Self-esteem of adolescent girls as related to weight

The Rosenberg Self-esteem Scale was administered to 550 14- and 16-yr.-old (+/- 6 mo.) girls. Self-esteem scores were categorized by weight and weight by height. Scores on the Quetelet Index for obesity were correlated with self-esteem scores. Mean self-esteem of the low- and middle-weight by height group was significantly higher than the mean of the high-weight by height group. In analyzing weight alone, the self-esteem of the middle-weight group was significantly higher than the self-esteem of the high-weight group. The correlation of the obesity index and self-esteem indicated that as weight increased self-esteem decreased.     

Dieting behavior in Norwegian adolescents

In a sample of Norwegian adolescents (n = 1117) 27, 4% of the girls and 9% of the boys reported that they were dieting. Using multiple regression analyses, we were able to predict 50% of girls dieting behavior and 24% of boys dieting behavior. Psychological concerns relating to weight and eating (WEC) as well as perceptions of feeling fatter than others were the only significant predictors of dieting in girls, whilst dieting in boys could also be predicted by their Body Mass Index. Dieting girls who scored high on the Weight and Eating Concerns Inventory were found to suffer constipation and binge eating attacks more often than other dieting girls. This was taken as an indication that these girls were at risk of developing an eating disorder.     

An exploration of body dissatisfaction and perceptions of Black and White girls enrolled in an intervention for overweight children

Silhouette measures are one approach to assessing body dissatisfaction in children, although little is known about their use among racially diverse, overweight girls seeking weight-loss treatment. This study assessed racial differences in body dissatisfaction and body size perceptions of 58 girls (ages 6–11, 66% Black, 34% White) participating in a randomized trial for pediatric overweight. Body dissatisfaction did not differ between races; 99% of girls reported an ideal figure smaller than their current one. Black girls selected a larger silhouette to represent their ideal body size, and most girls in both racial groups underestimated their actual size. Outcomes strengthen the argument that, despite an overall preference for a larger body size, obesity might mitigate cultural factors that protect Black girls from body dissatisfaction. Additional research is needed to enhance understanding of children's body size perceptions and dissatisfaction to inform assessment and treatment of pediatric obesity and associated disordered eating symptoms.     

Age-related differences in actual and perceived levels of physical activity in adolescent girls

Age-related differences in actual and perceived physical activity were investigated in a sample of adolescent girls, also considering the relationship between physical activity and motor abilities. Self-reported physical activity was measured in 11-year-old (n=66) and 13-year-old (n=52) girls by means of the physical activity questionnaire-children form, and actual levels of activity were assessed by means of the Lifecorder uniaxial accelerometer. The Sit-and-Reach Test was employed to estimate flexibility, while lower limb strength was measured by squat jump and counter-movement jump tests. Weight and height were measured, and sex-specific age-related body mass index cutoff points were used to identify overweight and obesity. Findings showed a drop in objective vigorous physical activity in older girls, which was also reflected in the physical activity questionnaire. Contrary to expectations, no association was found between motor abilities and measured physical activity. Results highlight the need to understand the reasons why girls progressively reduce their involvement in physical activity as they get older, so as to plan interventions aimed at preventing this decline.     

Accuracy of parents' reports of height and weight

The accuracy of parents' reports of their own height and weight and the height and weight of their obese children, who were about to enter a weight control program, was assessed. Measured height and weights of 146 mothers, 55 fathers, and 150 children who attended a screening session were compared to the heights and weights they had previously reported on a demographic questionnaire. Eighty-four percent of the reported weights were accurate within ±5 lbs.; 71% of the reported heights were accurate within ±1 in. Parents' reports of weight tended to underestimate actual weights, with the magnitude of underestimation greater for mothers than for fathers, while reported heights overestimated actual height, with the magnitude of overestimation greatest for fathers. Errors in the parents' reports of children's weight were related to the child's actual weight and body mass index (BMI), with substantial underestimation of actual weight in the heaviest decile of children in the sample.Preparation of this paper was supported in part by Grant HDMH12520-01 from the National Institute of Child Health and Human Development and Mental Health. Reprints can be obtained from Rena R. Wing, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15261.     

