A structural equation model relating adiposity, psychosocial indicators of body image and depressive symptoms among adolescents

Abstract

Objective: Psychosocial factors, including pressure to be thin and body dissatisfaction, have been hypothesized to mediate the relationship between obesity and depression, especially during adolescence when vulnerability to social pressures around body shape and image is heightened. The objective was to test a model of the relationships among adiposity, psychosocial factors and depression in adolescents. Method: In a population-based sample of 1127 boys and 1167 girls aged 13 and 16 years, a model of the relationships between adiposity, pressure to be thin, body dissatisfaction and depressive symptoms was tested using structural equation modeling. Results: Among girls, adiposity accounted for 62% of the total effect of depressive symptoms through its association with pressure to be thin and body dissatisfaction. Pressure to be thin was also uniquely related to depressive symptoms. Among boys, only body dissatisfaction was associated with depressive symptoms. Conclusion: Results support a relationship between adiposity, body satisfaction, pressure to be thin and depressive symptoms. Depressive symptoms should be assessed in obese adolescents, and interventions to prevent and treat obesity should incorporate elements targeting body dissatisfaction.

Association between weight status and depressive symptoms in adolescents: role of weight perception, weight concern, and dietary restraint

“…It was the attempt to diet or failure to lose weight by dieting, rather than weight status that caused depressive symptoms. Chaiton et al [6] concluded that adiposity was related to depressive symptoms through body dissatisfaction and pressure to be thin, which was consistent with our findings.…”

“…However, both obesity and depression are heterogeneous diseases, and not all obese individuals develop psychological consequences. Recent studies have shown that obese individuals with some risk factors, such as severe obesity [29], teasing [37], body image [1,6,19], and dieting history [9], are more likely to develop depression than normal weight individuals. Our study demonstrated that overweight perception, weight concern, and dietary restraint were also important mediating factors.…”

“…However, not all obese people experience psychological problems [12]. In fact, studies have shown that only obese individuals with certain risk factors, like gender [10], severe obesity [29], teasing [37], body image [1,6,19], and dieting history [9], develop depressive symptoms [13,14]. Probable mediators of the relationship between obesity and depression in adolescence include weight perception [39,40], weight concern [1,31], and dietary restraint [9,27].…”

Associations between anxious-depressed symptoms and cardiovascular risk factors in a longitudinal childhood study

“…Two other studies have also reported associations between depressive symptoms and adiposity only in girls (Chaiton et al, 2009;Hillman et al, 2010). A possible mechanism underlying the gender differences between anxious-depressive scores and adiposity at age 14 may be sex-related differences in hormones such as leptin.…”

Emotional eating and physical activity self-efficacy as pathways in the association between depressive symptoms and adiposity indicators

“…Evidence from prospective studies suggests that the relations between depression and obesity are bidirectional (4,5). Depressive symptoms have traditionally been examined as a consequence of obesity reflecting the stigma and discrimination that obese people encounter (58) and body dissatisfaction could be one pathway in this relation (59,60). To our knowledge, this is the first study to show that emotional eating and PA self-efficacy may act as pathways when considering weight gain as a consequence of depressive symptoms, but further prospective studies are needed to confirm the causality of these relations and to examine whether there are other behavior-specific psychosocial mediators.…”