Investigating the obesity trend of overweight and obese people with pictograms among Iranian adults

Purpose

Obesity is a major public health concern, particularly in resource-constrained areas where measuring it accurately is challenging due to insufficient equipment and trained personnel. In Iran, there is a notable lack of comprehensive longitudinal studies using modern tools to track adult obesity trends. This study employed body shape pictograms (BIP) to classify abdominal obesity and aimed to reveal trends in perceived obesity among Iranian adults.

Methods

This cross-sectional study involved individuals from the multidisciplinary obesity registry at Shariati Hospital, from 2013 to February 2021. It included patients aged 30 to 65 with morbid obesity (BMI ≥ 35) who were potential bariatric surgery candidates. Medical history, anthropometric data, laboratory data, and the obesity pictogram were collected through face-to-face private interviews.

Results

We recruited 346 participants (287 females and 59 males). The study found an upward trend in obesity, indicated by pictogram scores across all categories (p <.001). Mean pictogram scores significantly varied by obesity levels based on BMI (p <.001) and were positively associated with waist and hip circumference (p <.001). No significant associations were found with diabetes or metabolic syndrome status.

Conclusion

This study underscores the significant trend of perceived obesity among Iranian adults, as assessed through pictograms. Accurate data on obesity trends among overweight and obese individuals over time can play a crucial role in shaping the country's health policies to combat obesity.

Clinical trial number

Not applicable.

Research on the influence of body image on college students' weight-loss intention: chained intermediary analysis of self-efficacy and self-esteem

Purpose

This paper aims to explore the relationship between body image, self-efficacy, self-esteem, and weight-loss intention among college students, offering insights to promote healthy and confident lifestyle habits.

Methods

Undergraduate students from western China were selected using a stratified random sampling method. Data were analyzed using SPSS 19.0 and AMOS 21.0 statistical software.

Results

(1) Body image showed a significantly positive correlation with self-efficacy and self-esteem but a negative correlation with weight-loss intention. Self-efficacy exhibited a significantly positive correlation with self-esteem and a negative correlation with weight-loss intention, while self-esteem was significantly negatively correlated with weight-loss intention. (2) Body image directly impacted weight-loss intention [Effect Size (ES) = -0.120]. Self-efficacy (ES = -0.069) and self-esteem (ES = -0.119) played significant mediating roles between body image and weight-loss intention, respectively. (3) The chained intermediary role of self-efficacy and self-esteem also reached significance (ES = -0.038).

Conclusion

Body image conducts effect on the degree of weight-loss intention among college students through direct ways or indirect ways such as the intermediary role of self-efficacy and self-esteem, and also the chained intermediary role of self-efficacy and self-esteem. In addition, self-esteem is another key factors affecting college students' weight-loss intention.

Self-perception of physical appearance of adolescents and associated factors in Addis Ababa, Ethiopia

INTRODUCTION

Establishing a positive body image is a critical factor for adolescents' physical and mental health, as it determines self-confidence, and sustainable individual growth and development throughout their lives. This reality needs to be supported by evidences generated locally. However, there is a lack of information in this regard in the study setting. Thus, the aim of this study was to assess the self-perception of one's physical appearance and its associated factors among adolescents in Addis Ababa, Ethiopia.

METHODS AND MATERIALS

A community-based, cross-sectional study design was used to conduct the study. At the end of the multistage sampling procedure, a systematic random sampling technique was employed to select 308 study participants from selected districts. The questionnaire was adapted from previous studies as it was appropriate for local context. The data collectors were trained before the data collection and supervised during the data collection period, and the questionnaire was pretested. Bivariate logistic regression was used to identify candidate variables, and then variables with p<0.2 were taken to multiple logistic regressions to identify independent associated factors. Statistical significance was considered at P <0.05 with adjusted odds ratios calculated at 95% CIs.

RESULT

A total of 283 adolescents were participated in the study, with a response rate of 91.9%. The overall good self-perception of one's physical appearance was 48.4% [95% CI = 43.8, 54.1]. Having a BMI between 18.5 kg/m2-24.9 kg/m2 (AOR = 2.56; 95% CI: 1.45, 4.54), presence of enough sport fields in the school (AOR = 1.89; 95% CI: 1.09, 3.29), having daily access to internet services (AOR = 1.69; 95% CI: 1.07, 2.94), following Ethiopian movies/cinemas (AOR = 2.46; 95% CI: 1.46, 4.15), and regularly following western movies/cinemas (AOR = 2.0; 95% CI: 1.11, 3.59) were significantly associated with a good self-perception of one's physical appearance.