Self-reported versus measured weight and height by adolescent girls: a Croatian sample

Self-reported and measured weight and height of 234 Croatian girls in Grades 5, 8, and 11 were used to explore the validity of these measures for calculating Body Mass Index. For both weight and height, the correlations between self-reported and measured values were over .93. Overweight girls underreported their weight and overreported their height.     

Validation study on self-reported height, weight, and blood pressure

Self-report data were compared with actual recorded data on height, weight, and blood pressure during health examinations to check for validity. The subjects were 1,823 persons, ages 40-68 years. Pearson correlations for systolic blood pressure, diastolic blood pressure, height, weight, and Body Mass Index between data reported in 1993 and measurements made in 1991 were .63, .60, .96, .96, and .92, respectively. Pearson correlations for the same variables between the data reported in 1993 and the measurements made in 1992 were .73, .67, .97, .97, and .94, respectively. Self-reported values for height, weight, and Body Mass Index appear to be valid over years or so.     

Human figure drawing size and body image in preschool children from a self-physique perspective

To learn about the relationship between size of human figure drawings and the physiques of children, we investigated body image characteristics in childhood by using the Human Figure Drawing test. Height, weight, Kaup Index (a body mass index for children) and Human Figure Drawing traits (vertical height, horizontal width, waist size, surface area of head, surface area of the self-drawing) were measured for drawings of 122 4- to 6-yr.-old children (62 boys, 60 girls). Analysis showed that boys, who are physically larger than girls, produced self-drawings with somewhat larger surface areas. For vertical height of self-drawings of boys, 4-yr.-olds characteristically made taller self-drawings than 5-yr.-olds. While we hypothesized that taller children would make vertically taller self-drawings, we observed a negative relationship between children's physical height and the vertical height of the self-drawings. 4-yr.-old boys showed the most interest in their own physical height, making taller drawings and in doing so gave a clue to an early childhood feature of body image.     

Childhood Overweight and Obesity: Maternal and Family Factors

Treatment programs for childhood overweight and obesity have highlighted the importance of the family in treatment. Considering this, it is surprising that few studies have examined the role of family factors in the development of childhood overweight and obesity. The objective of this study was to examine which family and maternal factors predict increases in weight in boys and girls during middle to late childhood. This study used longitudinal data from the childhood growth and development (GAD) Study. The GAD Study involved 286 healthy weight, overweight and obese children, aged 6–13 years at baseline, who completed baseline, 1-year follow-up and 2-year follow-up assessments. Overweight/obese children were recruited from clinical and community settings. A broad range of maternal and family factors were assessed. Linear mixed models were used to identify which factors predicted child Body Mass Index (BMI) z-scores over time. For community-based children, maternal BMI and single-parent family structure were significant longitudinal predictors of child BMI z-scores. For the clinical participants, low family income was the only significant multivariate predictor of child BMI z-scores. The strong association between child BMI, maternal BMI and family structure confirms the need to target prevention and intervention efforts for childhood overweight and obesity towards families with overweight parents, particularly single-parent families.     

Negative Stereotyping of Obesity in Children: The Role of Controllability Beliefs

This study investigated the extent of negative stereotyping of obesity (compared to negative stereotyping of height) in children and its relationship with the perception of obesity as controllable. Questionnaires measuring negative stereotyping and controllability beliefs about weight (and height) were completed by 96 children from Grades 4 to 6. Consistent negative stereotyping of obesity was found for both child and adult targets, regardless of the child's own gender, age, or weight, Likewise, children uniformly believed obesity to be largely under volitional control. The degree of controllability assigned to obesity was positively correlated with the extent of negative stereotyping. It was concluded that control beliefs may provide a vehicle for changing the strong negative attitudes displayed toward fat people.     

Family-based obesity treatment, then and now: twenty-five years of pediatric obesity treatment.

