Perceived weight in youths and risk of overweight or obesity six years later

Objective

To examine the association between perceived overweight in adolescents and the development of overweight or obesity later in life.

Methods

This paper uses data from a prospective, two-wave cohort study. Participants are 2445 adolescents 11–17 years of age who reported perceived weight at baseline and also had height and weight measured at baseline and at follow-up six years later sampled from managed care groups in a large metropolitan area.

Results

Youths who perceived themselves as overweight at baseline were approximately 2.5 times as likely to be overweight or obese six years later compared to youths who perceived themselves as average weight (OR = 2.45, 95% CI = 1.77–3.39), after adjusting for weight status at baseline, demographic characteristics, major depression, physical activity and dieting behaviors. Those who perceived themselves as skinny were less likely to be overweight or obese later (OR = 0.36, 95% CI = 0.27–0.49).

Conclusions

Perceived overweight was associated with overweight or obesity later in life. This relationship was not fully explained by extreme weight control behaviors or major depression. Further research is needed to explore the mechanism involved.     

Abnormal perception of body weight is not solely observed in pubertal girls: incorrect body image in children and its relationship to body weight

Perceived actual body weight and perceived ideal weight were assessed in 255 Japanese children and adolescents (130 boys, 125 girls) aged 6 years through 18 years using the drawing test to clarify whether they wanted to be thinner or to gain weight. More than half (68%) of the girls attending high school and 41% of the elementary school girls perceived their ideal weight to be less than the standard. The mean difference between the perceived actual weight and the ideal weight was positive in the high school girls of normal weight as well as in the overweight girls, meaning that even the normal-weight girls wanted to lose weight. The difference was also slightly positive in the underweight girls. The difference in the high school boys was negative, demonstrating that they wished to gain weight. It is suggested that girls want to lose weight even before adolescence; this tendency becomes more prominent in the high school period and is mostly unrelated to their own weight.     

Perceived Mental Illness Stigma and HIV Risk Behaviors Among Adult Psychiatric Outpatients in Rio de Janeiro,Brazil

We examined the associations between perceived mental illness stigma and HIV risk and protective behaviors among adults with severe mental illness (SMI) in Rio de Janeiro, Brazil. We measured mental illness stigma across three domains (“Personal Experiences,” “Perceived Attractiveness,” and “Relationship Discrimination”), and examined the relationship between experiences of stigma in each domain and HIV risk and protective behaviors over the past 3 months in 98 outpatients with SMI. Those who reported greater “Relationship Discrimination” stigma were significantly more likely to be sexually active and to have unprotected sex; they were significantly less likely to report deliberately having fewer partners as a way to protect themselves from HIV. The role of stigma in unprotected sexual behavior should be examined further and considered in any HIV prevention intervention for people with SMI.     

Accuracy of Weight Perception Among Urban Early Adolescents with Uncontrolled Asthma and Their Caregivers

Background

Obesity is associated with poor asthma outcomes; weight loss improves such outcomes. Inaccurate recognition of obesity may impede weight control.

Purpose

We examined perception of weight by early adolescents with uncontrolled asthma and their caregivers, and tested the relationship between medical visit frequency and accuracy of perceived weight status.

Methods

A total of 373 adolescents and their caregivers reported the adolescent’s height/weight and weight perception; caregivers reported healthcare utilization. We measured height/weight. Logistic regression modeled accuracy of weight perception.

Results

A total of 43.7 % of the overweight/obese adolescents and caregivers accurately perceived weight status. BMI percentile [odds ratio (OR)?=?1.19, confidence interval (CI)?=?1.10–1.28] and total medical visits (OR?=?1.18, CI?=?1.05–1.33) were associated with higher accuracy in caregivers. Total medical visits (OR?=?0.84, CI?=?0.74–0.96) was associated with lower accuracy in adolescents.

Conclusions

Accurate perception of weight status was poor for overweight adolescents with uncontrolled asthma and their caregivers. Frequent medical visits were associated with improved caregivers’ but not adolescents’ perceptions.     

Does inhibitory control capacity in overweight and obese children and adolescents predict success in a weight-reduction program?

