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Lucibello KM, Zhang Q, Leatherdale ST, Patte KA. Changing eating to manage weight or shape: A cross-sectional and prospective study of the prevalence and correlates in a large Canadian adolescent cohort. Prev Med 2024; 184:107987. [PMID: 38714274 DOI: 10.1016/j.ypmed.2024.107987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/02/2024] [Accepted: 05/04/2024] [Indexed: 05/09/2024]
Abstract
OBJECTIVE The present study examined reports of changing eating to manage weight/shape over one year among adolescents. It also tested how changing eating for weight/shape was associated with physical activity (resistance training, moderate-to-vigorous physical activity; MVPA) and mental health (depressive symptoms, flourishing), and whether weight perceptions moderated these associations. METHODS Participants were Canadian adolescents (N = 20,614, Mage ± SD = 14.4 ± 1.3, 52.9% girls) who completed self-report surveys in the 2020-2021 and 2021-2022 waves of the COMPASS study. Separate multilevel models were tested for each outcome. RESULTS Approximately 30% of adolescents reported changing their eating to manage weight/shape at least once a week. More days of changing eating were associated with significantly higher depressive symptoms and lower flourishing cross-sectionally (b = 0.51, b = -0.27) and over time (b = 0.35, -0.20); the flourishing association over time was weaker for adolescents who perceived themselves as overweight relative to about right. More days of changing eating were also associated with more MVPA and resistance training cross-sectionally (b = 2.81, b = 0.19) and over time (b = 1.28, b = 10). The relationship between changing eating and MVPA over time was stronger for adolescents who perceived themselves as overweight relative to about right; whereas the cross-sectional relationship between changing eating and resistance training was weaker. CONCLUSIONS Reports of changing eating to manage weight/shape were associated with divergent health outcomes; research into how and to what extreme adolescents are changing eating to manage weight/shape, and identity factors that may contribute to these differences, is warranted.
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Affiliation(s)
- Kristen M Lucibello
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.
| | - Qianyu Zhang
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
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Manyanga T, White N, Sluggett L, Duchesne A, Anekwe D, Pelletier C. Perceived Barriers to Physical Activity Among Youth Living in Rural and Urban Canadian Communities: A Nationally Representative Cross-Sectional Study. J Phys Act Health 2024; 21:645-656. [PMID: 38575136 DOI: 10.1123/jpah.2023-0254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 01/18/2024] [Accepted: 02/28/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND We used nationally representative data to explore associations among location of residence (rural/urban) and perceived barriers to physical activity (PA) in Canadian youth. METHODS We analyzed the 2017 Canadian Community Health Survey, Barriers to Physical Activity Rapid Response data for 12- to 17-year-old youth. Nine items from the survey assessing perceived barriers to PA were combined into 3 barrier domains: resources, motivational, and socioenvironmental. The likelihood of reporting barriers to PA based on rural-urban location was examined using survey-weighted binary logistic regression following a model fitting approach. Sociodemographic factors were modeled as covariates and tested in interaction with location. For each barrier domain, we derived the best-fitting model with fewest terms. RESULTS There were no location-specific effects related to reporting any barrier or motivation-related PA barriers. We found a sex by location interaction predicting the likelihood of reporting resource-related barriers. Rural boys were less likely to report resource-related barriers compared with urban boys (odds ratio [OR] = 0.42 [0.20, 0.88]). Rural girls were more likely to report resource-related barriers compared with boys (OR = 3.72 [1.66, 8.30]). Regarding socioenvironmental barriers, we observed a significant body mass index by location interaction demonstrating that rural youth with body mass index outside the "normal range" showed a higher likelihood of reporting socioenvironmental barriers compared with urban youth (OR = 2.38 [1.32, 4.30]). For urban youth, body mass index was unrelated to reporting socioenvironmental barriers (OR = 1.07 [0.67, 1.71]). CONCLUSION PA barriers are not universal among Canadian youth. Our analyses highlight the importance of testing interactions in similar studies as well as considering key sociodemographic characteristics when designing interventions.