OBJECTIVE: Family-based treatments for pediatric obesity were developed over 25 years ago. Over that time, youth have become more obese and the environment more obesiogenic, which may influence efficacy of pediatric weight control. Mixed-effects regression models were used to compare the efficacy of programs initiated 20 to 25 years ago to current programs through 24-month follow-up, as well as to reanalyze 10-year outcomes of previous research using contemporary measures and analytic strategies. MAIN OUTCOME MEASURES: z-BMI and percent overweight. RESULTS: Results showed significant reductions over time, with no differences in z-BMI change for older versus contemporary studies. Age was a predictor of z-BMI up to 24 months, with younger children showing larger change. Mixed-effects regression models replicated previous long-term effects of family-based interventions. Gender was a predictor of long-term z-BMI change, with girls benefiting more over time than did boys. CONCLUSION: The efficacy of the family-based behavioral approach to treating pediatric obesity replicates over a 25-year period. Challenges in evaluating treatment effects over time are discussed. Ideas for studying choice of treatments that vary in effect size and for strengthening family-based behavioral treatments are noted.     

Downsizing obesity: On Ancel Keys,the origins of BMI,and the neglect of excess weight as a health hazard in the United States from the 1950s to 1970s

In 1972 Body Mass Index, BMI was put forth by physiologist Ancel Keys in his analysis of Seven Countries Study heart disease epidemiological data as the best available measure of obesity. This work culminated more than 20 years of effort by Keys to discredit the accepted measure of obesity, weight relative to height, along with a major public health campaign in the United States to fight heart disease through weight control. Here, I retrace his campaign to replace weight as a measure of obesity and analyze its methodology and relationship to the broader research field of heart disease epidemiology. I also explore why the epidemiological community accepted BMI despite Keys's failure to demonstrate that either it or adiposity (body fat content), were superior as predictors of heart disease—one of the Seven Countries Study's central aims.     

Factors associated with mothers' obesity stigma and young children's weight stereotypes

Parents and children hold negative attitudes about obesity, but little is known about individual differences in obesity stigma. The current study examined authoritarian parenting style, beliefs about the controllability of weight and fear of fat in relation to mothers' dislike of overweight individuals. Factors related to children's weight stereotypes were also investigated. Forty-nine mothers and children (43% girls) participated. Mothers showed more dislike and blame toward adults who are overweight than children who are overweight; parents were most often blamed for children's weight status. Authoritarian parenting and beliefs about controllability were related to mothers' anti-fat attitudes, but fear of fat was not. However, mothers' fear of fat was the best predictor of children's negative stereotypes toward overweight peers. The current study provides some preliminary insight into the role of mothers in children's attitudes about weight. Examining individual difference factors is also useful in planning targeted interventions to lessen obesity stigma.     

Physical fitness of South African primary school children, 6 to 13 years of age: discovery vitality health of the nation study

Basic physical fitness was measured using 8 different measures for 10,295 South African children and youths (5,611 boys, 4,684 girls) ages 6 to 13 years. These measurements included height, weight, Body Mass Index, standing long jump, shuttle run, sit-and-reach, sit-up (EUROFIT testing battery), and cricket ball throw scores. Due to the effects of earlier apartheid laws on separating communities, it was hypothesized that scores for different ethnic groups may differ. Therefore, in addition to the calculation of basic norms and sex differences, ethnic differences were also tested. Height and weight, relative to age, were different between the various ethnic groups (Black, White, and Mixed ancestry) for boys, with Black boys being shorter and lighter than White boys. There were no differences in sit-and-reach flexibility scores between the groups. With the exception of the cricket ball throw for girls, White children had higher scores in most tests. Although not significantly different from the White children, in the majority of cases, the children of mixed ancestral origin had scores that ranged between the other two ethnic groups. These results suggest a need for encouraging fitness in school children, and the reintroduction of formal physical education into the South African school curriculum, especially into schools in which Black children predominate.     