It has been assumed that inhibitory control capacity might influence the success of overweight or obese subjects in reducing weight. However, empirical research on this association is scarce. The present study, therefore, examines whether success in an outpatient weight-reduction program for children and adolescents can be predicted by pre-intervention inhibitory control capacity. The study sample consisted of 111 overweight and obese children and adolescents (7.5–15 years) who attended an outpatient weight-reduction program of 1 year’s duration. Inhibitory control was assessed by two computerized neuropsychological procedures, a Go-NoGo and an interference task. Principal component analysis revealed “impulsivity” (fast but less valid reactions) and “inattention” (slow and highly variable reaction times) component. Those who succeeded in the intervention (losing more than 5% of BMI-SDS; n = 63) scored significantly higher in the first component than those who failed, while controlling for pre-intervention BMI-SDS, age, gender, and maternal education level. The association was moderated by age. Although in younger children no effect was found, in adolescents high “impulsivity” predicted success. Our result supports the scant evidence for a role of inhibitory control. However, further studies are required to substantiate that weak inhibitory control, and thus high reactivity to external cues, entails a better outcome in behavior modification interventions.     

Dieting Behaviors,Weight Perceptions,and Life Satisfaction Among Public High School Adolescents

Relationships among perceived life satisfaction, perceptions of body weight, and dieting behaviors were examined in a statewide crosssectional study of public high school adolescents in South Carolina (N = 5,032). The Centers for Disease Control (CDC) Youth Risk Behavior Survey and the Brief Multidimensional Students' Life Satisfaction Scale were utilized for this study. Adjusted logistic regression analyses and multivariate models constructed separately (via SUDAAN), revealed that perceptions of overweight, perceptions of underweight, having dieted to lose weight, having vomited or used laxatives to lose weight, and taking diet pills were significantly related (p <.05) to reduced life satisfaction for adolescents. Differences in dieting behavior and perceptions of weight were demonstrated across gender and race. Measures of life satisfaction as a component of comprehensive assessments of adolescent weight management and healthy eating behaviors in clinic, fieldwork, research, and program-evaluation efforts should be considered.     

Valproic acid-associated weight gain in older children and teens with epilepsy

This research was undertaken to determine the incidence and predictors of weight gain in older children and teens treated with valproate for epilepsy. Subjects who were 10 to 17 years of age, who began valproate treatment between January 1, 1996, and December 31, 2000, and who had documented weight and height measurements at medication initiation and at least one follow-up visit were retrospectively identified. Exclusion criteria were follow-up <2 months, discontinuation of valproate within 2 months, concurrent therapy with medication known to affect weight, or gastrostomy feeding. Body mass index was calculated at initiation and either discontinuation of valproate or last follow-up and stratified into four categories: underweight, (/=eighty-fifth to ninety-fifth percentile) and overweight (ninety-fifth percentile or higher). Potential predictors of change in body mass index were examined. Mild-to-moderate weight gain was observed in 58% of the 43 subjects treated with valproate (median increase, 2; twenty-fifth to seventy-fifth percentile, 1-6.4). Seventy-nine percent remained in the same body mass index category, and 14% moved up to a potentially overweight or overweight category. The only predictor of an overweight category at follow-up was a potentially overweight or overweight category at initiation (P <0.0002). Two factors tended to predict an increase in body mass index: normal neurocognitive status (P = 0.06) and primary generalized seizure type (P = 0.07).     

The impact of adverse childhood experiences on obesity and unhealthy weight control behaviors among adolescents

