Body Image As Risk Factor for Emotional and Behavioral Problems Among Chinese Adolescents

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2018 Oct 18

PMID 30326854

Citations 14

Authors

Lingling Ren

Yuanyuan Xu

Xin Guo

Jing Zhang

Hong Wang

Xiaomin Lou

Jianping Liang

Fangbiao Tao

Affiliations

Soon will be listed here.

Abstract

Background: Being 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.

Methods: A 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.

Results: Our 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).

Conclusions: Being 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.

Citing Articles

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Body image and behavioural and emotional difficulties in German children and adolescents.

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References

Huang L, Tao F, Wan Y, Xing C, Hao J, Su P . Self-reported weight status rather than BMI may be closely related to psychopathological symptoms among Mainland Chinese adolescents. J Trop Pediatr. 2009; 57(4):307-11. DOI: 10.1093/tropej/fmp097. View

Sutaria S, Devakumar D, Yasuda S, Das S, Saxena S . Is obesity associated with depression in children? Systematic review and meta-analysis. Arch Dis Child. 2018; 104(1):64-74. DOI: 10.1136/archdischild-2017-314608. View

Sun L, Guo X, Zhang J, Liu H, Xu S, Xu Y . [Gender specific associations between early puberty and behavioral and emotional characteristics in children]. Zhonghua Liu Xing Bing Xue Za Zhi. 2016; 37(1):35-9. DOI: 10.3760/cma.j.issn.0254-6450.2016.01.007. View

Petersen A, Crockett L, Richards M, Boxer A . A self-report measure of pubertal status: Reliability, validity, and initial norms. J Youth Adolesc. 2013; 17(2):117-33. DOI: 10.1007/BF01537962. View

Goodman R . The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997; 38(5):581-6. DOI: 10.1111/j.1469-7610.1997.tb01545.x. View

Otakpor A, Ehimigbai M . Body image perception and mental health of in-school adolescents in Benin City, Nigeria. Niger Postgrad Med J. 2016; 23(2):71-8. DOI: 10.4103/1117-1936.186294. View

Griffiths S, Murray S, Bentley C, Gratwick-Sarll K, Harrison C, Mond J . Sex Differences in Quality of Life Impairment Associated With Body Dissatisfaction in Adolescents. J Adolesc Health. 2017; 61(1):77-82. DOI: 10.1016/j.jadohealth.2017.01.016. View

Damaso A, do Prado W, de Piano A, Tock L, Caranti D, Lofrano M . Relationship between nonalcoholic fatty liver disease prevalence and visceral fat in obese adolescents. Dig Liver Dis. 2007; 40(2):132-9. DOI: 10.1016/j.dld.2007.09.009. View

Geoffroy M, Li L, Power C . Depressive symptoms and body mass index: co-morbidity and direction of association in a British birth cohort followed over 50 years. Psychol Med. 2014; 44(12):2641-52. DOI: 10.1017/S0033291714000142. View

10.

Topcu S, Orhon F, Tayfun M, Ucakturk S, Demirel F . Anxiety, depression and self-esteem levels in obese children: a case-control study. J Pediatr Endocrinol Metab. 2015; 29(3):357-61. DOI: 10.1515/jpem-2015-0254. View

11.

Xie B, Chou C, Spruijt-Metz D, Reynolds K, Palmer P, Wu Q . Longitudinal analysis of weight perception and psychological factors in Chinese adolescents. Am J Health Behav. 2010; 35(1):92-104. PMC: 2957668. DOI: 10.5993/ajhb.35.1.9. View

12.

Li Y, Hu X, Ma W, Wu J, Ma G . Body image perceptions among Chinese children and adolescents. Body Image. 2007; 2(2):91-103. DOI: 10.1016/j.bodyim.2005.04.001. View

13.

Roberts R, Duong H . Perceived weight, not obesity, increases risk for major depression among adolescents. J Psychiatr Res. 2013; 47(8):1110-7. PMC: 3686272. DOI: 10.1016/j.jpsychires.2013.03.019. View

14.

Sun H, Ma Y, Han D, Pan C, Xu Y . Prevalence and trends in obesity among China's children and adolescents, 1985-2010. PLoS One. 2014; 9(8):e105469. PMC: 4139359. DOI: 10.1371/journal.pone.0105469. View

15.

Kostanski M, Gullone E . Adolescent body image dissatisfaction: relationships with self-esteem, anxiety, and depression controlling for body mass. J Child Psychol Psychiatry. 1998; 39(2):255-62. View

16.

Lam L, Yang L . Overweight/obesity and attention deficit and hyperactivity disorder tendency among adolescents in China. Int J Obes (Lond). 2007; 31(4):584-90. DOI: 10.1038/sj.ijo.0803526. View

17.

Ghomari-Boukhatem H, Bouchouicha A, Mekki K, Chenni K, Belhadj M, Bouchenak M . Blood pressure, dyslipidemia and inflammatory factors are related to body mass index in scholar adolescents. Arch Med Sci. 2017; 13(1):46-52. PMC: 5206370. DOI: 10.5114/aoms.2017.64713. View

18.

Li D, Shi H, Zhang Y, Wang W, Tan H, Wang Z . [Applicability of self-rated pubertal development scale among urban Chinese adolescents]. Zhonghua Liu Xing Bing Xue Za Zhi. 2012; 33(6):580-3. View

19.

Tang J, Yu Y, Du Y, Ma Y, Zhu H, Liu Z . Association between actual weight status, perceived weight and depressive, anxious symptoms in Chinese adolescents: a cross-sectional study. BMC Public Health. 2010; 10:594. PMC: 3091556. DOI: 10.1186/1471-2458-10-594. View

20.

Schiefelbein E, Mirchandani G, George G, Becker E, Castrucci B, Hoelscher D . Association between depressed mood and perceived weight in middle and high school age students: Texas 2004-2005. Matern Child Health J. 2010; 16(1):169-76. DOI: 10.1007/s10995-010-0733-1. View