Are overweight and obese youths more often bullied by their peers? A meta-analysis on the relation between weight status and bullying

Associations between specific and cumulative adverse childhood experiences, childhood obesity, and obesogenic behaviours

Background: Individuals impacted by adverse childhood experiences (ACEs) are at greater risk of developing obesity, however, few studies have prospectively measured ACEs and obesity during childhood. Associations with the adoption of obesogenic behaviours during childhood, which directly contribute to obesity are also understudied.Objective: To examine associations between individual and cumulative ACEs, obesity, and obesogenic behaviours during childhood.Methods: Data came from Growing Up in New Zealand. The study sample was restricted to those who provided obesity data at age 8 and one child per mother, resulting in an analytic sample of 4895 children. A newly developed ACEs index consisted of nine individual ACEs and cumulative ACEs scores (0, 1, 2, 3, 4+ ACEs), two obesity measures (BMI and waist circumference/height ratio), and eight obesogenic behaviours including unhealthy dietary behaviours, inadequate sleep duration, excessive screen time, and physical inactivity were included in the analyses.Results: ACEs were prevalent among this cohort of NZ children. By age eight, 87.1% of children experienced at least one ACE and 16% experienced at least 4 ACEs. Six individuals assessed ACEs showed significant associations with childhood obesity (AORs ranging from 1.22 to 1.44). A significant dose-response effect was observed where the experience of a higher number of ACEs was associated with greater risk for obesity (AORs increased from 1.78 for one ACE to 2.84 for 4+ ACEs). Further, a significant dose-response relationship was found between experiencing two or more ACEs and higher odds of adopting obesogenic behaviours (AORs ranging from 1.29 for physical inactivity to 3.16 for no regular breakfast consumption).Conclusions: ACEs exposure contributes to population-level burden of childhood obesity. Our findings highlight the importance of a holistic understanding of the determinants of obesity, reinforcing calls for ACEs prevention and necessitating incorporation of ACEs-informed services into obesity reduction initiatives.

Impact of child summertime obesity interventions on body mass index and weight-related behaviors: A systematic review and meta-analysis

INTRODUCTION

Obesity during childhood is a critical public health issue. The summer break from school is a time when children are prone to accelerated weight gain. We aimed to investigate how obesity prevention or treatment programs implemented over the summer affect anthropometric measures or weight-related behaviors.

METHODS

Published studies examining the impact of obesity prevention/treatment interventions targeting the summer with anthropometric or weight-related behaviors in children (5-18 years old) were identified using systematic searches of Medline, Cochrane, Scopus, CINAHL, PsycINFO, and EMBASE until April 2024. The summarized effect estimate was computed by applying the random-effects approach. The evidence certainty was assessed using GRADE.

RESULTS

Forty-seven studies were identified for inclusion. The majority of studies identified focused on physical activity and dietary habits. Only six studies that examined the effects of prevention interventions on weight, body mass index (BMI), and waist circumference (WC) were meta-analyzed. There was no evidence that prevention interventions impacted children's weight, BMI, and WC. However, most of the studies included in the systematic review indicated beneficial effects of interventions for anthropometric measures.

CONCLUSION

There was no evidence that summertime obesity interventions targeting physical activity and dietary intake were effective in the prevention of obesity in children.

A Longitudinal Examination of Body Esteem as a Predictor of Eating Behaviors, Physical Activity, and Quality of Life Among Youth with Obesity Attending Canadian Weight Management Programs

Background: This study explored whether baseline body esteem predicted changes in eating behaviors, physical activity (PA), and health-related quality of life (QoL) over a 24-month period among youth with obesity enrolled in weight management programs. Methods: Utilizing data from the CANadian Pediatric Weight Management Registry, the study included 415 participants (n = 221 girls, n = 194 boys) aged 10-17 years (mean = 13.2, standard deviation = 2.2). Baseline assessments included a measure of body esteem, while QoL, eating behaviors, and PA were reported at baseline, 12 months, and 24 months. Multilevel modeling was applied to examine the relationships between baseline body esteem and changes in outcomes over time. Results: Higher baseline body esteem was associated with higher initial QoL scores (β = 0.70, p < 0.001) and healthier eating behavior scores (β = -0.57, p < 0.001). Individuals with lower baseline body esteem exhibited greater improvements in QoL (β = -0.12, p = 0.010) and eating behaviors (β = 0.12, p = 0.004) over time. However, baseline body esteem did not significantly predict changes in PA. Conclusions: These findings highlight the prospective relationship of body esteem with future health behaviors and outcomes, providing evidence for weight management programs to consider addressing body esteem within pediatric obesity research and treatment.

Risk Factors and Correlates of School Bullying and Cyberbullying among Turkish Adolescents: Evidence from a School-Based Cross-Sectional Study

Background

Traditional school bullying and cyberbullying are common experiences that adversely affect the present and future mental health of adolescents. Cyberbullying has also increased during the last decade due to the growing use of the internet, mobile technological tools, and social network systems. This study aimed to investigate the risk factors of traditional school bullying and cyberbullying.

Methods

The sample comprised 5491 adolescents (53.7% male and 46.3% female) from Grades 7 to 12 in 15 public schools. Participants were administered a self-report survey, including sociodemographics, school bullying, cyberbullying, and related variables. A logistic regression analysis was performed to examine the factors related to school bullying and cyberbullying involvement.

Results

Boys were more prone to be perpetrators or victim-perpetrators of both school and cyberbullying. The results revealed that carrying a cutting tool, short sleep duration, using the computer and mobile phone longer, and poor academic performance were risk factors for being a perpetrator (p < 0.05). In addition, school bullying involvement was related to thin or overweight body perception (p < 0.001). Regression analysis indicated that being a victim or perpetrator of school bullying showed more significant risks for being a victim or perpetrator of cyberbullying (p < 0.001).

Conclusions

We found common risk factors for both types of bullying and an overlap between school bullying and cyberbullying. These findings should be considered for developing new intervention programs and policies for preventing bullying in Turkey.

Evaluating the impact of motor quotient physical fitness training on health-related fitness indicators and obesity risk in children aged 7-8 years in Tianjin, China

This study aimed to evaluate the impact of Motor Quotient (MQ) physical fitness training on health-related fitness indicators and obesity risk in children aged 7-8 years in Tianjin, China. A total of 60 obese participants were randomly divided into an experimental group (N = 30) and a control group (N = 30). The intervention program focused on improving children's physical, behavioral, and task-related capabilities through structured MQ training. Key results indicated that the experimental group demonstrated significant improvements in Body Mass Index (BMI), with a reduction from 21.28 ± 1.15 kg/m² to 18.86 ± 1.24 kg/m² for boys (p < 0.001) and from 21.04 ± 1.54 kg/m² to 17.47 ± 1.07 kg/m² for girls (p < 0.001). Physical performance metrics improved substantially, including enhanced 2 × 30 m Shuttle Run times (boys: +12.97%, girls: +13.96%, both p < 0.001) and increased Plank duration (boys: +41.36%, girls: +35.26%, both p < 0.01), reflecting improved cardiovascular endurance and core strength. Significant gains were also observed in task-related motor skills, such as Hand-eye Coordination, Behavior Imitation, and Reaction capability (all p < 0.001). Behavioral adaptations included higher scores in exercise behavior (p < 0.01), while strong correlations were found between BMI and cardiovascular fitness indicators, such as the 20 m Backward Run (r = 0.974, p < 0.001). These findings highlight the effectiveness of MQ training in reducing obesity risk and improving multidimensional fitness outcomes. The program demonstrates significant potential as a practical and evidence-based strategy to promote health-related fitness and motor development in children.

Family affluence and bullying victimisation affect life satisfaction in large-bodied adolescents: Evidence from 37 high-income countries

BACKGROUND

Adolescents with large body sizes often experience bullying which likely affects their overall well-being. Yet, there is limited research on how bullying victimisation affects overall life satisfaction among this cohort of adolescents, and how family affluence moderates this relationship.

OBJECTIVE

This study investigates the moderation effects of family affluence in the association between bullying victimisation and life satisfaction among adolescents with large bodies.

