Perceived rather than actual overweight is associated with mental health problems in adolescence

Lankinen, Vilma; Fröjd, Sari; Marttunen, Mauri; Kaltiala-Heino, Riittakerttu

doi:10.1080/08039488.2017.1389987

Cited by 16 publications

(15 citation statements)

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“…In this study, it was found that body dissatisfaction significantly affected mental health in both sexes. Our results, together with other similar studies [ 19 , 23 , 24 , 37 , 40 ], confirmed that body image (including perceived weight and body satisfaction) was a more substantial predictor of adolescent emotional and behavioral problems than actual overweight or obesity. Few previous studies simultaneously included actual weight, perceived weight, and body satisfaction.…”

Section: Discussionsupporting

confidence: 90%

“…Perceived underweight increased the risk of emotional problems, conduct problems, and total difficulties in boys, but it decreased risk of conduct problems in girls. Previous studies obtained similar results for boys [ 37 , 38 ]. These results may be explained by the fact that girls want to be thinner but boys want to be stronger and more muscular.…”

Section: Discussionsupporting

confidence: 79%

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Body image as risk factor for emotional and behavioral problems among Chinese adolescents

Ren

Guo

et al. 2018

BMC Public Health

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BackgroundBeing overweight and obesity during adolescence are worldwide public health problems. This study examined the relationship between actual weight, body image, and emotional and behavioral problems among Chinese adolescents.MethodsA total of 3841 adolescents (age range, 11–16 years) from 5 Chinese cities were included in this cross-sectional study. All of the study participants were asked to complete questionnaires (including demographic features, strengths and difficulties questionnaires, pubertal development scale), and their height and weight were measured at the same time. Body image was measured in two ways: self-perceived weight and body satisfaction. The relationship between weight status and mental health was estimated by multivariate logistic regression for boys and girls.ResultsOur study showed a difference by sex for prevalence of being overweight/obesity and body dissatisfaction among Chinese adolescents. Boys were more likely to be overweight or obese than girls (30.4% vs. 21.5%, p < 0.05), but girls were more likely to be dissatisfied with their bodies than boys (41.2% vs. 27.9%, p < 0.05). In the logistic regression, body image, not actually being overweight, was significantly associated with a higher risk of emotional and behavioral problems. Compared to perceived normal weight boys, boys who perceived themselves as underweight had an increased likelihood of emotional problems (adjusted odds ratio [OR] = 1.73; 95% confidence interval (CI), 1.16–2.57), conduct problems (OR = 1.73; 95% CI, 1.20–2.50), and total difficulties (OR = 1.50; 95% CI, 1.09–2.05). Compared to body satisfaction, body dissatisfaction was a risk factor for emotional problems (boys: OR = 2.80; 95% CI, 1.84–4.25; girls: OR = 2.18; 95% CI, 1.42–3.36), conduct problems (boys: OR = 1.87, 95% CI, 1.26–2.76; girls: OR = 2.79; 95% CI, 1.46–5.30), hyperactivity problems (boys: OR = 1.67; 95% CI, 1.09–2.55; girls: OR = 2.04; 95% CI, 1.13–3.69), and total difficulties (boys: OR = 2.03; 95% CI, 1.45–2.84; girls: OR = 2.30; 95% CI, 1.46–3.56).ConclusionsBeing overweight and obese during adolescence are very serious public health problems in China. Body image was a more substantial predictor for adolescent emotional and behavioral problems than actually being overweight/obesity.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 79%

Body image as risk factor for emotional and behavioral problems among Chinese adolescents

Ren

Guo

et al. 2018

BMC Public Health

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“…The authors agreed on the eligibility of 33/35 studies, and the remaining 2 were resolved by discussion. A total of 14 studies 13‐15,19,20,24‐26,30‐35 were included in the meta‐analysis, comprising a total of 52 separate effect sizes and 79 395 participants. The characteristics of the included studies are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…The average quality score of the 10 cross‐sectional studies according to The Joanna Briggs Institute Critical Appraisal tool 22 was 6.9/8, with no studies rated less than 5 (Table 3). Almost all of the studies, except one which was moderate, 31 were of high quality. Longitudinal studies were of moderate 13,25,26 to low quality 33 (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Association between child/adolescent overweight/obesity and conduct disorder: A systematic review and meta‐analysis

