Psychosocial Concerns and Health‐Compromising Behaviors among Overweight and Nonoverweight Adolescents

Abstract

Objective: To compare weight-specific and global psychosocial concerns and health-compromising behaviors among overweight and nonoverweight youth across gender and ethnicity. Methods: A cross-sectional schoolbased survey of 31,122 adolescents in grades 7 to 12. Based on self-reported heights and weights, respondents were categorized as nonoverweight (body mass index (BMI) 4 5 t h percentile), moderately overweight (85th percentile <BMI ~9 5 t h percentile), or severely overweight (BMI >95th percentile). Results: Global psychosocial concerns, such as emotional well-being, suicidal ideation, future job concerns, and peer concerns, did not differ greatly between nonoverweight, moderately overweight, and severely overweight adolescents. Substance abuse behaviors were equally or less prevalent among the overweight group. Overweight girls were significantly less likely to consume alcohol, whereas overweight boys were at lower risk for marijuana use. In contrast, overweight youth were more likely to perceive their health as only fair or poor and were more likely to express weight-specific concerns and engage in behav-NEUMARK-SZTAINER, DIANNE, MARY STORY, 5~237-249. iors such as chronic dieting and binge eating than nonoverweight youth. Overweight American Indian girls perceived their physical health more positively than nonoverweight American Indian girls. Strong associations were found between overweight status and chronic dieting among African American boys and girls. Conclusions: Nutritional counseling and educational programs need to address the weight-specific concerns and behaviors of overweight adolescents. However, assumptions regarding global psychosocial concerns and healthcompromising behaviors among overweight adolescents of different genders and ethnicities should be avoided. These broad issues need to be explored in more depth at both the research and intervention levels.

Schema and parental bonding in overweight and nonoverweight female adolescents

“…The findings are consistent with those who have failed to find increased distress in overweight adolescents 7 and contrary to findings in overweight children, 20 suggesting that eating disorder symptoms are not increased or elevated in this group. However, the current findings do indicate that some of the cognitions associated with eating disorders (and perhaps with other psychopathology) are present in the overweight group and not in the normal weight group.…”

“…To date the findings remain ambiguous. In their crosssectional school-based survey exploring psychosocial concerns and health-compromising behaviours, Neumark-Sztainer and colleagues 7 found that psychosocial concerns such as emotional well-being, suicidal ideation, peer concerns and future job concerns did not differ significantly between overweight and nonoverweight adolescents. However, their results did suggest that overweight adolescents were more likely than their normal weight counterparts to express weight-specific concerns and engage in behaviours such as chronic dieting and binge eating.…”

Relation Between Dieting and Weight Change Among Preadolescents and Adolescents

“…Numerous cross-sectional studies have observed that binge eating is more common among overweight adolescents and adults than their leaner peers. 2,26,27 Because weight gain results from an imbalance between energy intake and energy output, it seems likely that binge eating should result in weight gain. Nevertheless, we are unaware of other prospective studies on binge eating and weight change.…”

Role of physical activity in the prevention of obesity in children

“…14 This general rise in obesity is likely to have longlasting physical and mental health consequences for the population. Even during childhood, obesity is closely related to increased risk of CVD and noninsulin dependent diabetes mellitus (NIDDM), 15 ± 17 psycho-social concerns 18 and the increased risk of some forms of cancer. 19,20 There have been two recent studies which provide a clear indication of the epidemiological impact of childhood obesity on overall health risk.…”