SETTING AND PARTICIPANTS

This research involved 16,240 adolescents with large bodies based on the World Health Organization's Body Mass Index Chart/Classification for ages 13 to 15 years from 37 high-income countries in Europe and North America.

DESIGN

The study used data from the Health Behaviour in School-aged Children (HBSC) survey, a cross-national study of adolescent health and well-being. Hypotheses were assessed through mixed effects binary logit models with random intercepts, accounting for data clustering and variations across regions.

RESULTS

After controlling for covariates, both cyberbullying (AOR = 1.72; 95 % CI = 1.48-2.00) and traditional bullying (AOR = 1.74, 95 % CI: 1.53-1.99) were significantly associated with lower life satisfaction compared with no bullying experience among participants. Family affluence partly moderated these associations, wherein the highest level of affluence reduced the effects of cyberbullying (AOR = 1.57, 95 % CI: 1.09-2.27) and traditional bullying (AOR = 1.41, 95 % CI: 1.02-1.96) on life satisfaction compared to lower levels.

CONCLUSION

Both traditional and cyberbullying significantly reduced life satisfaction among adolescents with large body sizes. However, higher family affluence moderates (reduces) these negative effects, suggesting a protective role of socioeconomic status. These findings highlight the need for targeted interventions to support bullied adolescents, particularly those with large bodies and from lower socioeconomic backgrounds.

Prevalence and predictors of positive childhood experiences and their relationship with adverse childhood experiences among young adults in Delhi-NCR, India

BACKGROUND

Although positive childhood experiences (PCEs) have been reported to be crucial for healthy development and better mental and physical health outcomes, their epidemiology and relationship with adverse childhood experiences (ACE) exposure in low and middle-income countries, including India remain underexplored.

AIMS

The present study aimed to ascertain the prevalence and predictors of PCE exposure and understand the relationship between PCE and ACE exposure among young adults in Delhi-NCR, India.

METHODS

The present cross-sectional study involved a total of 1,573 young adults (18-25 years) of both sexes (69.7% females) recruited from two Universities in Delhi-NCR, India. PCEs and ACEs were measured using the Benevolent Childhood Experiences scale and ACE-International Questionnaire.

RESULTS

Of the total participants, 42.6% reported experiencing all 10 PCEs, while 50.2% had experienced 6 to 9, and 7.2% had experienced 0 to 5 PCEs. Further, the mean PCE score of the sample was 8.64. Certain sociodemographic groups, for instance, participants from immigrant families, sexual minority groups and those who were obese during childhood than their respective counterparts were at lower odds of high PCE exposure. Also, the study found a significant inverse correlation between ACE and PCE exposure levels; however, the effect size was moderate.

CONCLUSIONS

The study indicates the need for targeted PCE promotion interventions for disadvantaged sociodemographic groups. The intervention should simultaneously aim at reducing ACEs, as PCE promotion alone may not always lead to ACE reduction.

Associations Between Age-for-Grade, Sex, and Interpersonal Violence Among U.S. High School Students

The current study examines how atypical age-for-grade (i.e., being old- or young-for-grade) is associated with various types of interpersonal violence (e.g., physical fighting, school-based and electronic bullying victimization, and being threatened or injured with a weapon at school) among a nationally representative sample of U.S. high school students and explores these associations by sex. Data were from 21,892 students in 9th to 11th grades in the 2017 and 2019 National Youth Risk Behavior Survey. Weighted logistic regression models examined associations between age-for-grade categories and various types of interpersonal violence with peers, with stratified models exploring differences by sex. Results showed that, compared to their age-normative peers, students who were young-for-grade were more likely to report physical fighting, being threatened or injured with a weapon at school, and school-based and electronic bullying victimization. Students who were old-for-grade were more likely to report physical fighting than their age-normative peers. These associations differed for boys and girls, where being young-for-grade was more strongly associated with interpersonal violence for boys than for girls. Old-for-grade girls were more likely to report physical fighting than their age-normative peers, whereas young-for-grade girls were more likely to report being threatened or injured with a weapon at school. Findings from the current study may be explained by differences in physical, social, and emotional development in youth who are young-for-grade or old-for-grade compared to their age-normative peers. Results can inform school-level policies when identifying youth for grade retention or acceleration and may have implications for school-based interventions to prevent interpersonal violence between peers.

Literature Review and Content Analysis of Bullying Assessments: Are We Measuring What We Intend to?

The initial phase in any initiative aimed at preventing bullying involves evaluating the present prevalence to pinpoint students who might be more susceptible to involvement in the bullying dynamic. Assessment serves as a guide for shaping future decisions regarding intervention. The purpose of this study was to identify and evaluate current assessment tools to determine the extent to which the bullying dynamic is currently measured. The results indicated that assessment tools measured verbal bullying/victimization most frequently, followed by relational and physical. Also, items measured repetition and intent about 50% of the time, while they measured power imbalance less frequently (i.e., 25%). The importance of matching an appropriate assessment to a school's needs is emphasized. Implications for both researchers and practitioners are discussed.

Exploring the interplay of weight-based teasing and sociodemographic factors in adolescent weight bias internalization

OBJECTIVE

Research has highlighted the potential adverse effects of weight bias internalization (WBI) on adolescents, but there has been little examination of WBI and sources of weight teasing (family, peers, or both) or across racial/ethnic diversity of adolescents. We aimed to examine the relationship between WBI and sources of weight teasing across sociodemographic characteristics and weight status in a diverse community sample of adolescents.

METHODS

Data were collected from a U.S. sample of 1859 adolescents aged 10-17 years (59% female; 43% White, 27% Black or African American, and 25% Latino). An online questionnaire was used to assess participants' experiences of weight teasing from family members, peers, or both, and their weight status, weight-related goals, WBI, and sociodemographic characteristics.

RESULTS

Adolescents experiencing weight teasing from both family and peers reported the highest levels of WBI, while those reporting no teasing exhibited the lowest levels. These patterns were observed across sex, race/ethnicity, weight status, and weight goals, and persisted after controlling for depressive symptoms. Notably, family influences played a salient role, with adolescents reporting higher WBI if teased by family only compared to teasing from peers only. Sex and racial differences were also observed in adolescents' experiences with weight-based teasing.

CONCLUSION

Our study reveals associations between adolescent weight-based teasing, WBI, and sociodemographic factors. Weight-based teasing, whether from family and peers or from family only, was associated with increased WBI. Interventions targeting weight stigma in youth should not be limited to peer-focused efforts, but should also emphasize supportive family communication.

Meeting 24-h movement behavior guidelines is associated with academic engagement, social-emotional functioning in obese/overweight youth

BACKGROUND

The 24-h movement behavior (24-HMB) guidelines suggest that the integration of adequate sleep (SL), increased physical activity (PA), and limited screen time (ST) has general health benefits. However, associations of meeting integrated guidelines with academic engagement and social-emotional functioning among obese/overweight youth have yet to be fully examined. Thus, we aimed to investigate the associations between meeting 24-HMB guidelines and the above-presented outcome measures among this unique group.

METHODS

In this cross-sectional study, 2800 children and adolescents (youth aged 6-17 years old) that were retrieved from the National Survey of Children's Health (NSCH) were included for data analysis. Exposure of interests included adherence to 24-HMB guideline(s), while indicators of academic engagement and social-emotional functioning were operationalized. Furthermore, multiple logistic regression was conducted while adjusting for social-demographic variables including age, sex, ethnicity, household income, parental education level and mental health status.

RESULTS

The percentages of meeting 24-HMB guidelines varied greatly across different combinations: 1399 participants (49.96 %) met 1 of the 3 guidelines, 580 participants (20.91 %) met 2 guidelines, while only 91 participants (2.94 %) met all 3 guidelines. Meeting integrated guidelines was selectively associated with higher odds of indicators (showing interest/curiosity in learning, caring about school performance, and completing all required homework) of academic engagement. Additionally, Meeting SL + ST guideline (OR = 0.52, 95%CI: 0.29-0.93, p < 00.05) was associated with lower odds of serious difficulty in concentrating, remembering, and making decisions, while meeting ST + SL guideline (OR = 1.67, 95%CI: 1.03-2.69, p < 00.05) was more likely to be good at making and keeping friendships. Furthermore, meeting all 3 guidelines was associated with less argumentative behaviors (OR = 0.58, 95%CI: 0.33-0.99, p < 00.05) and a higher level of resilience (OR = 3.51, 95%CI: 1.88-6.54, p < 00.01), while meeting any two integrated guidelines was associated with a higher level of resilience (OR = 1.72, 95%CI: 1.09-2.71, p < 00.05).