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Affiliation(s)
- Taru Manyanga
- Division of Medical Sciences, University of Northern British Columbia, Prince George, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Nicole White
- University of Northern British Columbia, Prince George, BC, Canada
| | - Larine Sluggett
- University of Northern British Columbia, Prince George, BC, Canada
| | - Annie Duchesne
- Department of Psychology, University of Northern British Columbia, Prince George, BC, Canada
| | - David Anekwe
- Division of Medical Sciences, University of Northern British Columbia, Prince George, BC, Canada
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Chelsea Pelletier
- School of Health Sciences, Faculty of Human and Health Sciences, University of Northern British Columbia, Prince George, BC, Canada
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Zhou J, Da Q, Xie L, Jiang Y, Li L. Association between Body Mass Index and Externalizing and Internalizing Symptoms among Chinese Adolescents: Mediating Role of Traditional Bullying and Cyberbullying Victimization. Behav Sci (Basel) 2024; 14:427. [PMID: 38920759 PMCID: PMC11200949 DOI: 10.3390/bs14060427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/17/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Externalizing problems, internalizing problems, and obesity are among the greatest challenges to adolescent health. However, the moderating and mediating mechanisms that underlie this association remain predominantly unexplored. OBJECTIVES In this study, we examined the association between body mass index (BMI) and externalizing and internalizing scores in adolescents, tested whether traditional bullying and cyberbullying mediated the association, and explored the moderated role of sex. METHODS The data came from 1486 adolescents from grade 7, 8, and 10 living in Shantou, China. Information on BMI, traditional bullying, and cyberbullying victimization was obtained through a self-administered questionnaire. The students' externalizing and internalizing scores were evaluated using the Strengths and Difficulties Questionnaire (SDQ). Furthermore, we built two parallel mediation models with sex as a moderating variable. RESULTS Compared to their peers with normal weight, adolescents with increased BMI reported higher externalizing and internalizing scores. Traditional bullying and cyberbullying were both significant mediators in the two relationships. Sex moderated the pathway from BMI to cyberbullying. But sex did not moderate the relationship between BMI and traditional bullying. CONCLUSIONS The results highlight that it is imperative for educators to identify students who are subjected to weight-based bullying and provide them with recommendations for effective coping strategies. Meanwhile, both victims of traditional bullying and those affected by cyberbullying should be the focus of prevention and intervention efforts when developing a strategy to improve levels of internalizing and externalizing symptoms among adolescents with increased BMI.
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Affiliation(s)
- Jiajun Zhou
- School of Public Health, Shantou University, Shantou 515041, China; (J.Z.); (Q.D.); (L.X.); (Y.J.)
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Qingchen Da
- School of Public Health, Shantou University, Shantou 515041, China; (J.Z.); (Q.D.); (L.X.); (Y.J.)
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Linlin Xie
- School of Public Health, Shantou University, Shantou 515041, China; (J.Z.); (Q.D.); (L.X.); (Y.J.)
| | - Yifan Jiang
- School of Public Health, Shantou University, Shantou 515041, China; (J.Z.); (Q.D.); (L.X.); (Y.J.)
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
| | - Liping Li
- School of Public Health, Shantou University, Shantou 515041, China; (J.Z.); (Q.D.); (L.X.); (Y.J.)
- Injury Prevention Research Center, Shantou University Medical College, Shantou 515041, China
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Gu W, Yu X, Tan Y, Yu Z, Zhu J. Association between weight, weight perception, weight teasing and mental health among adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:39. [PMID: 38521915 PMCID: PMC10960988 DOI: 10.1186/s13034-024-00730-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/11/2024] [Indexed: 03/25/2024] Open
Abstract
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.
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Affiliation(s)
- Wenxin Gu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoyan Yu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Yinliang Tan
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | - Zhiping Yu
- Department of Nutrition and Dietetics, University of North Florida, Jacksonville, FL, USA
| | - Jingfen Zhu
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
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Bottaro R, Valenti GD, Faraci P. Internet Addiction and Psychological Distress: Can Social Networking Site Addiction Affect Body Uneasiness Across Gender? A Mediation Model. EUROPES JOURNAL OF PSYCHOLOGY 2024; 20:41-62. [PMID: 38487602 PMCID: PMC10936664 DOI: 10.5964/ejop.10273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/20/2023] [Indexed: 03/17/2024]
Abstract
Introduction The Internet, with its unlimited information, revolutionary communication capabilities, and innovative potential to expand knowledge, is ubiquitous throughout the world, but it also has significant implications for users' mental health. Given the not yet clearly defined and distinguishable nosographic categories of online addiction and the resulting difficulties in describing the impact on users' mental health, the present cross-sectional study aimed to gain new insights into the relationship between Internet addiction (especially social networking site [SNS] addiction), psychological distress, and physical discomfort, as well as gender differences in impact among users. Method A sample of 583 Italian speakers (50.8% males; 48.7% females) with a mean age of 30.96 (SD = 12.12) completed an online survey in July 2021. A set of psychometric self-report instruments was administered to assess the study variables. Mediation analyses were performed for both the whole sample and across genders. Results The study found that men exhibited higher levels of Internet addiction and craving than women, but no differences were found for SNS addiction. Furthermore, indicators of psychological distress (i.e., anxiety, depression, stress, loneliness, insomnia, and self-esteem) mediated the association between SNS addiction and body uneasiness, with slight differences across genders. Conclusion This paper contributes to the existing literature on online addictive behaviors by also highlighting gender differences. The findings underscore the need for educational experiences that can prevent problematic use of the Internet and SNSs.
