Sunday, January 27, 2008

Feeling fat rather than being fat is associated with psychological well-being

Childhood obesity has important short- and long-term consequences for physical health. In addition, the importance of psychological consequences to children is often emphasized. However, the evidence for a strong and predictive or causal relationship between childhood overweight and psychological well-being is not convincing (see for example the recent review by Wardle and Cooke; . They reviewed 53 recent studies on the relation between obesity and body dissatisfaction, self esteem, and depression, distinguishing clinical and community samples. They concluded that although levels of body dissatisfaction are higher in community samples of overweight and obese children and adolescents than in their normal-weight counterparts, few are significantly depressed or have low self esteem. Furthermore, it remains unclear if psychological well being predicts weight status or the other way around.
With Wilma Jansen as first author I co-authored a recent publication in the Journal of Adolescent Health ( to contribute to a further exploration of the association of psychosocial well-being with overweight and weight perception among adolescents. Data from the ongoing Rotterdam Youth Health Monitor were used from just under 2000 9–10-year-olds and almost 4000 12–13-year-olds. The association of mental health indicators with being overweight (i.e. weight status based on reports of weight and height) and with feeling overweight (i.e. whether the participants thought they were overweight) was studied. We found little evidence that mental health indicators were significantly and consistently associated with weight status or with changes in weight status over time. We also did not find consistent evidence that weight status predicted mental health or changes in psychological well-being over time. However, we did find some evidence that adolescents who thought they were overweight scored lower on indicators of psychological well being. Our conclusion: feeling overweight, rather than being overweight, appears to be important. These results further stress the importance of realistic body weight perceptions.