CONCLUSION

Findings have indicated the role of meeting 24-HMB guidelines, especially integrated guidelines in the healthy development of obese/overweight youth. Policymakers should implement a long-term plan for this unique group to engage in physical activity, achieve enough sleep, and limit screen time.

The influence of adolescents' nutrition knowledge and school food environment on adolescents' dietary behaviors in urban Ethiopia: A qualitative study

Adolescence is a critical period of physical, cognitive, and social development that needs to be supported with healthy diets. Dietary behaviours of adolescents can be shaped by their nutrition-literacy and their interaction with parents and peers as well as their school food environment. Therefore, the present study aimed to assess factors that influence dietary behaviours of adolescents in urban Ethiopia. Sex-disaggregated, focused group discussions (n = 70) were conducted in 36 private and government schools (n = 12/city) among adolescents (n = 432) 15-19 years of age in Addis Ababa, Bahir Dar, and Dire Dawa. Photovoice was applied in a subgroup of participants (n = 216) to gain further insights into adolescents' perception of their school food environment. Key informant interviews were conducted among school principals (n = 36). Adolescents had a relatively good nutrition knowledge and recognised the importance of diverse diets, but misperceptions also existed. They identified fruit and vegetables as healthy foods, but their consumption was deterred by food safety concerns. The adolescents identified foods high in salt, fat, and sugar, including processed/packaged foods as unhealthy, but still consumed them frequently due to their taste, affordability, availability and accessibility in and around schools. Both undernutrition and overweight/obesity were linked to social exclusion and bullying in school. Effective behavioural change communication is required to address common misperceptions. School nutrition programs should integrate water, sanitation and hygiene programs to ensure food safety. Regulations promoting healthy eating while discouraging unhealthy dietary behaviours are vital. Interventions to make nutrient-dense and healthy foods available, accessible, and affordable are urgently needed to improve the nutrition and health outcome of adolescents.

Young children's choices and thoughts about pro-social behaviour towards others with overweight

OBJECTIVES

This study aimed to investigate weight bias within young children's pro-social choices between characters who differed in body size.

METHODS

Seventy-six children aged 4-6 years read stories asking them to choose who they would first help, share with, comfort, and steal from, between a healthy weight and child with overweight. They also selected the one character they would most like to play with. Children's reasoning for these choices was recorded and analysed.

RESULTS

The character with overweight was helped first in only a third of the choices made. Children chose the characters with overweight more often as the target for anti-social action. In friendship selections, children overwhelmingly rejected the characters with overweight. However, weight bias was not prominent in the reasons children gave for the choices. Most children were not negative about body shape, weight or appearance. Similarly, in friendship choices, these were mostly expressed positively to the character chosen. Only a small minority of children were explicitly negative about the character with overweight.

CONCLUSIONS

A better understanding of weight bias acquisition and variation between children will benefit those working in health care and educational settings. Future research should link with developmental theory, such as on social categorization and theory of mind.

Assessing the impact of obesity interventions in the early years: a systematic review of UK-based studies

OBJECTIVES

Childhood obesity rates in the UK are high. The early years of childhood are critical for establishing healthy behaviours and offer interventional opportunities. We aimed to identify studies evaluating the impact of UK-based obesity interventions in early childhood.

DESIGN

Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

DATA SOURCES

Nine databases were searched in March 2023.

ELIGIBILITY CRITERIA

We included UK-based obesity intervention studies delivered to children aged 6 months to 5 years that had diet and/or physical activity components and reported anthropometric outcomes. The primary outcome of interest was z-score Body Mass Index (zBMI) change (within and between subjects). Studies evaluating the effects of breastfeeding interventions were not included as obesity prevention interventions, given that best-practice formula feeding is also likely to encourage healthy growth. The publication date for studies was limited to the previous 12 years (2011-23), as earlier reviews found few evaluations of interventions in the UK.

DATA EXTRACTION AND SYNTHESIS

The reviewers worked independently using standardised approach to search, screen and code the included studies. Risk of bias was assessed using Cochrane tools (ROB 2 or ROBINS-I).

RESULTS

Six trials (five studies) were identified, including two randomised controlled trials (RCT), one cluster randomised trial (CRT), two feasibility CRTs and one impact assessment. The total number of participants was 566. Three trials focused on disadvantaged families and two included high-risk children categorised as having overweight or obesity. Compared with baseline, five interventions reported reductions in zBMI, three of which were statistically significant (p<0.05). Compared with control, five interventions showed zBMI reductions, one of which was significant. Only two trials were followed up beyond 12 months. All studies were found to have a high risk of bias. Meta-analysis was not possible due to the heterogeneity of studies.

CONCLUSION

UK evidence was limited but some interventions showed promising results in promoting healthy growth. As part of a programme of policies, interventions in the early years may have an important role in reducing the risk of childhood obesity.

PROSPERO REGISTRATION NUMBER

CRD42021290676.

Temporal relation between pubertal development and peer victimization in a prospective sample of US adolescents

Peer victimization typically peaks in early adolescence, leading researchers to hypothesize that pubertal timing is a meaningful predictor of peer victimization. However, previous methodological approaches have limited our ability to parse out which puberty cues are associated with peer victimization because gonadal and adrenal puberty, two independent processes, have either been conflated or adrenal puberty timing has been ignored. In addition, previous research has overlooked the possibility of reverse causality-that peer victimization might drive pubertal timing, as it has been shown to do in non-human primates. To fill these gaps, we followed 265 adolescents (47% female) prospectively across three-time points (Mage : T1 = 9.6, T2 = 12.0, T3 = 14.4) and measured self-report peer victimization and self- and maternal-report of gonadal and adrenal pubertal development on the Pubertal Development Scale. Multilevel modeling revealed that females who were further along in adrenal puberty at age 9 were more likely to report peer victimization at age 12 (Cohen's d = 0.25, p = .005). The relation between gonadal puberty status and peer victimization was not significant for either sex. In terms of the reverse direction, the relation between early peer victimization and later pubertal development was not significant in either sex. Overall, our findings suggest that adrenal puberty status, but not gonadal puberty status, predicted peer victimization in females, highlighting the need to separate gonadal and adrenal pubertal processes in future studies.

Influence of body mass index on health complains and life satisfaction

PURPOSE

This research work investigates the influence of children's weight status on well-being and school context in a sample of Spanish adolescences.

METHODS

The Spanish records from the 2013-14 Health Behaviour in School-Aged Children Survey are used, which gathers 9,565 adolescences aged 11, 13 and 15. Studies do not usually address the endogeneity of body mass index when analysing their effect on life satisfaction and health complaints, thus resulting in biased estimates. Considering the endogeneity of body mass index, we use the frequency of alcohol consumption as an instrumental variable in order to obtain consistent estimates of its influence.

RESULTS

The two-stage least squares estimation shows that children's body mass index has a significant negative influence on health complaints and it conditions the way children relate to each other at school. Likewise, results report significant influence on children's subjective well-being and their self-assessment of general health.

CONCLUSIONS

The results of this study provide compelling evidence that BMI plays a crucial role in shaping adolescents' well-being and their interactions with peers at school. These findings underscore the importance of addressing childhood overweight and promoting healthy body mass index levels. Furthermore, the study highlights the need for targeted policy interventions to combat the social stigma associated with being overweight, fostering a more inclusive and supportive school environment for all students.