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Affiliation(s)
- Rossella Bottaro
- Department of Human and Social Sciences, University of Enna “Kore”, Enna, Italy
| | - Giusy Danila Valenti
- Department of Psychological, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Palmira Faraci
- Department of Human and Social Sciences, University of Enna “Kore”, Enna, Italy
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Li Y, Jin XY, Weng YQ, Edwards TC, Jiang XY, Chen YP, Lv YR, Wang ZC, Wang HM, Patrick DL. Individualized Implementation of Youth Quality of Life Instrument-Research Version (YQOL-R) Among Chinese Adolescents with Different Weight Status. Patient Prefer Adherence 2023; 17:2295-2309. [PMID: 37745633 PMCID: PMC10516194 DOI: 10.2147/ppa.s417847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/31/2023] [Indexed: 09/26/2023] Open
Abstract
Purpose This study implemented the individualized Youth Quality of Life Instrument-Research Version (YQOL-R) to estimate the quality of life (QoL) among Chinese adolescents with three different Body Mass Index (BMI) levels. The study aims to explore and provide a reference for developing individualized QoL (IQoL) measurements in China. Methods The sample consisted of 822 aged 11-18 from nine schools. The data collection included all participants' primary characters (age, sex, annual household income, parental education, and recruitment community) and their self-report QoL. Precisely, based on the generic measurement of YQOL-R, we developed IQoL measurements by asking adolescents' perceived five most important things to them (IQOLimportance) and the aspects they most want to change (IQOLchange) from 19 facets, respectively. The one-way analysis of variance (ANOVA) was applied to compare total and subscale scores of IQOLimportance, IQOLchange, and YQOL-R among adolescents with three different weight status. Also, the data analysis used multivariable linear regression modeling to test the effects on scores of IQOLimportance and IQOLchange. Results Overall, the obese adolescents identified "Having good physical health" as the most important (54.03%) and most like-to-change (42.65%); in contrast, the normal-weight group ranked "Being myself" as the top facet of IQOLimportance (52.42%) and "Having good friends" as the top facet of IQOLchange (43.12%). The obese adolescents' reported IQOLimportance scores are significantly lower than those of the normal-weight group (P=0.039). However, there is no significant difference in IQOLchange score among the three weight-status groups. The multivariable linear regression models indicated that adolescents who are girls (P=0.035), have higher educated fathers (P=0.049), and are overweight/obese (P=0.041) self-reported worse IQOLimportance score; yet, the girls (P=0.023) and older adolescents (P=0.004) answered lower IQOLchange scores. In addition, adolescents who had higher educated mothers (P=0.047; 0.023) and responded with higher total YQOL-R scores (P<0.001; <0.001) reported higher IQOLimportance and IQOLchange scores. Conclusion In the current study, although the self-reported YQOL-R scores from different weight status did not present a significant difference, the obese group reported a statistical trend towards lower IQOLimportance scores than the normal-weight and overweight adolescents. These findings emphasize that IQOLimportance and IQOLchange could capture adolescents' perspectives with different weight statuses about their lives, which are unique as complementary health outcomes accompanying YQOL-R in health surveys and interventions among Chinese adolescents.
