Body mass index and parent-reported self-estem in elementary school children: evidence for a causal relationship.

Hesketh, Kylie, Wake, M. and Waters, Elizabeth 2004, Body mass index and parent-reported self-estem in elementary school children: evidence for a causal relationship., International journal of obesity and related metabolic disorders, vol. 28, pp. 1233-1237, doi: 10.1038/sj.ijo.0802624.

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Title Body mass index and parent-reported self-estem in elementary school children: evidence for a causal relationship.
Author(s) Hesketh, KylieORCID iD for Hesketh, Kylie
Wake, M.
Waters, Elizabeth
Journal name International journal of obesity and related metabolic disorders
Volume number 28
Start page 1233
End page 1237
Publisher Nature Publishing Group
Place of publication Basingstoke, England
Publication date 2004
ISSN 0307-0565
Keyword(s) self-esteem
body mass index
longitudinal studies
Summary OBJECTIVE: To clarify relationships between body mass index (BMI) and self-esteem in young children at a population level. To assess whether low self-esteem precedes or follows development of overweight/obesity in children. DESIGN: Prospective cohort study in elementary schools throughout Victoria, Australia. Child BMI and self-esteem were measured in 1997 and 2000. SUBJECTS: Random sample of 1,157 children who were in the first 4 y of elementary school (aged 5-10 y) at baseline. MEASURES: BMI was calculated from measured height and weight, then transformed to z-scores. Children were classified as nonoverweight, overweight or obese based on international cut-points. Low child self-esteem was defined as a score below the 15th percentile on the self-esteem subscale of the parent-reported Child Health Questionnaire. RESULTS: Overweight/obese children had lower median self-esteem scores than nonoverweight children at both timepoints, especially at follow-up. After accounting for baseline self-esteem, higher baseline BMI z-score predicted poorer self-esteem at follow-up (P=0.008). After accounting for baseline BMI z-score, poorer baseline self-esteem did not predict higher BMI z-score at follow-up. While nonoverweight children with low baseline self-esteem were more likely to develop overweight/obesity (OR=2.1, 95% CI=1.2, 3.6), this accounted for only a small proportion of the incidence of overweight. CONCLUSIONS: Our data show an increasingly strong association between lower self-esteem and higher body mass across the elementary school years. Overweight/obesity precedes low self-esteem in many children, suggesting a causal relationship. This indicates that prevention and management strategies for childhood overweight/obesity need to begin early to minimise the impact on self-esteem.
Notes Published online 17 August 2004
Language eng
DOI 10.1038/sj.ijo.0802624
Field of Research 111704 Community Child Health
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2004, Nature Publishing Group
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