The visual analogue scale as a child-friendly measure of the unhealthy = tasty intuition

Worldwide, obesity is a growing concern. The implicit belief that healthiness and tastiness in food are inversely related (the Unhealthy = Tasty Intuition or UTI) decreases healthy food consumption and increases the risk of obesity. Since also childhood obesity has increased at an alarming rate and a large component of adult obesity is established during childhood, questions about children's own food beliefs and preferences are important. However, methods currently used to assess the UTI are either unvalidated Likert scales or implicit measures that are time intensive and too complex to be used for children. Two studies presented here offer an alternative measurement - the simple visual analogue scale. The findings show that this measure is more effective in predicting dietary quality in adults and the frequency of healthy food consumption in children compared to more traditional measures. This simple and effective tool could be used by academics and health practitioners alike to better understand children's food beliefs at an early age, which is a critical step when addressing the increasing obesity problem.

Psychosocial and environmental risk factors of obesity and hypertension in children and adolescents-a literature overview

Childhood obesity has become a worldwide epidemic in the 21st century. Its treatment is challenging and often ineffective, among others due to complex, often not obvious causes. Awareness of the existence and meaning of psychosocial and environmental risk factors seems to be an essential element in the prevention and treatment of obesity and its complications, especially arterial hypertension. In this review, we will discuss the role of that risk factors linking obesity and increased cardiovascular disorders including the role of nutritional factors (including the role of unhealthy diet, inadequate hydration), unhealthy behaviors (e.g. smoking, alcohol and drugs, sedentary behavior, low physical activity, disrupted circadian rhythms, sleep disorders, screen exposure), unfavorable social factors (such as dysfunctional family, bullying, chronic stress, mood disorders, depression, urbanization, noise, and environmental pollution), and finally differences in cardiovascular risk in girls and boys.

Pediatric Obesity: Complications and Current Day Management

Obesity affects approximately 1 in 5 youth globally and increases the risk of complications during adolescence and young adulthood, including type 2 diabetes, dyslipidemia, hypertension, non-alcoholic fatty liver disease, obstructive sleep apnea, and polycystic ovary syndrome. Children and adolescents with obesity frequently experience weight stigma and have an impaired quality of life, which may exacerbate weight gain. Pediatric obesity is typically defined using sex-, age-, and population-specific body mass index percentiles. Once identified, pediatric obesity should always be managed with lifestyle modification. However, adolescents with obesity may also benefit from anti-obesity medications (AOM), several of which have been approved for use in adolescents by the US Food and Drug Administration, including liraglutide, phentermine/topiramate, and semaglutide. For children with specific, rare monogenic obesity disorders, setmelanotide is available and may lead to significant weight loss. Metabolic and bariatric surgery may be used for the management of severe obesity in youth; though highly effective, it is limited to specialized centers and has had relatively low pediatric uptake. In this narrative review using pediatric-focused data from original research, reviews, clinical practice guidelines, governmental agencies, and pharmaceutical companies, we review obesity-related metabolic complications in youth and management strategies, including AOM and bariatric surgery.

Child and adolescent obesity

The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive-emotional control that is regulated by higher brain centres, operating at a conscious level. Health-related quality of life is reduced in those with obesity. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities.

Bystanders' Victim Blaming and Minimizing Consequences of Weight-Based Cyberhate Attacks: The Roles of anti-Fat Attitudes, Body-Positive Online Content, and Gender

Physical appearance and, specifically, weight are common reasons for cyberhate attacks among adolescents. Using a between-subject experimental design, this study focuses on the bystanders of such attacks on Instagram. We investigate bystanders' assessments in the form of two moral disengagement (MD) mechanisms-victim blaming and minimizing consequences-and we compare the assessments of attacks that are diversified by the victim's weight (i.e., a victim who is plus-size and a victim who is thinner). We also examine the moderating roles of bystanders' prejudice against people who are plus-size in the form of the so-called anti-fat attitudes, their frequency of viewing body-positive online content, and gender. The study's data come from an online survey conducted in 2020 with a representative sample of 658 Czech adolescents, aged 13-18. We tested our hypotheses with structural equation modeling. The results show that the two MD mechanisms work differently. The victim's displayed weight affected the bystanders' tendency to victim blame: adolescents blamed the victim who is plus-size more than the victim who is thinner, but the victim's weight made no difference in minimizing the consequences of the incident. A moderating effect for anti-fat attitudes and gender was found for victim blaming. Bystanders with higher anti-fat attitudes and boys blamed the victim who is plus-size more than the victim who is thinner. On the other hand, there was no effect for the frequency of viewing body-positive online content for either of the MD mechanisms. The results are discussed with regard to the differences between the two mechanisms and the practical implications for educational and prevention programs for youth.

Clustering of Obesogenic Behaviors Associated With Bullying Roles Among 100,794 Adolescents

Obesogenic behaviors have been individually associated with bullying during adolescence. However, physical activity, sedentary behavior, and diet manifest themselves in synergy and even behavioral profiles in which positive and negative behaviors coexist can be more positively associated with psychosocial outcomes. The present study aimed to analyze the association between clusters of obesogenic behaviors and different bullying roles in Brazilian adolescents. This cross-sectional study used data from the Brazilian School-based Health Survey-PENSE, 2015. A total of 100,794 male and female adolescents of the ninth-grade elementary school participated in the study. Students responded to an electronic questionnaire. Clusters of obesogenic behavior consisted of physical activity, exposure to sedentary behavior, and diet, and the different roles in bullying were: participant, victim, bully, and bully-victim. Binary logistic regression with 95% confidence intervals (CI) was used for data analysis (p < .05). Multiple adjustments and complex sampling procedures were employed. Adolescents in the cluster "Health-promoting sedentary behavior and Diet" had reduced chances of participating in bullying (odds ration [OR] = 0.70; 95% CI [0.64, 0.76]), of being a victim (OR = 0.87; 95% CI = 0.76-0.99), and being the bully (OR = 0.65; 95% CI [0.59, 0.71]); and those from the cluster "Health-promoting physical activity and Diet" had reduced chances of participating (OR = 0.81; 95% CI [0.76, 0.87]), being a victim of bullying (OR = 0.86; 95% CI [0.76, 0.98]), being the bully (OR = 0.79; 95% CI [0.72, 0.85]), and being a bully-victim (OR = 0.74; 95% CI [0.61, 0.90]), when compared to those from the "health-risk" cluster in the adjusted analysis. Clusters of obesogenic behavior may reduce adolescent bullying: victim, bully, and bully-victim benefit when exposed to healthier behavioral profiles. The school setting must recognize bullying as a problem and therefore simultaneously promote multi-component interventions to tackle physical activity, sedentary behavior, and eating behavior. Outcomes other than obesity should be acknowledged when promoting obesogenic behaviors.

Mediators of the association between childhood body mass index and educational attainment: Analysis of a UK prospective cohort study

BACKGROUND

Higher body mass index (BMI) in childhood is associated with lower academic achievement.

OBJECTIVE

To explore potential pathways linking childhood BMI with educational attainment.

METHODS

Using data from the Avon Longitudinal Study of Parents and Children prospective cohort study (N = 6949), we assessed the association between BMI z-scores at 11.7 years and educational attainment at 16 (General Certificate of Secondary Education [GCSE] results). Depressive symptoms, externalizing behaviours, bullying and school enjoyment were considered as potential mediators. Mediators were examined individually and jointly using sequential causal mediation.

RESULTS

Higher BMI z-scores were associated with lower GCSE scores (females β = -3.47 95% CI -5.54, -1.41 males β = -4.33 95% CI -6.73, -1.94). Together, bullying, externalizing symptoms, depressive symptoms and school enjoyment mediated 41.9% of this association in females, and 23.3% in males. In males, evidence for mediation was weak (confidence intervals for all indirect effects spanned the null). In both females and males, most of the mediation was driven by externalizing symptoms.

CONCLUSIONS

The detrimental effect of higher BMI on educational attainment appears to be partly explained by externalizing behaviours, particularly in females. Interventions to support behavioural problems may help the academic achievement of children with a higher body weight.

