Body Weight, Weight Self-Perception, Weight Teasing and Their Association with Health Behaviors among Chinese Adolescents-The Shanghai Youth Health Behavior Survey

A systematic review of weight stigma and disordered eating cognitions and behaviors

Weight stigma is persistent across contexts and is associated with disordered eating cognitions and behaviors. This systematic review aimed to examine the existing literature that has explored the relationship between weight stigma and disordered eating cognitions and behaviors. We specifically examined three dimensions of weight stigma - experienced, anticipated, and internalized - and adopted an inclusive conceptualization of outcomes related to disordered eating (including constructs such as binge eating, body dissatisfaction, and other cognitions and behaviors such as dietary restraint, unhealthy weight control behaviors, and drive for thinness). We searched PubMed, Embase, CINAHL, Web of Science, Sociological Abstracts, and PsycINFO for English-language, peer-reviewed articles and dissertations with quantitative methodology published through October 2023. The search resulted in 242 articles meeting inclusion criteria. A narrative review found a consistent relationship between greater weight stigma and more disordered eating cognitions and behaviors. Methodological and theoretical limitations are discussed, as are critical avenues for future research and potential clinical implications stemming from this body of research. Given the widespread nature and impact of weight stigma on disordered eating, it is imperative that we intervene to address weight stigma at all levels, from the structural to the intrapersonal.

Association between body weight perception and intuitive eating among undergraduate students in China: the mediating role of body image

Background

The association between body weight perception and intuitive eating among undergraduate students in China remains insufficiently understood. In the present study, we were aimed to examine the correlation between body weight perception, body image, and intuitive eating and determine whether the link between body weight perception and intuitive eating was influenced by body image.

Methods

A total of 1,050 undergraduate students completed the survey. Participants provided self-reported demographic details and completed two structured scales. The Body Esteem Scale for Adolescents and Adults (BESAA) and the Intuitive Eating Scale-2 (IES-2) were employed to assess body image and intuitive eating. Analysis of the mediation model was conducted using version 4.1 of the PROCESS Macro. Results with a value of p less than 0.05 were deemed statistically significant.

Results

The average age of the participants was 20.08 years (SD = 1.64). Among the students, 837 (79.7%) were female, and 212 (20.3%) were male. Body image (r = -0.429, p < 0.001) and intuitive eating (r = -0.313, p < 0.001) exhibited significant negative associations with body weight perception. Furthermore, body image showed a significant positive correlation with intuitive eating (r = 0.318, p < 0.001). Significant mediating effects of body image were identified concerning intuitive eating and body weight perception in the right weight (95% bootstrap CI = 0.007, 0.040) and overweight groups (95% bootstrap CI = -0.048, -0.009). The indirect effects of body image constituted 12.19% and 15.33% of the total effects of intuitive eating in these two groups.

Conclusion

Although the indirect effects were not substantial, these outcomes shed light on the partial understanding of how body weight perception impacted intuitive eating via body image. Importantly, our findings emphasized the significance of body image and body weight perception, offering a novel insight for prospective interventions targeting undergraduate students.

Individualized Implementation of Youth Quality of Life Instrument-Research Version (YQOL-R) Among Chinese Adolescents with Different Weight Status

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.

Adherence to 24-h movement guidelines and cognitive difficulties in adolescents

BACKGROUND

Studies have identified sleep, screen time, and physical activity as independent risk factors for cognitive impairment in adolescents. However, little is known about how these factors interact to contribute to cognitive difficulties. This study aimed to investigate the association between 24-h movement guidelines and cognitive difficulties in adolescents.

METHODS

Data from the 2019 Youth Risk Behaviour Surveillance was used for analysis. Participants self-reported their screen time, sleep, and physical activity levels, and cognitive difficulty was assessed using a standardized protocol with a binary response (Yes or No). Logistic regression analysis was used to evaluate the association between 24-h movement behaviours and cognitive difficulty, with results reported as the odds ratio (OR) with a 95% confidence interval (CI).

