Children who are overweight in adolescence could benefit from the promotion of self-esteem and body-positive images during their earlier years, according to a new study from Imperial College.
Both girls and boys who are unhappy with their appearance and suffer low self-esteem at age 14 are more likely to have mental health difficulties at age 17, including anxiety and depression, aggression, and impulsivity and a higher BMI than those with a more positive self-image.
The researchers found that if children gained increased satisfaction with their appearance and improved their self-esteem from early adolescence, it can reduce poor mental health associated with being higher weight in later adolescence.
The findings, published in eClinicalMedicine, suggest that mental health and obesity, two of today’s biggest population health challenges, may be modifiable during adolescence.
Overweight and obesity are growing problems in teenagers, and the link between higher weight and poor mental health is well established. Nearly twenty per cent of young people with obesity live with mental health issues such as depression and anxiety, around twice that observed for young people with a healthy Body Mass Index (BMI).
Using the Millennium Cohort Study, the researchers analysed data from over 12 000 children in the UK. They looked at happiness with appearance, self-esteem, and bullying at 14 years, as well as BMI z-score at 11 and 17 years (the latter of which is a measure of how many standard deviations a young person’s BMI is above or below the average BMI for their age and gender) and mental health conditions. The overall aim was to explore the impact of psychological and social factors on the relationship between mental health and BMI throughout adolescence.
The researchers found that children’s happiness with their appearance and positive self-esteem had the most significant influence on the relationship between BMI and mental health.
Obese children had a greater prevalence of emotional problems at age 11 compared to healthy-weight children and entered their teenage years with low self-esteem. Each increase in BMI z core at 11 years old was associated with an increase in scores of unhappiness with appearance at age 14. By aged 17, these children were more likely to suffer from mental health difficulties, such as anxiety, depressive symptoms, aggression, and impulsivity and had higher BMIs than those with a more positive self-image.
Dr Hanna Creese, from Imperial College London and the study’s first author, explained that the links between mental and physical health are well established. She said: We know that children who are overweight or obese are much more likely to suffer social and emotional problems, such as depression and anxiety. But unpicking the different factors driving these outcomes is challenging – such as the complex two-way relationship between mental health and BMI.’
She added: ‘It’s important for children to maintain a healthy weight, but our study highlights that this shouldn’t be achieved at the expense of children’s long-term mental health or by stigmatising their weight and driving poor body image and low self-esteem, as this can have damaging and long-lasting impacts.’
In addition to measures already in place to reduce rates of obesity and poor mental health among young people, this study supports the need for the promotion of positive body image and self-esteem among young people. The researchers suggest interventions delivered to the national curriculum and via social media could reduce some of the social and emotional issues experienced by older, high-weight teenagers.