A network analysis of the causal attributions for obesity in children and adolescents and their parents

Understanding children's voices about enablers of obesity from a causal attribution's stance: a vignette study

OBJECTIVE

Childhood obesity is a public health challenge with health, economic and psychosocial consequences. The design of interventions addressing childhood obesity seldom considers children's perspectives on the topic. Weiner's causal attribution framework was used to explore children's perspectives on enablers of obesity.

METHODS AND MEASURES

Children (N = 277) responded to a vignette with an open-ended question. Data were analyzed using content analysis.

RESULTS

Children perceived internal, unstable and controllable causes (e.g. dietary intake, self-regulation and emotionality) as the main enablers (76.53%) of obesity, while some (11.91%) highlighted external, unstable and controllable causes (e.g. parent food restrictions). A focus on children with healthy body weight showed that they mentioned more internal, stable and controllable causes for obesity than children with unhealthy body weight/obesity did. The latter mentioned more external, unstable and controllable causes than their counterparts.

CONCLUSIONS

Understanding children's causal attributions for obesity is expected to deepen our knowledge of obesity enablers and help design interventions matching children's perspectives.

Psychopathological Symptoms and Well-Being in Overweight and Underweight Adolescents: A Network Analysis

Overweight and underweight adolescents have an increased risk of psychological problems and reduced quality of life. We used a network analysis approach on a variety of psychopathology and well-being variables to identify central factors in these populations. The network analysis was conducted on data of 344 overweight adolescents (>90th BMI-percentile) and 423 underweight adolescents (<10th BMI-percentile) drawn from a large community sample (10-19 years) including behavioral and emotional problems (Youth Self-Report), eating disorder risk (SCOFF) and well-being variables (KIDSCREEN). Additionally, psychopathology and well-being scores of overweight and underweight individuals were compared with 1.560 normal weight adolescents. Compared to their normal weight peers, overweight adolescents showed elevated psychopathology and eating disorder risk as well as reduced well-being. Underweight adolescents reported increased levels of internalizing problems but no increased eating disorder risk or reduced well-being. The network analysis revealed that anxious/depressed mood and attention problems were the most central and interconnected nodes for both overweight and underweight subsamples. Among underweight individuals, social problems and socially withdrawn behavior additionally functioned as a bridge between other nodes in the network. The results support psychological interventions focusing on improving mood, coping with negative emotions and tackling inner tension.

Barriers to Behavior Change in Parents With Overweight or Obese Children: A Qualitative Interview Study

Overweight and obesity among children and adolescents are global problems of our time. Due to their authority and role modeling, parents play an essential part in the efficacy of prevention and intervention programs. This study assessed the barriers that parents of overweight/obese children face in preventive and interventional health care utilization. Sixteen parents were qualitatively interviewed. A content analysis was performed, and barriers to change were allocated to their stage of change according to the transtheoretical model. Among the main barriers is the underestimation of health risks caused by overweight/obesity in association with diminished problem awareness. Parents seem not necessarily in need of theoretical knowledge for prevention and interventions. They do however need support in evaluating the weight status of their child and the knowledge of whom to turn to for help as well as specific and hands-on possibilities for change. The results extend past studies by adding specific barriers to change that parents commonly experience. Possibilities to address these barriers, e.g., through trainings at the pediatric practice or adoption of conversation techniques, are discussed. Future studies might identify subgroups experiencing specific barriers and thus be able to address these in an individualized way.

Depression is associated with lower levels of physical activity, body image dissatisfaction, and obesity in Chilean preadolescents

Mental health during the preadolescent years may be determinant for later periods of life; therefore, the factors that influence it need to be studied deeply. The aim of this study was to determine the association between depressive symptoms with physical activity (PA), body image dissatisfaction and weight status in preadolescents. A total of 269 girls and 329 boys (age 12.02 ± 0.98 years) were included in this study. Body mass index (BMI), waist circumference, body image dissatisfaction, PA and depressive symptoms were assessed. The PA reported an inverse association with depression in girls (β:-2.12, P < 0.0001) and boys (β:-1.13, P = 0.001). Instead, BMI in girls (β: 1.00, P < 0.0001) and boys (β: 0.70, P < 0.0001), and body image dissatisfaction in girls (β: 0.05, P = 0.017) and boys (β: 0.04, P = 0.003) reported positive association with depression. In the same way, depression was associated with obesity (odds ratio [OR] = 2.05, P = 0.020), but, the boys had higher risk (OR = 18.4, P < 0.001) than girls. In conclusion, depression in Chilean preadolescents presented association with low levels of PA, obesity and body image dissatisfaction. Therefore, schools should target and promote PA to improve psychological and physical health in preadolescents, which may reduce the future burden of mental illness.