RESULTS

After controlling for covariates (e.g., sex, age), compared to adolescents not adhering to none of the 24-h movement guidelines, adhering to the screen time (OR = 1.68, 95%CI: 1.37-2.05) and sleep guidelines (OR = 1.32, 95%CI: 1.08-1.61) were more likely to report no cognitive difficulties in adolescents, respectively. Adhering to all the 24-h movement guidelines was also likely to increase the odds of reporting no cognitive difficulties (OR = 3.38, 95%: 2.15-5.30).

CONCLUSIONS

The study findings suggest that promoting better 24-h movement behaviours could be an effective approach to reducing cognitive difficulties in adolescents. Future studies should use improved study designs to confirm or refute these results.

The Importance of Healthy Habits to Compensate for Differences between Adolescent Males and Females in Anthropometric, Psychological and Physical Fitness Variables

Adolescence is a crucial stage in human development, and differences in psychological, physical and body composition variables between males and females have been amply demonstrated. However, the role played by certain healthy habits, such as the practice of physical activity, adherence to the Mediterranean diet (AMD) or the maintenance of an adequate weight status, in compensating for the differences found between males and females in these variables, is not well known. For this reason, the study aimed to analyze whether the practice of physical activity, optimal AMD, and adequate weight status can compensate for the differences between adolescent males and females in anthropometric variables, psychological state, and physical fitness. The sample was composed of 791 adolescents (404 males and 387 females) aged twelve to sixteen years old, whose anthropometric, psychological (autonomy, competence, relatedness, and life satisfaction), and physical fitness variables (cardiorespiratory fitness, upper strength and explosive lower limb power, hamstring and lower back flexibility, and speed) were measured. All measurements were carried out in a single day using the sports pavilion of the four participating schools. The most novel results of this research show that the practice of physical activity was determinant mainly in females, as it reduced the differences found in comparison with males in psychological (p < 0.001−0.045) and anthropometric variables (p < 0.001). Regarding weight status and AMD, these were still relevant for the adolescent population, mainly the achievement of optimal AMD, but males continued to present higher values in physical fitness tests (p < 0.001) and lower values in fat accumulation (p < 0.001), regardless of weight status or AMD. Thus, physical activity seems to be the most determining factor that compensates for the differences between adolescent boys and girls.

Cross-sectional associations between screen time and the selected lifestyle behaviors in adolescents

Background

In adolescents, excessive screen time leads to many adverse health outcomes and is associated with a variety of lifestyle behaviors. This study was conducted to investigate the associations between the two types of screen time and a variety of lifestyle behaviors in American adolescents.

Methods

Based on the Youth Risk Behavior Surveillance System, this cross-sectional study was conducted. With the help of data collectors, participants self-reported screening time, lifestyle behaviors, and demographic data via well-validated tools.

Results

19% and 43.4% of the participants spent more than two hours a day watching television and using the computer, respectively, while the prevalence of physical inactivity and insufficient sleep was 75.1 and 74.4% respectively. Furthermore, 11.9, 7.3, 14.3, and 21.3% of the participants reported skipping fruits, vegetables, breakfast and milk, respectively. Moreover, the prevalence of alcohol and tobacco consumption and sexual activity was 26.8, 5.3, and 23.5% respectively. More than two hours of television time was significantly associated with high risks of fewer frequency for eating fruit (OR = 1.605, 95%CI: 1.308-1.970), vegetables (OR = 1.389, 95%CI: 1.029-1.873), and smoking (OR = 1.465, 95%CI: 1.088-1.972). Computer/video time for more than two hours was significantly associated with high risks of physical inactivity (OR = 1.724, 95%CI: 1.531-1.941), insufficient sleep (OR = 1.354, 95%CI: 1.151-1.592), and not eating fruit (OR = 1.434, 95%CI: 1.179-1.745).

Conclusion

Increased screen time may be associated with specific unhealthy lifestyle behaviors in adolescents. Furthermore, the associations between different types of screen time and various lifestyle behaviors varied.