A Novel Symbiotic Formulation Reduces Obesity and Concomitant Metabolic Syndrome in Rats by Raising the Relative Abundance of Blautia

Obesity is regarded as an abnormal or excessive buildup of fat that may be bad for health and is influenced by a combination of intestinal flora, genetic background, physical activity level and environment. Symbiotic supplementation may be a realistic and easy therapy for the reversal of obesity and associated metabolic problems. In this study, we chose two Bifidobacterium species, three Lactobacilli species and four prebiotics to make a new symbiotic formulation. High or low doses of the symbiotic were administered to rats, and biochemical indicators were recorded to assess the biological effects in a high-fat-diet-induced rat model. The underlying mechanisms were explored by integrating 16S rRNA sequencing with an extensively targeted metabolome. High-dose symbiotic supplementation was effective in reducing obesity and concomitant metabolic syndrome. The high-dose symbiotic also significantly increased the abundance of Blautia, which was negatively correlated with taurocholic acid and the main differential metabolites involved in amino acid and bile acid metabolism. While the low-dose symbiotic had some therapeutic effects, they were not as strong as those at the high dose, demonstrating that the effects were dose-dependent. Overall, our novel symbiotic combination improved plasma glucose and lipid levels, shrunk adipocyte size, restored liver function, increased the abundance of Blautia and adjusted bile acid and amino acid metabolism.

Scoping literature review and focus groups with healthcare professionals on psychosocial and lifestyle assessments for childhood obesity care

BACKGROUND

Childhood obesity is a complex disease resulting from the interaction of multiple factors. The effective management of childhood obesity requires assessing the psychosocial and lifestyle factors that may play a role in the development and maintenance of obesity. This study centers on available scientific literature on psychosocial and lifestyle assessments for childhood obesity, and experiences and views of healthcare professionals with regard to assessing psychosocial and lifestyle factors within Dutch integrated care.

METHODS

Two methods were used. First, a scoping review (in PubMed, Embase, PsycInfo, IBSS, Scopus and Web of Science) was performed by systematically searching for scientific literature on psychosocial and lifestyle assessments for childhood obesity. Data were analysed by extracting data in Microsoft Excel. Second, focus group discussions were held with healthcare professionals from a variety of disciplines and domains to explore their experiences and views about assessing psychosocial and lifestyle factors within Dutch integrated care. Data were analysed using template analysis, complemented with open coding in MAXQDA.

RESULTS

The results provide an overview of relevant psychosocial and lifestyle factors that should be assessed and were classified as child, family, parental and lifestyle (e.g. nutrition, physical activity and sleep factors) and structured into psychological and social aspects. Insights into how to assess psychosocial and lifestyle factors were identified as well, including talking about psychosocial factors, lifestyle and weight; the professional-patient relationship; and attitudes of healthcare professionals.

CONCLUSIONS

This study provides an overview of psychosocial and lifestyle factors that should be identified within the context of childhood obesity care, as they may contribute to the development and maintenance of obesity. The results highlight the importance of both what is assessed and how it is assessed. The results of this study can be used to develop practical tools for facilitating healthcare professionals in conducting a psychosocial and lifestyle assessment.

Impact of a School-Based Nutrition Intervention in Preventing Overweight and Obesity in Children in Thailand

BACKGROUND

This study evaluated the impact of a school-based nutrition program on preventing overweight and obesity in children in Thailand from 2014 to 2019.

METHODS

We used difference-in-differences with matched comparison group to evaluate program impact. Treatment schools were categorized into those that participated in phase 1 only, and those that participated in phase 1 and 2. We matched 311 treatment schools in phase 1 only with 1504 comparison schools, and 75 treatment schools in both phases with 216 comparison schools. Administrative data from Thailand Office of Basic Education Commission were used from 2014 (baseline), 2016 (first follow-up), and 2019 (second follow-up).

RESULTS

Program resulted in a 0.6-1.1 percentage point reduction in the students' probability of overweight by the end of phase 1, and 1.7 percentage points by the end of phase 2. Impact on obesity was found only for schools participating in both phases (0.4 and 0.9 percentage points by the end of phase 1 and 2, respectively).

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Program continuity and intensity are key to achieve a reduction in overweight and obesity in schoolchildren.

CONCLUSIONS

The program was successful in reducing overweight and/or obesity given appropriate level of continuity and intensity.

Adverse childhood experiences and mental ill-health - obesity comorbidity among British adolescents - A national cohort study

Background

Mental ill-health and obesity are increasingly prevalent in childhood with both conditions likely to co-occur. Less is known about associations between adverse childhood experiences (ACEs) and mental ill-health and obesity (MH-OB) comorbidity in adolescence. The aim of this study was to examine associations between ACEs and MH-OB comorbidity in adolescents from a national cohort study.

Methods

Participants; 10,734 adolescents (males = 50.3%) from the Millennium Cohort Study with 6 ACEs (for e.g., parental MH, drug/alcohol misuse, physical punishment) collected prospectively between ages 3-11 years. MH-OB comorbidity (binary indicator) was based on objectively measured BMI (for overweight/obesity) and self-reported depression/anxiety at ages 14 and 17. Associations between: 1.total ACE scores (0, 1, 2 or ≥3) and additionally each individual ACE, and MH-OB, were analysed used logistic regression, separately at 14 and 17 years.

Results

At age 14, ACE scores were associated with higher odds for MH-OB comorbidity, with a gradient of increasing odds ratios (OR) with increasing ACEs. Individuals with 1 (OR:1.22[95%CI: 1.1-1.6]), 2 (OR:1.7[1.3-2.3]), or ≥3ACEs (OR:2[1.5-2.6]) had increased odds for MH-OB comorbidity compared to those with 0 ACEs. At age 17, associations between ACE scores and MH-OB were attenuated and observed in individuals with ≥3ACEs (OR:1.54, 1.1-2.3). Parental MH (OR:1.5, 1.2-1.9), intimate-partner violence (OR:1.2, 1.1-1.6), physical punishment (OR:1.3, 1.1-1.6), bullying (OR:2, 1.6-2.5) were associated with MH-OB comorbidity age 14. However, only parental MH (OR:1.5, 1.1-2.1) and bullying (OR:1.6, 1.2-2.1) were associated with MH-OB comorbidity at age 17.

Conclusion

ACEs are associated with increased risk of MH-OB comorbidity in between ages 14 and 17. These findings provide timely opportunity for interventions to reduce risk and are pertinent given that MH and obesity contribute significantly to global burden of disease and track across the lifecourse.

The prevalence of peer bullying and psychiatric symptoms among high school students in southeast Turkey

PURPOSE

The purpose of this study is to examine the prevalence of bullying among high school students, its associated factors, and the effects of engaging in bullying behaviors on mental health.

MATERIALS AND METHODS

This cross-sectional study was conducted between 2021 and 2022 in the province with the highest population of children in the Southeast Anatolia region of Turkey. The data of the study were collected using the Sociodemographic Characteristics Questionnaire prepared by the researchers, Olweus Bully/Victim Questionnaire (OBVQ), and Depression Anxiety Stress Scale 42 (DASS-42).

RESULTS

Of the 880 students who participated in the study, 34.2% reported being a victim of bullying and 13.9% reported bullied someone. Regression analysis revealed that overweight/obesity was a risk factor for both victims and bullies. On the other hand, male gender and alcohol consumption were significantly associated with bullying. Scores for depression, anxiety, and stress were significantly higher in both the victim and the bullying groups compared to students who did not fall into this cycle.

CONCLUSIONS

The present findings suggest that bullying in school creates problems not only for the bullying victims but also for the bullies. Health professionals assessing youth should be aware of the characteristics of young people who may be involved in bullying.

Association between weight status and bullying experiences among children and adolescents in schools: An updated meta-analysis

BACKGROUND

The association between weight status and bullying experience is well established, but little is known about the association between overweight or obesity and bullying behaviors among children and adolescents.

OBJECTIVE

The aim of this study was to provide updated evidence on the association between weight status and exposure to bullying among school children and adolescents.

METHODS

All literature published not later than December 12, 2019 was obtained from PubMed, Web of Science, Embase, and PsycINFO databases. The odds ratios (ORs) and corresponding 95 % confidence intervals (CIs) were used to measure the effect size. Results were combined using random-effects or fixed-effects meta-analysis, and sensitivity analysis was conducted to explore potential heterogeneity moderator factors.