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Affiliation(s)
- Ying Li
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, People’s Republic of China
- School of Public Health, Xi’an Medical University, Xi’an, Shaanxi, 710021, People’s Republic of China
| | - Xiao-Yuan Jin
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, People’s Republic of China
| | - Yi-Qing Weng
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, People’s Republic of China
| | - Todd C Edwards
- Department of Health Systems and Population Health, Seattle, WA, 98195, USA
| | - Xiao-Ying Jiang
- The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310003, People’s Republic of China
| | - Ying-Ping Chen
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, 310051, People’s Republic of China
| | - Yi-Ran Lv
- Qingdao Municipal Hospital, Qingdao, Shandong, 266073, People’s Republic of China
| | - Zhao-Chen Wang
- Department of Social Medicine of School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, People’s Republic of China
| | - Hong-Mei Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310058, People’s Republic of China
| | - Donald L Patrick
- Department of Health Systems and Population Health, Seattle, WA, 98195, USA
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Jeong E. Factors associated with the adoption of extreme weight control behavior by non-obese adolescents: a secondary analysis. BMC Pediatr 2023; 23:464. [PMID: 37710201 PMCID: PMC10500794 DOI: 10.1186/s12887-023-04299-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/08/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Misperceptions about obesity is common among adolescents. Adolescents who overestimate their body size tend to indulge in extreme weight control behaviors. However, little is known about the factors involved in the adoption of extreme weight control behavior (EWCB) by non-obese adolescents who are mistaken for being overweight. This study identified factors associated with unhealthy behaviors among normal/underweight high school students who overestimate their body image and attempt to lose weight. DESIGN A secondary analysis of nationally representative data from the Korea Youth Risk Behavior Survey focused on adolescents who attended vocational and academically oriented high schools. METHODS The analysis included data from 4,286 non-obese respondents (15-18 years) who overestimated their body weight. Of them, 2,887 were girls (66.5%), while 1,399 were boys (33.5%). Multiple logistic regression was used to investigate risk factors for EWCB by sex. A statistical analysis reflecting strata, clusters, and weights of the complex sampling design was adopted. RESULTS Of the respondents, 674 (23.3%) girls and 162 (11.5%) boys reported EWCB. For both sexes, vocational high school attendance and depression were significantly influenced by EWCB. EWCB was linked to perceived stress in girls and living in a big city in boys. CONCLUSIONS The findings suggest the importance of providing quality health education, including that for non-obese adolescents, in school obesity prevention programs along with the expansion of tailored intervention programs based on sex, following a consideration of the characteristics of high schools as well as individuals.
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Affiliation(s)
- Eunha Jeong
- Pungnap Middle School, Seoul, Republic of Korea.
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Ozbardakci EV, Lydecker JA. Reframing How Providers Advocate for Adolescent Well-Being in Body Image, Eating, and Weight. J Am Acad Child Adolesc Psychiatry 2023; 62:957-962. [PMID: 36948394 PMCID: PMC10728998 DOI: 10.1016/j.jaac.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 12/27/2022] [Accepted: 03/13/2023] [Indexed: 03/24/2023]
Abstract
Adolescence is a critical developmental period when youth are vulnerable to messages that promote unrealistic body shapes and a culture of weight-based stigma. Adolescents' vulnerability is reflected in high prevalence of body dissatisfaction among adolescents of all genders,1-3 which can lead to negative mental health consequences including disordered eating and depression.4,5 Importantly, body concerns are compounded among adolescents with higher weights who are more likely to experience weight-based victimization and internalize weight-based stigma compared with adolescents with lower weights.6,7 Health care providers have an opportunity to advocate for well-being of adolescent patients by providing nonstigmatizing messages regarding body image, eating, and weight. While body image prevention programs emphasize the need to promote positive body image and awareness of weight-based victimization, clinical guidelines instead focus on preventing or treating conditions (ie, obesity or eating disorders). Yet, adolescents' well-being would benefit from weight-inclusive, positive body image messages. Providers can model the importance of prioritizing positive body image messages by spending time discussing body image through a positive rather than problem-focused lens. We propose an advocacy framework for health care providers to support adolescents' body image and to reduce the impact of weight bias across 4 settings: the clinic, social media, adolescents' homes, and school.