Identification and Description of New Tests of Executive Functioning in Children

The understanding of executive functioning in pediatric neuropsychological evaluation is of clinical significance, yet there are few developmentally appropriate executive function measures that have been adequately normed in this population. The present study provides normative data, collected on a sample of 89 normal children from ages 7-12, for several measures thought to be appropriate for assessing executive functioning in children. Executive function measures were selected and/or modified to be developmentally appropriate, to tap less complex and integrative aspects of executive function, and to assess fundamental working memory (Self-Ordered Pointing: Delayed Alternation/Non-alternation) and inhibitory control (Developmental Stroop tasks: Go/No Go) dimensions of executive functioning. The results supported the potential utility of these measures in assessing those abilities in children.     

Physical, Sociocultural, and Behavioral Factors Associated with Body-Esteem in 16-Year-Old Swedish Boys and Girls

Body Mass Index (BMI), weight loss attempts, pubertal timing, body ideal internalization, and peer appearance teasing were examined in relation to three dimensions of body-esteem; weight-based body-esteem (Weight), appearance-based body-esteem (Appearance), and beliefs about how others view one’s body and appearance (Attribution). Participants were 758 Swedish 16-year-olds. Results showed that the factors examined varied in importance depending on gender and body-esteem dimension. Whereas a majority of the factors examined were related to the Weight dimension, fewer were related to the Appearance dimension, and almost none were related to the Attribution dimension. Furthermore, the factors examined were generally able to explain a much greater amount of variance in girls’ body-esteem than boys’.     

Body image of obese adolescent girls in a high school and clinical setting

There have been many investigations of body image in cases of anorexia nervosa in adolescent females. However, there has been limited research with normal adolescent girls who happen to be overweight. In this study, 27 girls found to be obese (at least 20 percent above average body weight for age, sex and height) among 203 girls in home economics classes of four suburban high schools were compared to 20 girls seeking help for their obesity on an outpatient basis in hospital-affiliated programs for weight reduction in a nearby city. The two groups were assessed and compared regarding body image factors. The clinical subjects showed a significantly greater difference in their selection of outline drawings of the female figure perceived to represent their actual as compared to ideal body sizes. No significant difference was found in articulation of body concept as revealed in human figure drawings judged according to Witkin's Articulation of Body Concept (ABC) Scale, and in the mean number of uncomplimentary adjectives used to describe present appearance. However, the difference between the mean scores of the two groups in the latter two variables, when submitted to t tests, were shown to approach significance (.017 less than p less than .05).     

‘He's got his father's bias’: Parental influence on weight bias in young children

Our aim was to explore the role of parents in the transmission of stereotypical body size attitudes and awareness of weight loss strategies to preschool children. Participants were 279 3‐year‐old children and their parents, who provided data at baseline and 1 year later. Parents completed self‐report body size attitude and dieting measures. Child weight bias and awareness of weight loss strategies were assessed through interview. Over time, negative associations with large bodies and awareness of weight loss strategies increased. Fathers’ attitudes prospectively predicted boys’ weight bias and awareness of weight loss strategies. Among girls, parental attitudes were less predictive. Findings confirm the importance of fathers in the development of boys’ body attitudes and inform prevention programmes.     

Teaching Clinical Psychology Trainees about Weight Bias

Abstract

As an assistant professor who teaches clinical psychology trainees about social aspects of behavior, I devote one week to the topic of weight bias. In this class, I rely on the research literature to challenge common myths about “obesity,” demonstrate the pervasiveness and harm of weight bias, and offer recommendations to trainees to apply to their own professional and personal lives. I encourage trainees to shift focus from weight and weight loss to health and well-being and to engage in self-reflection on the role of weight bias in their interactions with others. Here, I describe my weight bias seminar and outline common questions and my responses to them (e.g., Do you actually believe that “obese” people can be healthy?). Weight bias is a neglected topic in most clinical psychology training programs. Weight bias must be addressed in clinical psychology programs to produce culturally competent graduates who are aware of diversity issues.