BackgroundChildhood abuse and other early-life stressors associate with being overweight or obese later in life. In addition to being overweight, unhealthy weight control behaviors (e.g., vomiting, using diet pills, fasting, and skipping meals) have been shown to be common among adolescents. To our knowledge, the association between these behaviors and adverse childhood experiences (ACEs) remains unexamined.MethodsWe examined the association of ACEs to body mass index (BMI) and unhealthy weight control behaviors among 449 Finnish adolescents aged 12 to 17 years admitted to an acute psychiatric hospital unit between April 2001 and March 2006. We used the Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) and the European Addiction Severity Index (EuropASI) to obtain information about ACEs, psychiatric diagnoses and weight control behaviors. BMI was calculated using the weight and height measured for each adolescent upon admission.ResultsGirls who experienced sexual abuse were more likely to be obese (OR: 2.6; 95% CI: 1.1–6.4) and demonstrate extreme weight loss behaviors (EWLB) (OR: 2.2; 95% CI: 1.0–4.7). Among girls, parental unemployment is associated with an increased likelihood of obesity (OR: 3.5; 95% CI: 1.2–9.6) and of being underweight (OR: 3.6; 95% CI: 1.1–11.6). A proneness for excessively exercising was found among girls who had witnessed domestic violence (OR: 3.5; 95% CI: 1.4–9.2) and whose parent(s) had died (OR: 5.4; 95% CI: 1.1–27.7).ConclusionThis study showed that female adolescents with a history of traumatic experiences or difficult family circumstances exhibited an elevated likelihood of being obese and engaging in unhealthy weight control behaviors.     

Perceived stress among a workforce 6 months following hurricane Katrina

To determine stress levels among a workforce 6 months after hurricane Katrina made landfall, a web-based survey that included the four-item Perceived Stress Scale was administered to employees of the largest employer in New Orleans. An overall Perceived Stress Scale score was obtained by pooling responses for the four items. Among 1,542 adult respondents, 24.1% stated they felt that they were “fairly often” or “very often” unable to control the important things in their life and 21.4% considered that their difficulties were “fairly often” or “very often” piling up so high that they could not overcome them. Also, 6.1% reported that they “almost never” or “never” felt confident about their ability to handle their personal problems and 15.2% indicated that things were “almost never” or “never” going their way. The overall mean Perceived Stress Scale score was 6.3 (standard deviation = 3.1; range = 0–16). Higher stress scale scores, indicating more stress, were present for women, and for participants with lower income, displaced longer than 3 months, who were more afraid of losing their life during hurricane Katrina and its immediate aftermath, and who knew someone that died during the storm. Additionally, participants who were living in a relative of friend’s house or in a temporary trailer at the time of the survey had higher stress scores compared to their counterparts who had returned to live in their pre-hurricane residence. There was a direct association between higher stress scores and symptoms of post-traumatic stress disorder. Employers and health care providers should be apprised of the need for monitoring stress and offering counseling opportunities for returning workforces following future large-scale disasters.     

Association between body weight status and suicidal ideation among Chinese adolescents: the moderating role of the child’s sex

Purpose

Suicidality (ranging from suicidal ideation to suicidal attempts and completed suicide) is a major and preventable public health concern, and body weight is considered a modifiable factor which might be helpful to the early risk assessment of suicidal ideation. This study aimed to comprehensively evaluate the association of body weight status with suicidal ideation across sex among Chinese adolescents.

Methods

Data were drawn from the 2015 National School-based Chinese Adolescents Health Survey, and 54,640 students’ questionnaires were completed and qualified for the survey. Body mass index z scores were calculated and categorized into four levels: underweight (less than the 5th percentile for sex and age), normal weight (between the 5th and 85th percentile), overweight (between the 85th and 95th percentile), and obese (above the 95th percentile).

Results

Of the total sample, 47.3% (25,852) were boys. The weighted prevalence of suicidal ideation among Chinese adolescents is 15.7% (14.6% in boys and 17.3% in girls). After adjusting for demographics, smoking, drinking, and depressive symptoms, our final multivariate logistic regression models demonstrated that only boys identified as underweight (Adjusted odds ratio [AOR] = 1.23, 95% CI = 1.06–1.44) or obese (AOR = 1.19, 95% CI = 1.02–1.38) were at a higher risk of suicidal ideation. Additionally, the association between weight status and suicidal ideation among boys might be moderated by academic pressure, smoking, and depressive symptoms.

Conclusions

There was a significant J-shaped association between relative body weight and suicidal ideation in boys. The child’s sex should be taken into consideration when developing interventions against unhealthy weight and suicidal ideation.