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Creese H, Saxena S, Nicholls D, Pascual Sanchez A, Hargreaves D. The role of dieting, happiness with appearance, self-esteem, and bullying in the relationship between mental health and body-mass index among UK adolescents: a longitudinal analysis of the Millennium Cohort Study. EClinicalMedicine 2023; 60:101992. [PMID: 37396802 PMCID: PMC10314161 DOI: 10.1016/j.eclinm.2023.101992] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 07/04/2023] Open
Abstract
Background Mental illness and obesity are among the biggest challenges to population health, they are linked, and may be modifiable during adolescence. We aimed to determine intervening pathways between mental health and BMI z-score symptoms across adolescence. Methods In this longitudinal cohort study, we used path models to examine self-reported dieting, happiness with appearance, self-esteem and bullying at 14 years as potential mediators of the cross-lagged relationship between mental health (via the Strengths and Difficulties Questionnaire) and Body Mass Index (BMI) z-score at 11 and 17 years by sex in the UK Millennium Cohort Study, a prospective cohort study of 18,818 children born in the UK between September 1st, 2000, and January 31st, 2002. Full, incomplete data on all singleton children still participating in the study by age 11 years were analysed in GSEM via maximum likelihood estimation (N = 12,450). Findings We found happiness with appearance and self-esteem, but not dieting or bullying, mediated the relationship between BMI age 11 and mental health age 17. Each increase in BMI z-score at 11 years was associated with 0.12 increase for boys and a 0.19 increase for girls in scores of unhappiness with appearance (boys: b 0.12, 95% C.I.; girls b 0.19, C.I. 0.14 to 0.23) and a 16% increase for boys and a 22% increase for girls in odds of low self-esteem (boys OR 1.16, 95% C.I. 1.07 to 1.26; girls: OR 1.22, 95% C.I. 1.15 to 1.30) at 14 years. In turn, for both boys and girls, being unhappy with appearance and low self-esteem at 14 years were associated with a greater likelihood of emotional and externalizing symptoms at 17 years. Interpretation Early prevention strategies to encourage healthy physical and mental development of children need to focus on the promotion of positive body-mage and self-esteem. Funding The National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR).
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Affiliation(s)
- Hanna Creese
- School of Public Health, Imperial College London, London, UK
| | - Sonia Saxena
- School of Public Health, Imperial College London, London, UK
| | - Dasha Nicholls
- Department of Brain Sciences, Imperial College London, UK
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Liu Z, Sun L, Zhang Y, Wang J, Sun F, Zhang Z, Sun G, Sun L, Yang R. The prevalence of underweight and obesity in Chinese children and adolescents with major depressive disorder and relationship with suicidal ideation and attempted suicide. Front Psychiatry 2023; 14:1130437. [PMID: 37215666 PMCID: PMC10196048 DOI: 10.3389/fpsyt.2023.1130437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/17/2023] [Indexed: 05/24/2023] Open
Abstract
Background The high rates of obesity and suicide have become serious public health problems worldwide, especially in children and adolescents with major depressive disorder (MDD). This research aimed to explore the rates of underweight, overweight or obesity, suicidal ideation and attempted suicide in hospitalized children and adolescents with MDD. Then, we analyzed the correlation between underweight or obesity and suicidal ideation and attempted suicide, and finally obtained the independent influencing factors of underweight or obesity. Methods A total of 757 subjects in the Third People's Hospital of Fuyang from January 2020 to December 2021 were enrolled in this study. According to the underweight, overweight and obesity screening table for school-age children and adolescents published and implemented by the health industry standard of China, all subjects were divided into different body mass index (BMI) categories. We measured fasting blood glucose (FBG) and lipid levels in all subjects and assessed suicidal ideation, attempted suicide, and the severity of depressive symptoms. The socio-demographic and clinical data were collected and analyzed by SPSS 22.0. Results The rates of underweight, overweight, obesity, suicidal ideation and attempted suicide were 8.2% (62/757), 15.5% (117/757), 10.4% (79/757), 17.2% (130/757), and 9.9% (75/757), respectively. Correlation analysis indicated that BMIs level was positively correlated with age, age of first hospitalization, total duration of disease, number of hospitalizations, FBG, TG (triglyceride), TC (total cholesterol), LDL (low density lipoprotein), and negatively correlated with HDL (high density lipoprotein). Binary logistic regression analysis showed that male and high level of HDL were risk factors for MDD inpatients with underweight, while high level of TG was a protective factor. Meanwhile, higher levels of FBG, TG and CGI-S were risk factors and suicidal ideation and high dose of antidepressant drugs were protective factors for obesity in children and adolescents with MDD. Conclusion The prevalence of underweight, obesity, suicidal ideation and attempted suicide were high in children and adolescents with MDD, and severe depressive symptoms are independent risk factors for obesity, while suicidal ideation and high dose of antidepressants may be protective factors for obesity.
