Mediating factors and psychological effects of obese children

Abstract

Objective. This study examined obese children and adolescents who attended a children's weight down program at Maimonides Medical Center. Specifically, it explored the effects of BMI, gender, ethnicity, teasing, and age on depression, self esteem and body image dissatisfaction. Three hypotheses were tested. The primary hypothesis proposed that patients who exhibited a higher BMI would have a lower self esteem, more body image dissatisfaction, and would exhibit more depression. The secondary hypothesis proposed that age, gender, teasing, and ethnicity would moderate the relationship between BMI and self esteem, body image or depression. The third hypothesis proposed that patients with a more dissatisfied body image would have lower self esteem and would display more depressive symptoms. Methods. Intake questionnaires (consisting of Rosenberg Self Esteem Scale, CDI-S, Body Image Silhouettes Scale) and intake interview forms of 205 patients, ranging in age from 8 to 18 years, were examined. Results. The primary hypothesis of the study was not fully supported by the study sample. No significant relationship was determined between overweight children and adolescent's BMI's and the Rosenberg Self Esteem questionnaire, Children Depression Inventory-short version (CDI-S) as indicated by the simple linear regressions with respective F-statistics, p-values, and R2 values for the model (F(1, 203) = 0.40, p=0.53, R2<0.001) and (F(1, 203) = 1.72, p=0.19, R2= 0.01). However significance was found between BMI and Body Image Dissatisfaction as indicated by the simple linear regressions with respective F statistics, p-values, and R2 value for the model (F(1, 203) = 7.35, p = 0.01, R2 = 0.03). In the second hypothesis both multiple linear regressions and MANOVA'S were used, revealing that teasing was significantly related to Depression, Self Esteem and BMI, but not to Body Image. The individual supporting t-statistic and p-values of teasing in the multiple linear regressions are (1) for Depression (t(199) = 2.16, p = 0.03), (2) for Self Esteem (t(199) = -2.15, p = 0.03) (3) BMI (t(200) = 3.07, p < 0.01) and (4) Body Image (t(199) = 1.43, p = 0.15) and for the MANOVAs (1) for Depression (t(199) = 2.20, p = 0.03), (2) for Self Esteem (t(199) -2.14, p = 0.03), (3) BMI (t(200) = 2.61, p = 0.01) and (4) Body Image (t(199) = 1.51, p = 0.13). Specifically, patients who were teased had greater symptoms of depression, lower self esteem scores, and higher BMI's. The third hypothesis found a significant relationship between body image and self esteem and depression as indicated by the simple linear regressions with respective F-statistics, p-values, and R2 values for the model (F(1, 203) = 13.74, p < 0.01, R2 = 0.06) and (F(1, 203) = 11.40, p < 0.01, R2 = 0.05). Patients who had greater body image dissatisfaction had lower self esteems and greater symptoms of depression. Discussion . These findings expand on the current literature of the psychological sequela of pediatric obesity. The conclusions from this study indicate that psychological distress may not be a function of weight and may be a more complicated process. However, the findings from this study suggest that teasing and body image may be more relevant and significant in explaining psychological outcomes of pediatric obesity. These results support further investigation of teasing and body image and their impact on psychological well being of obese children and adolescents.