BackgroundStudies among adults show an association between abuse and Body Mass Index (BMI) status. When an aberrant BMI status as a consequence of abuse is already prevalent in adolescence, early detection and treatment of abuse might prevent these adolescents from developing serious weight problems and other long-term social, emotional and physical problems in adulthood. Therefore, this study investigated the prevalence of physical, sexual and mental abuse among adolescents and examined the association of these abuse subtypes with BMI status.MethodsIn total, data of 51,856 secondary school students aged 13–16 who had completed a questionnaire on health, well-being and lifestyle were used. BMI was classified into four categories, underweight, normal weight, overweight and obesity. Adolescents reported if they had ever been physically, sexually or mentally abused. Crude and adjusted General Estimation Equation (GEE) analyses were performed to investigate the association between abuse subtypes and BMI status. Analyses were adjusted for ethnicity and parental communication, and stratified for gender and educational level.ResultsEighteen percent of the adolescents reported mental abuse, 7% reported sexual abuse, and 6% reported physical abuse. For underweight, overweight and obese adolescents these percentages were 17%, 25%, and 44%; 7%, 8%, and 16%; and 6%, 8%, 18% respectively. For the entire population, all these subtypes of abuse were associated with being overweight and obese (OR=3.67, 1.79 and 1.50) and all but sexual abuse were associated with underweight (OR=1.21 and 1.12). Stratified analyses showed that physical and sexual abuse were significantly associated with obesity among boys (OR=1.77 and 2.49) and among vocational school students (OR=1.60 and 1.69), and with underweight among girls (OR=1.26 and 0.83).ConclusionMental abuse was reported by almost half of the obese adolescents and associated with underweight, overweight and obesity. Longitudinal analyses are recommended to explore the causality of and the mechanisms explaining this association between abuse and overweight.

EpidEmiologyAlthough there is a full body of evidence for an association between obesity and depression in adolescents, evidence for the association between obesity and psychological health, suicidal thoughts and suicide attempts is still limited (1-4). The present study investigated the association between selfreported weight status and self-reported psychological health, suicidal thoughts in the past 12 months and lifetime suicide attempts in Dutch adolescent boys and girls. Methods and ProceduresDuring one classroom session, 35,107 students of the second (13-14 years) and fourth grade (15-16 years) filled out an Internet-based questionnaire as part of the 2003 Electronic Monitor and Health Education (E-MOVO) project (5,6).Based on self-reported weight and height, BMI was calculated and students were classified into five groups of weight status using age-and gender-specific international standards (7,8). The five-item version of the Mental Health Inventory (MHI-5) was used to assess the MHI-5 score (0 = very unhealthy to 100 = perfectly healthy) (9). Scores of ≤60 were classified as "psychologically unhealthy" (10). To check the robustness of the results, alternative cutoff values (i.e., 65 and 72) were used, and the MHI-5 score was analyzed as a continuous measure. Suicidal thoughts in the past 12 months were measured by a single question of which answers were dichotomized into "yes" ("very often", "occasionally" and "a few times") and "no" ("never"). Lifetime suicide attempts ("yes" or "no") were also measured by a single question.In total, 21,730 students (10,667 boys and 11,063 girls) were included in the analyses. Logistic regression, linear, and polytomous