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Affiliation(s)
- Zhiwei Liu
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Liang Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Yulong Zhang
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Juan Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Department of Psychiatry, The Fourth People’s Hospital of Chengdu, Chengdu, China
| | - Feng Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Zhaokun Zhang
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Guangying Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Longlong Sun
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
| | - Rongchun Yang
- Department of Psychiatry, The Third People’s Hospital of Fuyang, Fuyang, China
- Department of Psychiatry, Fuyang Mental Health Center, Fuyang, China
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Yang K, Zhao A, Xie Y, Xu Z, Peng Y, Tang H. Sociodemographic factors associated with weight perception of adolescents: A systematic review and meta-analysis. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2023; 36:95-104. [PMID: 36647840 DOI: 10.1111/jcap.12406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/25/2022] [Accepted: 01/05/2023] [Indexed: 01/18/2023]
Abstract
PURPOSE To systematically assess the main sociodemographic factors associated with weight perception of adolescents. METHODOLOGY All studies related to adolescents' weight perception were retrieved from seven databases from January 2001 to July 2022. A total of 13 Medical Subject Headings (MeSH) and keywords were used to identify qualified studies, and reference lists included in the retrieved studies were manually searched to identify potentially relevant publications. Two evaluators independently assessed the eligibility and extracted data of each study. Agency for Healthcare Research and Quality (AHRQ) risk of bias evaluation tool was used to evaluate the quality and bias risk of included studies. RevMan (version: 5.3) software was used to conduct heterogeneity test and meta-analysis. RESULTS A total of 12 studies, published between 2003 and 2020, were selected and included in the systematic review and meta-analysis, consisting of 325,367 adolescents from five countries. The risk of bias evaluation indicated that risk of bias was low in five studies and moderate in seven studies. The results of meta-analysis showed that there were no differences in the weight perception accuracy among adolescents under different gender (odds ratio [OR] = 1.00, 95% confidence interval [CI]: 0.88-1.15, p = 0.940), place of residence (OR = 0.98, 95% CI: 0.83-1.16, p = 0.800), grade (OR = 1.73, 95% CI: 0.68-4.42, p = 0.250), and family economic level (OR = 0.94, 95% CI: 0.86-1.02, p = 0.140). Egger's linear regression showed that there was no significant publication bias in the primary analysis. CONCLUSIONS The current analysis indicates that gender, place of residence, grade, and family economic level were not identified as influencing factors for adolescents' weight perception accuracy. Due to the limitations of the review and included studies, more robust trials are warranted in different social and economic environments to confirm our findings.
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Affiliation(s)
- Kaihan Yang
- School of Preclinical Medicine/School of Nursing, Chengdu University, Chengdu, Sichuan Province, China
| | - Anqi Zhao
- School of Preclinical Medicine/School of Nursing, Chengdu University, Chengdu, Sichuan Province, China
| | - Yujie Xie
- School of Preclinical Medicine/School of Nursing, Chengdu University, Chengdu, Sichuan Province, China
| | - Zhanyi Xu
- School of Preclinical Medicine/School of Nursing, Chengdu University, Chengdu, Sichuan Province, China
| | - Yubinxin Peng
- School of Preclinical Medicine/School of Nursing, Chengdu University, Chengdu, Sichuan Province, China
| | - Haiyang Tang
- School of Preclinical Medicine/School of Nursing, Chengdu University, Chengdu, Sichuan Province, China
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12
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Lucibello KM, Sabiston CM, Pila E, Arbour-Nicitopoulos K. An integrative model of weight stigma, body image, and physical activity in adolescents. Body Image 2023; 45:1-10. [PMID: 36731346 DOI: 10.1016/j.bodyim.2023.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 02/03/2023]
Abstract
Negative weight-related experiences and internalized weight stigma have been associated with poorer body image and reduced physical activity in adolescents. However, exploring body image and physical activity as discrete weight stigma outcomes fails to consider the theoretically- and empirically-supported covariation between the two. The present study tested a novel integrated model of the associations among negative weight-related experiences and internalized weight stigma (via weight-related distress), body image (shame, authentic pride, body appreciation), and physical activity. Canadian adolescents (N = 311, Mage ± SD = 16.00 ± 1.01, 75.5% girls) completed a cross-sectional self-report survey. A structural equation model with maximum likelihood robust estimation was tested. Higher negative weight-related experiences were indirectly associated with poorer body image (i.e., higher shame; lower authentic pride and appreciation) through higher weight-related distress. Authentic pride was associated with moderate-to-vigorous physical activity. Higher negative weight-related experiences were indirectly associated with lower physical activity through higher weight-related distress and lower body-related authentic pride. These findings elucidate targetable individual mechanisms and larger systems that could improve body image and foster physical activity among adolescents who encounter negative weight-related experiences and internalized weight stigma.
