Obesity, body image, and its impact on children's eating and exercise behaviors in China: A nationwide longitudinal study

Abstract

Body image seems to mediate the association between obesity and health behaviors as well as weight control attempts. We examined the distribution of children's body image by demographic characteristics and their subsequent associations with eating, exercise, and weight change. Child body image and health behaviors from the China Health National Survey 2000-2011 were assessed at baseline and in follow-up for 6- to 17-year-old children during 2000-2011 using mixed models. There was a large discrepancy between children's actual weight status (overweight: 16.9%) vs. self-rated body image (fat: 2.4% in 2011). Less than 1% of children desired a fat body; girls were more likely to want to be thin (52.5% vs. 40.9%) than boys. About 11% of children needed to lose weight in order to be at their desired baseline. During follow-up, those needing weight loss to be as desired were more likely to attempt dieting to change their weight (OR, 95% CI=1.9, 1.1-3.5 in boys; 1.7, 1.1-2.5 in girls) and less likely to feel they had enough physical activity (OR, 95% CI=0.5, 0.4-0.7 in boys; 0.6, 0.5-0.9 in girls), although their weight gain had been significantly higher than those having consistent self and desired body images (β [SE]=0.4 [0.1] in boys; 0.2 [0.1] in girls, all p<0.05). However, no significant difference was shown in subsequent health behaviors among overweight children by body image discrepancy. The discrepancy in self vs. desired body image motivated children to change their obesity-related health behaviors among non-overweight children in China.

Double Burden of Malnutrition: Examining the Growth Profile and Coexistence of Undernutrition, Overweight, and Obesity among School-Aged Children and Adolescents in Urban and Rural Counties in Henan Province, China

“…stunting. e findings are consistent with the literature as studies suggest overweight or obesity is more prevalent in urban than in rural areas [32][33][34][35], trends uncommon across the globe, and unique to the country of China. Surprisingly, subjects in a small-medium city had the highest rate of underweight and second-highest rate of overweight or obesity.…”

Relationships among Body Mass Index, Body Image, and Depression in Korean Adults: Korea National Health and Nutrition Examination Survey 2014 and 2016

“…In contrast, the above Chinese study found that having a fat body image helped children to realize the need for weight loss, attempt to go on a diet, and recognize that they engaged in little exercise, thereby serving as a source of self-motivation to achieve average weight 21. The study suggests that appropriate body image perception motivates individuals to change their health behavior.…”

“…Compared to Chinese boys, a higher proportion of Chinese girls were in the lower actual BMI group, and they more often desired a thinner body. About 11% of the children attempted to lose weight and believed they engaged in little physical activity 21…”

Does Eating-Away-from-Home Increase the Risk of a Metabolic Syndrome Diagnosis?

“…Third, Chinese men engaged in more social activities, which usually take place in restaurants (see Table S3 in the supplementary file), and they tend to drink (see Table 1) and eat a lot, during these meals [4]. On the contrary, females, particularly young females, were usually more self-aware and more subject to peer pressure and had a higher preferences for thinness [35]; thus they were less likely to be affected by EAFH. More importantly, young females who had a higher frequency of EAFH were usually those who had a higher social-economic-status, and they were well-educated (see Table 1), had decent jobs (which can be reflected by the lower physical activity level shown in Table 1), and had a healthier lifestyle (less likely to smoke and drink as shown in Table 1), all of which could contribute to a lower risk of MetS.…”