et al. 2020

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Summary Background Research findings of the association and its pattern between obesity and psychiatric/psychological comorbidities are not consistent across the types of comorbidities or the study subgroups. Objectives We aimed to perform meta‐analysis of cross‐sectional studies and longitudinal studies analysing obesity as a risk factor for conduct disorder in order to assess the association between child/adolescent overweight/obesity and conduct disorder. Methods Systematic literature search, study selection and data extraction were performed independently by the two authors. Data were analysed by Comprehensive Meta‐analysis software. Results Analysis of 13 high‐quality cross‐sectional studies including 79 027 children and adolescents indicated a significant association between overweight/obesity and conduct disorder among children and adolescents (OR 1.32 [95% CI, 1.18‐1.49], I2 = 86.68), with no publication bias. Subgroup analyses yielded a significant difference (P < .01) between boys and girls. Analysis of four low‐ to moderate‐quality longitudinal studies (OR 1.11 [95% CI, 0.89‐1.38], I2 = 57.69) showed no prospective association between overweight/obesity and conduct disorder. Subgroup analysis according to gender revealed a significant positive association for boys and negative association for girls. Conclusions Based on the high‐quality cross‐sectional data, overweight and obesity are associated with conduct disorder among children and adolescents, affecting boys more frequently than girls. Results of the longitudinal analysis indicated possible association in boys, while girls seem to be protected from conduct disorder. However, these results are very unreliable, indicating the need of well‐designed longitudinal studies to elucidate the pattern of association between these disorders.

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“…Individuals who are attracted to the same sex, both sexes, or are questioning their sexual orientation (i.e., sexual minorities) may have elevated risk for maladaptive or disordered eating behaviors such as restrictive dieting (extreme food intake restriction) and diet pill use (Austin et al, 2004;Diemer, Grant, Munn-Chernoff, Patterson, & Duncan, 2015). During adolescence, perceived overweight has been identified as a stronger correlate of mental health problems and excessive school absenteeism than objective overweight (Duncan et al, 2017;Lankinen, Fröjd, Marttunen, & Kaltiala-Heino, 2018). For sexual minority youth, minority stressors such as internalized homophobia, expectation of rejection, and peer victimization could lead to a more negative perception of one's own body image and weight status .…”

Section: Introductionmentioning

confidence: 99%

A longitudinal investigation of perceived weight status as a mediator of sexual orientation disparities in maladaptive eating behaviors

et al. 2019

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Sexual minority adolescents are more likely than heterosexual peers to engage in maladaptive eating behaviors such as restrictive dieting. However, prior studies relied on cross-sectional data and did not test potential mechanisms. This study examined longitudinal associations between adolescent sexual minority status and three maladaptive eating behaviors (restrictive dieting, diet pill use, and drug-related dieting) in young adulthood and tested higher perceived weight status as a mediator of observed disparities. Data were drawn from Waves 2 (11 th grade in 2010/2011) to 7 (4 years post high school in 2015/2016) of the NEXT Generation Health Study, a U.S. national longitudinal cohort of adolescents (n = 1925). Logistic regression analyses revealed that, relative to heterosexual females, sexual minority females were more likely to report any restrictive dieting (extreme food intake restriction) in the past year (62.9% vs. 37.0%; Adjusted Odds Ratio = 2.26, 95% CI = 1.07, 4.76). Associations between sexual minority status and diet pills use or drugrelated dieting were not found. Results from structural equation modeling indicated that higher perceived weight status was a significant mediator of the association between sexual minority status and restrictive dieting among females. These findings highlight higher perceived weight status as an important cognitive mechanism explaining why sexual minority females are at heightened risk for restrictive dieting in young adulthood. To optimally inform prevention efforts, additional research is needed to test the extent to which minority stressors may shape weight perceptions and their contribution to maladaptive and disordered eating behaviors among sexual minority adolescents.

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Perceived rather than actual overweight is associated with mental health problems in adolescence

Abstract: Perceived overweight rather than actual weight status is associated with both internalizing and externalizing mental health problems in adolescents.

Cited by 16 publications

References 63 publications

Body image as risk factor for emotional and behavioral problems among Chinese adolescents

Body image as risk factor for emotional and behavioral problems among Chinese adolescents

Association between child/adolescent overweight/obesity and conduct disorder: A systematic review and meta‐analysis

A longitudinal investigation of perceived weight status as a mediator of sexual orientation disparities in maladaptive eating behaviors

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