RESULTS

This meta-analysis included 26 studies on the association between obesity overweight and bullying. Overall, children and adolescents with obesity had greater odds of experiencing bullying than their counterparts with healthy weight. Children and adolescents with obesity (OR = 1.46, 95 % CI:1.31-1.62), and overweight (OR = 1.24, 95 % CI: 1.17-1.32) were more likely to experience bullying than their normal weight peers. With regards to gender, boys with obesity experienced an increased risk of bullying behaviors than girls with obesity (OR = 1.40, 95 % CI: 1.30-1.50). Similarly, boys with overweight experienced an increased risk of bullying behaviors than girls with overweight (OR = 1.19, 95 % CI:1.06-1.34).

CONCLUSIONS

The present results suggest that children and adolescents must be protected from bullying, especially those that are children and adolescents with obesity overweight and effective strategies are needed to reduce bullying behaviors among children and adolescents in schools.

Past-Year Abuse and Eating Disorder Symptoms Among U.S. College Students

Evidence consistently indicates associations between eating disorders (EDs) and childhood emotional, physical, and sexual abuse, but the relationship between EDs and abuse occurring later in development has largely been unexplored. Therefore, the objective of this study was to examine associations between past-year abuse and ED symptoms among college students. Participants represented 12 U.S. colleges and universities participating in the Healthy Bodies Study (HBS) between 2013 and 2015 (N = 10,204; M_age = 23.38 years). Students self-reported experiences of emotional, physical, and sexual abuse over the past year. Cognitive ED symptoms (i.e., dietary restraint, shape/weight overvaluation, body dissatisfaction) were measured via the Short-Eating Disorder Examination-Questionnaire (S-EDE-Q), and behavioral ED symptoms (i.e., binge eating, purging) were measured via items from the full EDE-Q. Regression models that adjusted for demographics and weight status were conducted to examine associations between past-year abuse and ED symptoms. Past-year emotional, physical, and sexual abuse each exhibited independent associations with ED symptoms. When mutually adjusting for emotional, physical, and sexual abuse, past-year emotional abuse was associated with higher levels of dietary restraint (b = 0.20, p = .02), shape/weight overvaluation (b = 0.85, p < .001), body dissatisfaction (b = 0.63, p < .001), binge eating (prevalence ratio [PR] = 1.23, p = .002), and purging (PR = 1.68, p < .001), and past-year sexual abuse was associated with shape/weight overvaluation (b = 0.35, p = .03) and purging (PR = 1.71, p = .009) but no other ED symptoms. No associations were observed for past-year physical abuse in mutually adjusted models. In summary, past-year emotional abuse emerged as a key correlate of all ED symptoms examined in this sample of U.S. college students, while past-year sexual abuse also emerged as a key correlate of shape/weight overvaluation and purging. Findings emphasize the need to screen for abuse and implement abuse prevention efforts on college campuses.

The association between weight loss and long term development in quality-of-life among children living with obesity: a pragmatic descriptive intervention study

Background

Childhood obesity is associated with impaired Quality-of-Life (QoL), increased stigmatization and higher risk of development of depression compared to their peers. This report describes the long-term development in QoL for cohort of children with obesity after a sustainable weight reduction.

Methods

This pragmatic descriptive intervention study enrolled 120 children with obesity, age 5–17 years, in a multifactorial lifestyle intervention. The intervention was an across sectors collaboration between a department of pediatrics and community health care workers. QoL was assessed yearly throughout the intervention and evaluated by a 6-item Visual Analogue Scale (VAS). For analyzing changes in VAS, as function BMI-SDS, regression models were used, while ANOVA and Wilcoxon test were applied for normal and not-normal distributed data. 95% confidence interval not containing 0 and p-value < 0.05 was considered statistically significant.

Results

After 26.4 months (13.9 SD) an overall decrease in bullying (0.6 vs. 0.0 median) and motivation (10.0 vs. 9.6) was observed. QoL increased in children with a BMI-SDS reduction (0.65 (2.49 SD)) opposite children with no-change or increasing BMI-SDS who reported reduced QoL (-0.36 (1.55 SD) and -0.96 (2.27 SD)). A significant inverse relationship was observed for Joy of Life, QoL and body perception as a function of BMI-SDS per year.

Conclusion

Weight reduction causes improvement in QoL for children with obesity and an inverse relationship for QoL and changing BMI-SDS / year was establish.

Longitudinal association between the timing of adiposity peak and rebound and overweight at seven years of age

Background

The timing of adiposity peak (AP) or adiposity rebound (AR) is a determinant of overweight or obesity in adolescence and adulthood. However, limited studies have reported the association in young school-age children. We aimed to evaluate this association and explore the role of health behaviours in it.

Methods

Routinely collected, sequential, anthropometric data from the 1st to 80th months of age were used to estimate AP and AR timings in 2330 children born in Shanghai between 2010 and 2013. Multivariate regression analyses were applied to identify the associations between the AP or AR timings and the risk of developing overweight or obesity in first-grade school children. The roles of health behaviours, including dietary patterns, physical activity level, sleep and snacking habits, and screen time, were also evaluated.

Results

Children with a late AP or an early AR were at higher risk of overweight but not obesity or central obesity in their first grade. A high physical activity level was associated with a lower risk of having overweight in children with a late AP, and limited screen time was associated with a decreased risk of having overweight or obesity in children with an early AR. The absence of a late-night snacking habit in children with a non-early AR indicated a decreased risk of having overweight. However, this association was not observed among children with an early AR.

Conclusion

The timings of AP and AR are tied to overweight in middle childhood. Prevention strategies are suggested to move forward to control late AP and early AR.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12887-022-03190-9.

The Relationships between Childhood Bullying, School Connectedness, and Adolescent Adiposity, the Fragile Families Child and Wellbeing Study

BACKGROUND

School environments are important to consider for children's health. This study aims to determine if childhood peer bullying and school connectedness are associated with adolescent adiposity.

METHODS

A total of 3377 children from the age 9 child interview of the Fragile Families and Child Wellbeing Study had self-reported bullying and school connectedness data at age 9, height and weight measured at ages 9 and 15, and waist circumference was measured during an age 15 home visit. Linear regression models estimated the association between bullying and school connectedness and (1) change in BMI between age 9 and 15, and (2) waist circumference at age 15. Models were stratified by sex.

RESULTS

Girls had larger increases in body mass index (BMI) when experiencing low school connectedness, and students that experienced both bullying and low school connectedness had larger increases in BMI. Girls had larger waist circumferences for increased levels of bullying, low connectedness, and experiencing both.

CONCLUSIONS

School environments may play a role in the development of increased adiposity and there may be gender differences in the types of factors that are important to consider, particularly for central adiposity. Positive and engaging school environments can help support students' development and healthy behaviors.

The Childhood Obesity Data Initiative: A Case Study in Implementing Clinical-Community Infrastructure Enhancements to Support Health Services Research and Public Health

CONTEXT

We describe a participatory framework that enhanced and implemented innovative changes to an existing distributed health data network (DHDN) infrastructure to support linkage across sectors and systems. Our processes and lessons learned provide a potential framework for other multidisciplinary infrastructure development projects that engage in a participatory decision-making process.

PROGRAM

The Childhood Obesity Data Initiative (CODI) provides a potential framework for local and national stakeholders with public health, clinical, health services research, community intervention, and information technology expertise to collaboratively develop a DHDN infrastructure that enhances data capacity for patient-centered outcomes research and public health surveillance. CODI utilizes a participatory approach to guide decision making among clinical and community partners.

IMPLEMENTATION

CODI's multidisciplinary group of public health and clinical scientists and information technology experts collectively defined key components of CODI's infrastructure and selected and enhanced existing tools and data models. We conducted a pilot implementation with 3 health care systems and 2 community partners in the greater Denver Metro Area during 2018-2020.

EVALUATION

We developed an evaluation plan based primarily on the Good Evaluation Practice in Health Informatics guideline. An independent third party implemented the evaluation plan for the CODI development phase by conducting interviews to identify lessons learned from the participatory decision-making processes.