     

Further evidence for a low body weight in male children and adolescents with Asperger's disorder

The study explores the common clinical impression and previously reported finding by Hebebrand et al. (7) of reduced body weight in male children and adolescents with Asperger's disorder (AD). Body weight and height of 36 consecutively admitted male patients with AD were retrospectively assessed for the calculation of body mass indices (BMI, kg/m²). The BMIs were transformed to percentile ranks and plotted into BMI-centiles representative for the German population. In addition, comorbid psychopathology was assessed to explore a possible relationship between associated psychopathology and body weight. The mean BMI-centile of all patients was 34.7 ± 31.8 and, thus, differed significantly from the mean centile of an age- and gender-matched psychiatric control group, which was 52.7 ± 28.3. Thirteen patients had a BMI below the 10th centile and five even below the third. Three of the latter presented with disturbed eating behaviour. Altogether four patients showed disturbed eating behaviour. They had a significantly lower mean BMI-centile than the rest of the group. The BMI-centiles of patients with other additional psychopathology did not differ significantly from the mean percentile of the whole cohort. The results clearly show an increased risk for underweight and disturbed eating behaviour in patients with Asperger's disorder which should be evaluated in further studies. Accepted: 26 January 1999     

Low body weight in male children an adolescents with schizoid personality disorder or Asperger's disorder

This study explored the hypothesis that body weight is reduced in male children and adolescents with schizoid personality disorder or Asperger's disorder. The body weights of 33 consecutively admitted male subjects with one of these disorders were retrospectively assessed with percentiles for the body mass index (BMI). The mean percentile (±SD) for the BMI was 31.6±27.6 and differed significantly from the expected value of 50 (P < 0.001). Ten subjects had a BMI of ≤10th age percentile. Post hoc comparisons revealed that BMI percentiles were (a) reduced to a similar extent in patients with schizoid personality disorder and Asperger's disorder and (b) reduced to a greater extent in patients with abnormal eating behaviour. During childhood and adolescence both diagnoses are associated with an increased risk of being underweight. Population-based BMI percentiles are useful for detecting associations between specific psychopathological syndromes and body weight.     

Adolescents’ Commitment to Continuing Psychotropic Medication: A Preliminary Investigation of Considerations,Contradictions, and Correlates

This mixed-method study examines (1) the extent to which fifty adolescents receiving wraparound treatment and prescribed psychotropic medication for various psychiatric disorders report that they would continue taking medication if the decision was entirely their own (termed “medication commitment”); (2) their general subjective experiences with medication; and (3) which medication experiences and clinical, social, and demographic factors are associated with greater medication commitment. We found that most adolescents (62%) would discontinue treatment; these “less committed” youth were more likely to report various negative medication perceptions and experiences in open-ended questions, relative to “committed” youth. Multivariate analysis indicated that significant correlates of commitment to medication were: taking antipsychotic medication, greater perceived family support, and lack of perceived coercion to take the medication; clinical or demographic factors were not significantly related to medication commitment. The results reinforce the importance of addressing youths’ concerns about medication and maximizing their participation in treatment decision-making.     

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

Background: Overweight and perceived overweight are common among adolescents. The nature of the relationship between overweight/perceived overweight and mental health problems is still unclear.

Aims: The aim of this study was to examine whether actual overweight, perceived overweight or both are associated with internalizing and externalizing disorders among adolescents.

Methods: Data were collected by two similar school surveys in all Finnish-speaking secondary schools in Tampere (population 200,000) in the academic years 2002–2003 and 2012–2013. A total of 2775 acceptable responses were received. All the analyses were carried out separately for girls and boys. Mean age of the respondents was 15.6 years.

Results: In multivariate analyses perceived overweight, not actual weight, was significantly associated with higher risk of self-reported depression (OR: 4.3, 95% CI: 2.9–6.3, p?p?p?=?.001) and self-reported social phobia (OR: 2.4, 95% CI: 1.0–5.6, p?=?.05) in boys.