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Affiliation(s)
| | | | - Eva Pila
- School of Kinesiology, Western University, London, Ontario, Canada
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13
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Sarrias M, Blanco A. Bodyweight and human capital development: Assessing the impact of obesity on socioemotional skills during childhood in Chile. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101190. [PMID: 36306701 DOI: 10.1016/j.ehb.2022.101190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/02/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
This article analyzes the effect of bodyweight on socioemotional skills for children aged two to 12 years in Chile. Using an instrumental variable approach and a representative survey, we show that both BMI and obesity are causality related to children's socioemotional development, even after assuming that our instrument is imperfect. Although we did not find significant differences between boys and girls, we do identify heterogeneous effects by age: the weight penalty for girls starts earlier than for boys. Our findings suggest that early interventions for childhood obesity not only might generate positive impacts on children's health, but also a greater accumulation of non-cognitive human capital in the future.
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Affiliation(s)
- Mauricio Sarrias
- Facultad de Economía y Negocios, Universidad de Talca, Talca, Chile.
| | - Alejandra Blanco
- IDEAR, Department of Economics, Universidad Católica del Norte, Antofagasta, Chile.
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14
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Lee K. Self-perceived weight and self-rated health have distinct relationships according to body mass index in Korean teenagers. Nutr Res 2022; 107:179-186. [PMID: 36288656 DOI: 10.1016/j.nutres.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 12/27/2022]
Abstract
It was hypothesized that adolescents who perceived themselves as underweight or overweight would be positively associated with poor self-rated health (SRH), regardless of their actual weight status, and that the SRH would be varied depending on the combination of their actual weight and their perceived weight. The study aimed to evaluate associations of self-perceived weight and body mass index (BMI)-based weight status with SRH in Korean adolescents. A cross-sectional study was conducted in 1658 female and 1888 male adolescents aged 10 to 18 years based on the Korea National Health and Nutrition Examination Survey using complex-samples logistic regression. Weight estimation was determined by comparing BMI-based weight and self-perceived body shape. Age, family affluence, and health status were confounders. In sex-specific analysis, the odds for poor SRH were higher in males who accurately estimated underweight or overweight and those who were normal weight, but overestimated weight compared with those who accurately self-perceived as being normal weight. In females, the odds for poor SRH were higher in those with normal weight but underestimated or overestimated weight compared with a female comparison group. In the overall analysis, males who accurately perceived their weight as underweight, males and females who perceived their weight as overweight despite being normal weight or overweight, and females who perceived weight as underweight despite being normal weight had higher odds for poor SRH compared with a female comparison group. In conclusion, as the hypothesis of this study, self-perceived overweight and underweight in adolescents were associated with poor SRH regardless of BMI, and the association differed by BMI in Korean adolescents.
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Affiliation(s)
- Kayoung Lee
- Department of Family Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
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15
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Body Weight, Weight Self-Perception, Weight Teasing and Their Association with Health Behaviors among Chinese Adolescents-The Shanghai Youth Health Behavior Survey. Nutrients 2022; 14:nu14142931. [PMID: 35889888 PMCID: PMC9320621 DOI: 10.3390/nu14142931] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/11/2022] [Accepted: 07/14/2022] [Indexed: 01/16/2023] Open
Abstract
Weight-related status has been associated with the physical and psychological health of adolescents. This cross-sectional study evaluated three different kinds of weight-related statuses (Body Mass Index (BMI), weight self-perception and weight teasing from others) among Chinese adolescents and identified their associations with health risk behaviors (lack of healthy dietary behavior, unhealthy dietary behavior, binge eating behavior, lack of physical activity (PA), sedentary behaviors (SB) and sleep disturbance). A stratified random cluster sampling method was used to select 10,070 students aged 11−18 years old from schools in Shanghai. Self-reported questionnaires were collected, weight-related statuses were divided into three categories and six specific health risk behaviors were classified into two groups: positive or negative. Overall, 27.82% of the adolescents were classified as being overweight and obese (35.61% of boys and 18.21% of girls), 43.45% perceived themselves as too heavy and 30.46% experienced weight teasing in the past. Among overweight or obese participants, 50.55% have been teased about their weight, and 77.48% perceived themselves as too heavy. Weight perception and weight teasing were significantly associated with health risk behaviors rather than the actual body weight status based on BMI, especially regarding binge eating behavior (body weight status (BMI): p > 0.05, underweight perception: OR = 1.18, 95%CI 1.03−1.34; weight teasing for more than once a year: OR = 2.00, 95%CI 1.76−2.27). In addition, weight perception and weight teasing were significantly associated with health risk behaviors, mainly in normal and overweight/obese groups but not in underweight groups. Weight teasing and weight self-perception play an independent and stronger role than actual body weight in the health behaviors of adolescents. This calls for more attention and intervention to reduce peer bullying and stigmas on weight among adolescents.