DISCUSSION

We demonstrate the feasibility of rapid innovation based upon an iterative and collaborative process and existing infrastructure. Collaborative engagement of stakeholders early and iteratively was critical to ensure a common understanding of the research and project objectives, current state of technological capacity, intended use, and the desired future state of CODI architecture. Integration of community partners' data with clinical data may require the use of a trusted third party's infrastructure. Lessons learned from our process may help others develop or improve similar DHDNs.

Weighing the Risk: Developmental Pathways and Processes Underlying Obesity to Substance Use in Adolescence

Research on co-occurring obesity and substance use in adolescence has grown substantially in the past decade, but questions on the pathways and processes underlying co-occurrence remain. This review first synthesizes empirical findings on the relationship between obesity and substance use (e.g., alcohol, cannabis, tobacco use). Multidisciplinary theoretical frameworks referencing behavioral medicine, neuroscience, psychology, and public health are then used to inform an interdisciplinary, conceptual model focused on pathways and processes by which obesity increases risk of substance use. Recommendations for future research underscore the importance of prospective studies that encompass multiple domains of development. Recommendations for practice include family-based interventions that promote adaptive self-regulation, targeted antibullying or victimization interventions, and increased attention by health professionals on risky behavior associated with adolescent obesity.

Bullying and coping with bullying among obese\overweight and normal weight children

This study aimed to determine the obese\overweight and normal weight children's status of encountering and coping with bullying and the correlational factors. This case-control study was conducted with 1.680 students in the second level (5th, 6th, 7th, 8th grades) from September 24, 2018 to May 31, 2019 in the Mediterranean Region in Turkey. The data were collected using a personal information form, the Traditional Peer Victimization Scale and the Coping with Bullying Scale. Data were analyzed using the Shapiro-Wilk test, Mann-Whitney U test, Binary Logistic Regression, Backward Wald Elimination, and Simple Linear and Backward Stepwise Multiple Linear Regression analyses. This study indicated that the risk of becoming victims, bullies or bully-victims increases among boys and 8th grade students. It also found that the risk of being victims and bully-victims increases among children whose father is illiterate. There was no significant difference between obese\overweight and normal weight children in terms of being victims, bullies and bully-victims. Grade level, academic performance, father's education level and awareness of reporting bullying were effective in coping with bullying among the children, while weight was not. Further studies are needed to determine different factors that affect children's coping strategies against bullying.

Perception of students on factors contributing to overweight and obesity among high school students in Kiribati: A qualitative study

BACKGROUND

Overweight and obesity among high school students is a growing distress not only to the individual wellbeing of a person but also to the productivity of communities and economic expense of both developed and developing nations. This study aimed to determine factors contributing to overweight and obesity among high school students in Kiribati through the perception of students.

METHODS

This qualitative study was conducted in four (4) randomly selected senior high schools on South Tarawa, Kiribati from August to November, 2020. A purposive sampling was used to select thirty-two (32) students enrolled into form levels 4-7. A semi-structured open-ended questionnaire was used for data collection using face-to-face in-depth interviews. Data was transcribed and analyzed using thematic analysis method.

RESULTS

This research revealed that the participants were 21 (65.6%) were females and 11 (34.4%) males from form levels four with 9 (28.1%) participants, five with 9 (28.1%) participants, and form seven with 14 (43.8%) participants. Five themes identified including determinants and prevention of overweight and obesity, education and health system factors, stigma, and being fat comes with high risk. These themes collectively elaborate on the essentials of overweight and obesity that are obtained from perspectives of students.

CONCLUSION

A strong cultural belief and practice has caused misperception of overweight and obesity among students with knowledge-behavior gap recognized as the main reason behind the failure in lifestyle changes among adolescents. Strengthen healthy behavioral lifestyle, improve awareness, and support feasible preventative strategies is recommended to all students.

Prevalence and associated factors of school bullying among Chinese college students in Changsha, China

BACKGROUND

School bullying has attracted worldwide attention for its adverse outcomes; however, there is still a lack of research among college students. The aim of this study was to investigate the prevalence of school bullying victimization and the associated factors among Chinese college students.

METHODS

8098 Chinese college students from two universities in Hunan province were recruited in this cross-sectional study, and data on participants' demographic information, bullying history, suicidal behaviors, anxiety (Self-Rating Anxiety Scale) and depression (Self-reporting Depression Scale) were collected. Binary logistic regression was used to analyze the independent correlates of school bullying.

RESULTS

The prevalence of school bullying was 8.03% in our study. Gender (OR,0.792;95%CI[0.660,0.950]; p = 0.012); depression (OR,1.979; 95%CI[1.359,2.883]; p < 0.001); anxiety (OR,1.996; 95%CI[1.388, 2.869]; p < 0.001); suicidal ideation (OR,1.353;95%CI[1.087,1.684]; p = 0.007); suicide attempts (OR,1.772;95%CI[1.306,2.403]; p < 0.001); family income between 30,000 and 70,000/year (yuan) (OR,0.763;95% CI[0.627,0.929]; p = 0.007) and family income more than 70,000/year (yuan) (OR,0.578;95%CI[0.461,0.725]; p < 0.001) were independent correlates of school bullying. The bullying score was positively correlated with physical or mental disorder history, family history of mental disorder, suicidal ideation, suicide plans, suicide attempts, anxiety, depression, smoking and drinking alcohol (all p < 0.05), and negatively correlated with right-handedness, good relationship with parents and family income (all p < 0.05).

LIMITATIONS

No causal relationship could be drawn due to the cross-sectional design.

CONCLUSION

School bullying is quite common among college students. In order to improve students' mental health and prevent suicide, we should pay attention to the negative effects of bullying victimization such as depression, anxiety, suicidal behaviors and so on, apart from putting in place anti-bullying interventions.

Prevalence of overweight and obesity among Kuwaiti adolescents and the perception of body weight by parents or friends

Objective

Recently, the State of Kuwait has witnessed a steady rise in the prevalence of obesity among children and adolescents. The present study aims to provide an update on the rate of overweight or obesity among Kuwaiti adolescents and examines the associations between adolescents’ overweight/obesity levels and their perception of body weight as seen by parents or friends.

Methods

A cross-sectional study was conducted in Kuwaiti secondary schools and included adolescents between the ages of 15 and 18 years, using a multistage stratified random sampling method. Body weight and height were measured. A specifically designed self-report questionnaire was used to assess parents’ and friends’ perceptions of an adolescent’s body weight.

Results

A total of 706 adolescents were included the study. The prevalence of overweight or obesity among Kuwaiti adolescents reached nearly 50%, with males (54.3%) having a significantly higher overweight or obesity percentage than females (44.6%). No significant difference in the prevalence of obesity relative to age, from 15 to 18 years, was found. In addition, logistic regression analysis, adjusted for age and gender, revealed that adolescents perceived their parents (p = 0.011 and p < 0.001) or friends (p = 0.002 and p < 0.001) as more likely to classify their weight as overweight or obese, respectively.

Conclusion

Overweight or obesity levels appear to be high among Kuwaiti adolescents, and appears to have reached a plateau recently. Efforts to combat obesity and promote physical activity and healthy nutrition are needed. Future studies should seek to identify important moderators of parental and social underestimation/overestimation of children’s overweight or obesity.

Bullying Victimization Profiles of School-Aged Adolescents and Associations With Weight Statuses: A Latent Class Analysis

Bullying and childhood obesity are public health concerns in the United States. While obesity has been found to be associated with bullying victimization, it is less clear how it is differentially associated with biological sex and grade level across varying patterns of bullying victimization. Based on the subset of U.S. students in the Health Behavior in School-Aged Children study, patterns of co-occurring bullying victimization and sex and grade level differences in the association between the patterns of bullying victimization and weight status were examined among 9,124 students in Grades 5 to 10. The latent class analysis revealed three patterns of bullying victimization: verbal-relational victimization (Class 1), all-type victimization (Class 2), and noninvolved pattern (Class 3). The results found that females had a higher likelihood of being in Class 1 than males. Moreover, fifth to sixth and seventh to eighth-graders were more likely than ninth to tenth graders to be in both Class 1 and Class 2. Obese males and overweight females were more likely to be in Class 1 and Class 2 than in Class 3. In addition, obesity and overweight status were positively associated with bullying victimization among fifth to sixth and seven to eighth-graders. However, no significant association was found between obesity and overweight status and bullying victimization among ninth to tenth graders. Findings from the study suggest that school-based strategies, especially sex- and age-specific programs, need to take into consideration the bullying involvement of students who are overweight or obese.

