violence victimization. Furthermore, given the stigma associated with overweight/obesity, perceptions and misperceptions of overweight may be more important than actual weight status for dating violence victimization. This study examines the association of three weight indices (weight status, perceived weight, and weight perception accuracy) with psychological and physical dating violence victimization. The 2010 baseline survey of the 7-year NEXT Generation Health Study used a three-stage stratified clustered sampling design to select a nationally representative sample of U.S. 10th-grade students (n = 1,983). Participants who have had a boyfriend/girlfriend reported dating violence victimization and perceived weight. Weight status was computed from measured height/weight. Weight perception accuracy (accurate/underestimate/overestimate) was calculated by comparing weight status and perceived weight. Gender-stratified regressions examined the association of weight indices and dating violence victimization. Racial/ethnic differences were also examined. The association of weight indices with dating violence victimization significantly differed by gender. Overall, among boys, no associations were observed. Among girls, weight status was not associated with dating violence victimization, nor with number of dating violence victimization acts; however, perceived weight and weight perception accuracy were significantly associated with dating violence victimization, type of victimization, and number of victimization acts. Post hoc analyses revealed significant racial/ethnic differences. White girls who perceive themselves (accurately or not) to be overweight, and Hispanic girls who are overweight, may be at increased risk of dating violence victimization. These findings suggest a targeted approach to dating violence victimization prevention.

"I'm thankful for being Native and my body is part of that": the body pride experiences of young Aboriginal women in Canada

Body pride may be a predictor of health and well-being among Aboriginal youth. Body pride could potentially be addressed in health interventions, but it is critical to understand how body pride is conceptualized among Aboriginal youth. The purpose of this qualitative description study was to better understand the experiences of body pride among young Aboriginal women living in urban centers in Alberta, Canada. Eight young Aboriginal women (15-18 years old) participated in one-on-one interviews. A qualitative content analysis highlighted five themes that represent the participants' meanings of body pride. Participants described how body pride is: (a) accepting everything about your body, (b) who you are and how you show it, (c) connected to culture, (d) being healthy, and (e) being thankful to be Native. This research makes a contribution to the growing body pride literature by providing an initial glimpse into the complexities of young Aboriginal women's body pride experiences.

Dietary and weight-related behaviors and body mass index among Hispanic, Hmong, Somali, and white adolescents

BACKGROUND

The population of the United States is becoming increasingly ethnically and racially diverse, much of it due to immigration patterns. However, little is known about dietary intake and weight-related concerns and behaviors of youth from some ethnic-minority groups, especially Hispanic, Hmong, and Somali adolescents.

OBJECTIVE

Our aim was to describe dietary intake and weight-related concerns and behaviors among Hispanic, Hmong, and Somali adolescents and compare them with white adolescents.

DESIGN

We performed a cross-sectional analysis of data from Eating and Activity in Teens 2010, a population-based study in the Minneapolis/St Paul metropolitan area.

PARTICIPANTS/SETTING

Current analysis includes 1,672 adolescents (Hispanic: n=562 [33.6%]; Hmong: n=477 [28.5%]; Somali: n=113 [6.8%]; white: n=520 [31.1%]; mean age=15.0 years). Adolescents completed classroom surveys and had their height/weight measured during the 2009-2010 academic year.

STATISTICAL ANALYSIS

Multivariable regression models, adjusted for socioeconomic status, age, and school as a random effect were used to examine racial/ethnic differences for each outcome variable for boys and girls.

RESULTS

There were numerous differences in the behaviors of Hispanic, Hmong, and Somali adolescents as compared with whites. Hispanic and Somali youth consumed fruit and fast food more frequently. Hmong adolescents consumed sugar-sweetened beverages less frequently, and Somali boys consumed energy and sport drinks more frequently than whites. Compared with white boys, overweight/obesity was higher among Hispanic and Hmong. A higher percentage of Hmong and Somali adolescents engaged in unhealthy weight control behaviors. Body satisfaction was lower for all Hmong adolescents compared with whites.

CONCLUSIONS

There were varying areas of concern in dietary intake, weight, and weight-related concerns and behaviors among adolescents in all ethnic groups. Future nutrition and physical activity interventions that include adolescents from these ethnic and cultural groups can benefit from, for example, modifying intervention strategies to the specific priority behaviors within the target population.

Dietary and weight-related behaviors and body mass index among Hispanic, Hmong, Somali, and white adolescents

BACKGROUND

The population of the United States is becoming increasingly ethnically and racially diverse, much of it due to immigration patterns. However, little is known about dietary intake and weight-related concerns and behaviors of youth from some ethnic-minority groups, especially Hispanic, Hmong, and Somali adolescents.