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16
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Examining the role that weight perception and social influences have on mental health among youth in the COMPASS study. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1671-1684. [PMID: 35044480 PMCID: PMC8767527 DOI: 10.1007/s00127-022-02219-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 01/06/2022] [Indexed: 11/10/2022]
Abstract
PURPOSE We investigated whether social health mitigates the association between weight perception and anxiety and depression 1 year later in a large sample of Canadian youth in a prospective, gender-specific analysis. METHODS We used 2 years of linked survey data from 20,485 grade 9-11 students who participated in wave 6 (2017/18) and 7 (2018/19) of the COMPASS study. Mental health outcomes included the Generalized Anxiety Disorder-7 item (GAD-7) scale and the 10-item Centre for Epidemiological Studies Depression Scale Revised (CESD-10-R). Social health encompassed students' perceived relationships with friends, family, teachers, and within schools. Multilevel, prospective, linear models regressed mental health (at wave 7) on social health (at wave 6) and weight perception (at wave 6) while controlling for weight status, ethnicity, and grade (at wave 6). Interaction terms were used to test social health factors as moderators in the association between weight perception and mental health. RESULTS Overweight perceptions were associated with higher anxiety and depression scores among youth; this was more pronounced among females. Social health was associated with lower anxiety and depression scores. Among females only, an overweight perception had the highest predicted scores for significant depressive symptoms. Among males only, underweight perceptions were associated with higher anxiety scores. No social health factors had moderating effects in females, and only two interactions were significant among males: feeling safe at school had protective associations with anxiety scores among those with underweight perceptions while those with overweight perceptions had higher depression scores when they reported rewarding social relationships. CONCLUSION Overweight perceptions in all youth, and underweight perceptions in males, predicted anxiety and depression symptoms 1 year later. The role of social health should not be discounted as a means of preventing anxiety and depression in youth, although this study suggests it is not sufficient to protect against adverse associations with overweight perceptions for all youth, and underweight perceptions for males.
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Brooks SJ, Feldman I, Schiöth HB, Titova OE. Important gender differences in psychosomatic and school-related complaints in relation to adolescent weight status. Sci Rep 2021; 11:14147. [PMID: 34239031 PMCID: PMC8266882 DOI: 10.1038/s41598-021-93761-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/30/2021] [Indexed: 12/17/2022] Open
Abstract
Underweight or overweight in adolescence is linked to several adverse health outcomes. Less evidence exists about the association between weight status and school-related psychosocial characteristics in high income countries. We sought to investigate the relationship between weight status and psychosomatic and school-related complaints with a focus on gender differences. The study is a cohort of 18,462 adolescents (12-19 years; 51% girls) conducted in Sweden. The associations between weight status and psychosomatic and school-related complaints were estimated by binary logistic regression adjusted for several potential confounders. After correction for multiple testing, being underweight or overweight/obese was adversely associated with several psychosomatic and school-related complaints with significant differences between boys and girls. Specifically, underweight boys had higher odds to have psychosomatic complaints than normal-weight boys, while no such associations were observed among underweight girls. Overweight/obese (vs. normal-weight) boys had higher odds to complain about headache, pain in the back/hips, and feeling low. Overweight/obese (vs. normal-weight) girls were more likely to complain about feeling low, anxious/worried and having difficulty in falling asleep (P ≤ 0.01). In relation to school-related complaints (e.g., being bullied at school and academic failure), greater associations were observed for overweight/obese girls and boys than for underweight adolescents compared with normal-weight peers.
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Affiliation(s)
- Samantha J Brooks
- Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Faculty of Health, School of Psychology, Liverpool John Moores University, Liverpool, SE3 3AF, UK.,Neuroscience Research Laboratory (NeuRL), Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Inna Feldman
- Uppsala County Council, Uppsala, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Olga E Titova
- Department of Neuroscience, Uppsala University, Uppsala, Sweden. .,Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Epihubben, Dag Hammarskjölds väg 14 B, 75185, Uppsala, Sweden.
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