Neural mechanisms that promote food consumption following sleep loss and social stress: An fMRI study in adolescent girls with overweight/obesity

STUDY OBJECTIVES

Insufficient sleep and social stress are associated with weight gain and obesity development in adolescent girls. Functional magnetic resonance imaging (fMRI) research suggests that altered engagement of emotion-related neural networks may explain overeating when under stress. The purpose of this study is to explore the effects of acute sleep restriction on female adolescents' neural responding during social evaluative stress and their subsequent eating behavior.

METHODS

Forty-two adolescent females (ages 15-18 years) with overweight or obesity completed a social stress induction task in which they were told they would be rated by peers based on their photograph and profile. Participants were randomly assigned to one night of sleep deprivation or 9 hours of sleep the night before undergoing fMRI while receiving positive and negative evaluations from their peers. After which, subjects participated in an ad libitum buffet.

RESULTS

Sleep deprived, relative to non-deprived girls had distinct patterns of neural engagement to positive and negative evaluation in anterior, mid, and posterior aspects of midline brain structures. Moreover, a sleep deprivation-by-evaluation valence-by-caloric intake interaction emerged in bilateral dorsal anterior cingulate. Among sleep deprived girls, greater engagement during negative, but not positive, feedback was associated with lower caloric intake. This was not observed for non-sleep deprived girls.

CONCLUSIONS

Results suggest an interaction between acute sleep loss and social evaluation that predicts emotion-related neural activation and caloric intake in adolescents. This research helps to elucidate the relationship between sleep loss, social stress, and weight status using a novel health neuroscience model.

Systematic Review of Setting-Based Interventions for Preventing Childhood Obesity

Introduction

Child obesity is recognized as one of the major public health problems globally, which demands multicomponent and comprehensive interventions. The objective of this systematic review is to evaluate, synthesize, and combine the existing evidence of various setting-based interventions across developed and developing countries that aim to prevent childhood obesity.

Methods

An electronic and systematic search was conducted on setting-based interventions related to childhood obesity both in developed and developing countries. A study was considered eligible if it was a randomized controlled trial that focused on home-based, school-based, or community-based intervention for childhood obesity and published in English from 2010 to 2020. A wide range of electronic bibliographic databases, such as PubMed, Medline, Embase, and ERIC were searched. The various studies were carried out among children aged 4-18 years old. A total of 32 studies were identified; out of which 24 were school-based interventions, and the remaining were nonschool-based.

Results

The studies in this review highlighted important school and nonschool-based interventions to avoid obesity among children and adolescents. School-based interventions that had considered both physical activity (PA) and diet along with home elements showed great effectiveness. These findings reveal that the specific intervention components such as nutrition education curriculum, prolonged time for PA, and upgrading self-efficacy of study participants should be considered to prevent obesity across developed and developing countries. However, the findings from nonschool-based interventions were restricted by the scarcity of the studies.

Conclusion

Multisetting and multipronged strategies are required to avoid or reduce childhood obesity across the globe. However, additional studies are needed with a large sample size. Further study designs based on theory should be conducted in nonschool settings for the creation of meaningful and detailed guidelines that can support the prevention of obesity in children.

Do I Look Gawky? The Association between Pubertal Asynchrony and Peer Victimization

Pubertal synchrony is defined as the degree of coherence to which puberty-related body changes (e.g., breast development, growth spurt, voice change, underarm hair growth) are coordinated. During the pubertal transition, youth’s body parts grow asynchronously, making each youth’s physical appearance unique. Physical appearance is a known correlate of youth’s psychosocial functioning during adolescence, but we know little about how pubertal asynchrony plays a role in their peer relationships. Using data from an adoption study (the Early Growth and Development Study; n = 413; 237 boys, 176 girls), this study examined the effect of pubertal asynchrony on peer victimization. Results revealed sex-specific effects of pubertal asynchrony; pubertal asynchrony was associated with a higher risk of peer victimization for girls but a lower risk for boys. Findings highlight the intersection of physical development and social context in understanding youth’s experiences of puberty.

The role of structure in dietary approaches for the treatment of pediatric overweight and obesity: A critical review

A multicomponent approach for the treatment of pediatric overweight/obesity, which includes behavioral strategies to alter diet and physical activity/sedentary behavior, has graded recommendations for its use. Dietary interventions to be used within this approach do not. In adults, research indicates that strongly graded dietary interventions providing greater structure (or more control over the types/amount of food consumed) produce better weight outcomes. For this critical review, dietary interventions recommended by the Expert Committee for the treatment of pediatric overweight/obesity were categorized according to their potential degree of dietary structure, and their impact on weight outcomes was described. Four levels of dietary structure were reviewed, operationalized as alterations to the following: food groups, such as fruits and vegetables (low structure); daily eating occasions, such as meals (moderate structure); large nutrients, such as energy (high structure); and energy plus additional dietary alterations (very high structure). In total, 24 interventions (four low, three moderate, five high, and 12 very high structure structure) were identified and reviewed. Reductions in standardized body mass index increased with increasing structure, and interventions ≥6 months had better outcomes than interventions <6 months. Future research should empirically test dietary intervention structure to determine its impact on weight status during pediatric overweight/obesity treatment.

"It's tough because I see that it's upsetting her…": A qualitative exploration of parents' perceptions of talking with their adolescents about having a visible difference

Many adolescents live with a visible difference that affects their lives in profound ways, but studies investigating parents' perceptions of raising appearance issues during conversations with their adolescent are lacking. As part of a larger study exploring the effectiveness of a web-based intervention (YP Face IT), semi-structured interviews were conducted with 18 parents of adolescents with a visible difference. Thematic analysis revealed four overarching themes: (1) Conversational settings; (2) Understanding adolescents' feelings and thoughts; (3) Providing parental guidance and encouragement; and (4) When the dialogue becomes difficult. Results showed that parents resorted to specific settings when instigating conversations about appearance, such as when their adolescents expressed a need for emotional care, were perceived to be upset, or whilst managing their condition. The choice of setting was also important as some parents generally felt uncomfortable raising appearance issues with their adolescent, for fear of fueling appearance concerns. Results further suggest that open communication can enable parents to stay informed about their adolescent's psychosocial adjustment to a visible difference. These results stress the need to make available support to facilitate open communication about appearance-related topics between parents and adolescents.

Experiences of weight stigma in adolescents with severe obesity and their families

AIM

To describe the experiences of weight stigma in adolescents with severe obesity and their parents.

DESIGN

Qualitative descriptive secondary analysis.

METHODS

A secondary analysis on 31 transcripts from a larger study of 46 transcripts conducted between February 2019 and June 2020. Semi-structured interviews were conducted with 19 parents (n = 17 mothers, n = 2 fathers) and 12 adolescents (n = 7 male, n = 5 female). Interviews were digitally audio recorded, transcribed and analysed using conventional content analysis.

RESULTS

Four common themes were identified reflecting experiences of weight stigma: weight-based teasing and bullying, interactions with healthcare providers (HCPs), family interactions and blame. Subthemes were fairness and impact on mental health.

CONCLUSION

This secondary analysis adds to the sparse literature documenting the experiences of weight stigma from adolescents with severe obesity and their families. It is important to understand the experiences of weight stigma from the adolescent and parent perspective as it can inform healthcare, education and policies across communities and facilitate holistic health for this vulnerable population.

IMPACT

The need for research to better understand how experiences of weight stigma correlate with physiological and psychological outcomes and inform innovative interventions are critical to improve treatment of severe obesity. Healthcare providers across disciplines are in a strategic position to change the paradigm through which we provide care to youth with severe obesity and guide families in supporting their children's weight management efforts without contributing to weight stigma.