OBJECTIVE

Our aim was to describe dietary intake and weight-related concerns and behaviors among Hispanic, Hmong, and Somali adolescents and compare them with white adolescents.

DESIGN

We performed a cross-sectional analysis of data from Eating and Activity in Teens 2010, a population-based study in the Minneapolis/St Paul metropolitan area.

PARTICIPANTS/SETTING

Current analysis includes 1,672 adolescents (Hispanic: n=562 [33.6%]; Hmong: n=477 [28.5%]; Somali: n=113 [6.8%]; white: n=520 [31.1%]; mean age=15.0 years). Adolescents completed classroom surveys and had their height/weight measured during the 2009-2010 academic year.

STATISTICAL ANALYSIS

Multivariable regression models, adjusted for socioeconomic status, age, and school as a random effect were used to examine racial/ethnic differences for each outcome variable for boys and girls.

RESULTS

There were numerous differences in the behaviors of Hispanic, Hmong, and Somali adolescents as compared with whites. Hispanic and Somali youth consumed fruit and fast food more frequently. Hmong adolescents consumed sugar-sweetened beverages less frequently, and Somali boys consumed energy and sport drinks more frequently than whites. Compared with white boys, overweight/obesity was higher among Hispanic and Hmong. A higher percentage of Hmong and Somali adolescents engaged in unhealthy weight control behaviors. Body satisfaction was lower for all Hmong adolescents compared with whites.

CONCLUSIONS

There were varying areas of concern in dietary intake, weight, and weight-related concerns and behaviors among adolescents in all ethnic groups. Future nutrition and physical activity interventions that include adolescents from these ethnic and cultural groups can benefit from, for example, modifying intervention strategies to the specific priority behaviors within the target population.

Establishing the optimal body mass index - body esteem relationship in young adolescents

Background

This study sought to compare the utility of either inverted body mass index or body mass index to optimise the relationship with body esteem in young adolescents Design: The study was cross sectional in design and assessed body esteem and weight status in756 young adolescents (394 boys, 362 girls, mean age ± S.D. 11.4 ± 1.6 years).

Methods

Body esteem was determined using the body esteem scale for children. Height and body mass were measured directly. Body mass index was determined as kg/m² and iBMI as cm²/kg.

Results

Results indicated that the association between iBMI and body esteem was curvilinear in nature and iBMI was the better predictor of body esteem (P = .001) predicting 21.3% of the variance in body esteem scores compared to 20.5% using BMI (P = .001). When split by gender, the curvilinear relationship was still evident but significantly different between boys and girls although iBMI remained a better predictor of body esteem compared to BMI in both boys and girls. The peak differed between gender groups with the association between iBMI and body esteem peaking at 642 cm²/kg for boys and 800.64 cm²/kg for girls.

Conclusion

This study suggests that iBMI is a better predictor of body esteem in young adolescents, and that the association between body esteem and iBMI is curvilinear in nature. However, the peak of body esteem scores occured at a lower degree of leanness for boys compared to girls and indicated that the point at which body esteem scores are highest for girls is at a point of extreme leanness whereas the peak for boys was within the values considered as ‘normal’ on the leanness to obesity continuum. iBMI may therefore be a useful measure of leanness for future studies examining the association between overweight/obesity and body esteem in young adolescents.

Weight status, body image and bullying among adolescents in the Seychelles

We investigated the relationship between being bullied and measured body weight and perceived body weight among adolescents of a middle-income sub Saharan African country. Our data originated from the Global School-based Health Survey, which targets adolescents aged 13–15 years. Student weights and heights were measured before administrating the questionnaire which included questions about personal data, health behaviors and being bullied. Standard criteria were used to assess thinness, overweight and obesity. Among 1,006 participants who had complete data, 16.5% (95%CI 13.3–20.2) reported being bullied ≥3 days during the past 30 days; 13.4% were thin, 16.8% were overweight and 7.6% were obese. Categories of actual weight and of perceived weight correlated only moderately (Spearman correlation coefficient 0.37 for boys and 0.57 for girls; p < 0.001). In univariate analysis, both actual obesity (OR 1.76; p = 0.051) and perception of high weight (OR 1.63 for “slightly overweight”; OR 2.74 for “very overweight”, both p < 0.05) were associated with being bullied. In multivariate analysis, ORs for categories of perceived overweight were virtually unchanged while ORs for actual overweight and obesity were substantially attenuated, suggesting a substantial role of perceived weight in the association with being bullied. Actual underweight and perceived thinness also tended to be associated with being bullied, although not significantly. Our findings suggest that more research attention be given to disentangling the significant association between body image, overweight and bullying among adolescents. Further studies in diverse populations are warranted.