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

Glucose and lipid metabolism disorders in children and adolescents with spinal muscular atrophy types 2 and 3

We aimed to estimate the prevalence of glucose and lipid metabolism disorders in children and adolescents with spinal muscular atrophy (SMA) types 2 and 3. A cross-sectional study was conducted. Medical history, anthropometric measurements, pubertal status, blood chemistry (glucose and insulin levels, lipid profile, aminotransferases, and hemoglobin A1c [HbA1c]), and liver ultrasound were obtained in all patients. Oral glucose tolerance test was performed in those with body mass index (BMI) >25th percentile or glucose or HbA1c levels in the prediabetic range. A total of 37 patients with SMA (22 type 2, 15 type 3) with a median age of 8.5 years (range 2–18.9 years) were included. Eleven patients (29.7%) met the criteria for prediabetes, but none had overt type 2 diabetes. Dyslipidemia was detected in 11 patients (29.7%), and 4 (10.8%) had hepatic steatosis on ultrasound. Sixteen patients (43.2%) had at least one abnormal finding (prediabetes, dyslipidemia, or hepatic steatosis); all but one were non-ambulatory and 12 (75%) had BMI ≥85th percentile. One young child developed fasting hypoglycemia. Our results suggest that non-ambulatory overweight/obese SMA patients are particularly prone to abnormalities in glucose and lipid metabolism. Young underweight patients might develop fasting hypoglycemia.     

Relationship between body-mass index and depressive symptoms in patients with major depression.

BACKGROUND: Appetite and weight changes are commonly occurring symptoms of depressive illness. The occurrence of these symptoms may not only be related to depressive mood but may also be related to body weight. AIM: To examine the relationship between symptoms of depression and body weight. METHODS: Symptoms of depression were assessed by the Montgomery-Asberg depression rating scale (MADRS) in 1694 patients seeking medical help and fulfilling DSM-IV criteria for a major depressive episode. The level of anxiety was evaluated by Covi's anxiety scale. Body weight was expressed as body-mass index (BMI, kg/m(2)) and treated both categorically and continuously. RESULTS: The total MADRS score was not statistically different across the four BMI categories (underweight: 32.3 +/- 0.6, normal weight: 30.9 +/- 0.2, grade 1: 30.6 +/- 0.3, and 2 overweight: 30.6 +/- 0.6, P = 0.053 (NS)). In women with BMI 相似文献   

Deliberate self-harm behaviors in Chinese adolescents and young adults

The aim of this paper was to describe the prevalence of deliberate self-harm (DSH) and to determine the socio-demographic, behavioral, and psychological correlates of DSH behaviors in Chinese adolescents and young adults in a representative sample of the general population. The data were obtained from an epidemiologic study involving adolescents and young adults from junior and senior schools and colleges located in eight provinces of China. A total of 17,622 cases were retained for analysis. The relationship between the explanatory variables with self-harm was analyzed using a Pearson χ ² test and a multinomial logistic regression model. A total of 3,001 (17.0%) students reported that they had harmed themselves deliberately in the past 12 months. The act of DSH occurring 1 and >2 times accounted for 4.2% (742) and 12.8% (2,259) of all respondents, respectively. The most frequently reported form of DSH was self-hitting. If the reference category was No DSH, the findings indicated that family composition, father’s education, perceived family economic status, cigarette use, perceived body image, and higher scores in depression scales were important concomitants of repeat-incidents of DSH. The students, in western areas, who were younger, reported that having unhealthy weight control behaviors, and alcohol use had a higher risk for both types of DSH. Regarding students of age 15–18 years perceived body image (too fat), having unhealthy weight control behaviors or a high level of depression symptoms demonstrated an elevated risk for repeat-incident DSH when single-incident DSH was used as the reference category, whereas the students in middle area reported family composition (both parents), education of the father (less than college) or alcohol use had a decreased risk for repeat-incident DSH. The results of this study suggest that both types of DSH are associated with other wide-ranging problems in the students’ lives. Despite their common features, these phenomena also differed from each other. It is necessary to investigate the possible neurobiologic underpinnings of DSH within a longitudinal study to enhance the knowledge of this behavior.     

Stability of childhood anxiety disorder diagnoses: a follow-up naturalistic study in psychiatric care

Few studies have examined the stability of major psychiatric disorders in pediatric psychiatric clinical populations. The objective of this study was to examine the long-term stability of anxiety diagnoses starting with pre-school age children through adolescence evaluated at multiple time points. Prospective cohort study was conducted of all children and adolescents receiving psychiatric care at all pediatric psychiatric clinics belonging to two catchment areas in Madrid, Spain, between 1 January, 1992 and 30 April, 2006. Patients were selected from among 24,163 children and adolescents who received psychiatric care. Patients had to have a diagnosis of an ICD-10 anxiety disorder during at least one of the consultations and had to have received psychiatric care for the anxiety disorder. We grouped anxiety disorder diagnoses according to the following categories: phobic disorders, social anxiety disorders, obsessive–compulsive disorder (OCD), stress-related disorders, and “other” anxiety disorders which, among others, included generalized anxiety disorder, and panic disorder. Complementary indices of diagnostic stability were calculated. As much as 1,869 subjects were included and had 27,945 psychiatric/psychological consultations. The stability of all ICD-10 anxiety disorder categories studied was high regardless of the measure of diagnostic stability used. Phobic and social anxiety disorders showed the highest diagnostic stability, whereas OCD and “other” anxiety disorders showed the lowest diagnostic stability. No significant sex differences were observed on the diagnostic stability of the anxiety disorder categories studied. Diagnostic stability measures for phobic, social anxiety, and “other” anxiety disorder diagnoses varied depending on the age at first evaluation. In this clinical pediatric outpatient sample it appears that phobic, social anxiety, and stress-related disorder diagnoses in children and adolescents treated in community outpatient services may have high diagnostic stability.     

Is body mass index a useful measure of excess body fatness in adolescents and young adults with Down syndrome?

Background To determine the validity of body mass index (BMI) to identify excess fatness in youth with Down syndrome (DS). Methods Using the Centers for Disease Control and Prevention (CDC) growth reference, we defined overweight (≥85th percentile) and obesity (≥95th percentile) based on participants' age‐ and sex‐specific BMI z‐scores, calculated from measured height and weight. Percentage body fat was measured by dual‐energy X‐ray absorptiometry. We determined sensitivity, specificity, positive predictive value, negative predictive value and efficiency of BMI percentiles to identify excess adiposity relative to elevated percentage body fat cut‐offs developed from the Pediatric Rosetta Body Composition project in 32 youth (20 boys/12 girls), ages 13–21 years with Down syndrome. Results For adolescents with Down syndrome using the cut‐off points of 95th percentile for BMI (obesity), sensitivity and specificity were 71% and 96% respectively. Positive predictive value was 83% and negative predictive value was 92%. Overall efficiency was 91%. Sensitivity and specificity for BMI cut‐offs above the 85th percentile (overweight) were 100% and 60% respectively. The positive predictive value was 41% and negative predictive value was 100%. Overall efficiency was 69%. Conclusion On the whole, the obesity (≥95th percentile) cut‐off performs better than the overweight cut‐off (85th–94th percentile) in identifying elevated fatness in youth with DS.     

Serum lipids, metabolic syndrome and lifetime suicide attempts in patients with bipolar disorder

Obesity in children and adolescents is a worldwide health problem, characterized by various somatic, psychosocial and psychiatric complications, and is often associated with adult obesity and related complications. Brain-derived neurotrophic factor (BDNF) is a neurotrophin with important roles in feeding behavior, food intake regulation, energy metabolism and weight control. A common polymorphism of the BDNF genotype (Val66Met) has been associated with various forms of eating disorders, alterations in body mass index (BMI) values and obesity in adult populations. The aim of this study was to determine the association between the gene variants of the BDNF Val66Met polymorphism and obesity in 300 healthy Caucasian children and adolescents of the same ethnic background of Croatian origin, subdivided according to the BMI percentile, but without any form of eating disorders. The frequency of the Met/Met, Met/Val and Val/Val genotypes, Met and Val alleles, and Met carriers (the combined Met/Met and Met/Val genotypes versus the homozygous Val/Val genotype) differed significantly between underweight, normal weight, overweight and obese children, and the presence of one or two Met alleles contributed to this significant effect. These results showed for the first time the significant association between the presence of one or two Met alleles and obesity in ethnically homogenous groups of healthy Caucasian children and adolescents. These data confirmed the major role of BDNF in energy metabolism, food regulation and BMI.