CONCLUSION

According to this study, only 48.4% of respondents reported a good self-perception of their physical appearance. Adolescents and their family need to work to bring normal body mass index, which in turn will increase good self-perceptions of their physical appearance. Schools and the local administrations need to increase availability and access to enough sport fields for students to strengthen their physical fitness, which increases their good self-perception of their physical appearance.

Autoeficácia alimentar em crianças e adolescentes com sobrepeso ou obesidade: revisão integrativa de instrumentos

RESUMO Objetivo: Descrever as características dos instrumentos para avaliação da autoeficácia alimentar no sobrepeso e na obesidade em crianças e adolescentes. Métodos: Revisão integrativa da literatura, realizada em maio de 2020, em seis bases de dados (PubMed; Web of Science; Scopus; CINAHL, ADOLEC e PsycINFO) com a seguinte estratégia de busca: self-efficacy and (Overweight OR Obesity) and (Child* OR Adolescent). Resultados: Incluíram-se 35 artigos e 21 instrumentos aplicados às crianças de 6 a 9 anos (n=2), em adolescentes de 10 a 19 anos (n=9) e em crianças e adolescentes de 7 a 18 anos (n=10). Os instrumentos têm de 4 a 30 itens e variaram de duas a cinco dimensões, sendo as mais frequentes “alimentação saudável” e “atividade física”. Conclusão: Existem diferentes instrumentos confiáveis destinados à avaliação da autoeficácia alimentar do público adolescente e infantil, o que sinaliza a importância desse construto para prevenção e controle da obesidade e sobrepeso.

Eating self- efficacy in overweight and obese children and adolescents: integrative review of instruments

ABSTRACT Objective: To describe the characteristics of instruments to assess eating self-efficacy in overweight and obesity in children and adolescents. Methods: Integrative literature review, conducted in May 2020, in six databases (PubMed; Web of Science; Scopus; CINAHL, ADOLEC, and PsycINFO) with the following search strategy: Self-efficacy and (Overweight OR Obesity) and (Child* OR Adolescent). Results: The inclusion of thirty-five articles and twenty-one instruments was applied to children 6 to 9 years old (n=2), adolescents 10 to 19 years old (n=9), and children and adolescents 7 to 18 years old (n=10). The instruments have 4 to 30 items and vary from two to five dimensions, the most frequent being “healthy eating” and “physical activity.” Conclusion: There are different reliable instruments designed to assess eating self-efficacy in adolescents and children, indicating the importance of this construct for preventing and controlling obesity and overweight.

Body image insatisfaction in students from the sixth grade of public schools in Caxias do Sul, Southern Brazil

OBJECTIVE

To estimate the prevalence of body image insatisfaction among schoolchildren aged 11 to 14 years from the municipality of Caxias do Sul, Southern Brazil, and to determine the possible associations with nutritional status, socioeconomic status, gender, and maternal education.

METHODS

A cross-sectional study was conducted and 1,417 children were evaluated regarding total body weight, height, and waist circumference. Obesity was defined based on the body mass index according to sex and age. Body image was evaluated using a nine-silhouette scale. A descriptive and bivariate analysis was carried out between the independent variables and the outcome.

RESULTS

The prevalence of body image insatisfaction was 71.5%. Gender (PR 0.77, 95%CI 0.60 - 0.98) and nutritional status (PR 3.84, 95%CI 2.72 - 5.41) were significantly associated with body image insatisfaction. Maternal education, socioeconomic level, and age did not present any association with body image insatisfaction.

CONCLUSIONS

The prevalence of body image insatisfaction in this population was high and should be a matter of concern to health professionals.

Weight status misperception as related to selected health risk behaviors among middle school students

BACKGROUND

Weight misperception has been documented among children although the impact on health risk behaviors is less understood, particularly among middle school students. The goals of this study were to describe sociodemographic differences in actual and perceived weight, correspondence between actual and perceived weight, and weight-related health risk behaviors, as well as to examine weight misperception and interactions with sociodemographic variables in explaining weight-related health risk behaviors.

METHODS

Participants were recruited at 11 public school districts participating in the Tennessee Coordinated School Health (CSH) pilot program. A total of 10,273 middle school students completed the Centers for Disease Control and Prevention's Youth Risk Behavior Survey administered by teachers in the school setting.

RESULTS

Findings revealed sociodemographic differences in actual and perceived weight as well as weight misperception. Although overestimating one's weight was significantly related to greater likelihood of weight-related health risk behaviors, significant interactions showed this relationship to be especially pronounced in females. Additional distinctions based on sociodemographic variables are indicated.

CONCLUSIONS

Results highlight the importance of screening for health risk behaviors including weight misperception among middle school students. The CSH program offers an opportunity to understand health risk behaviors among students while also informing and evaluating methods for intervention.

Do depression, self-esteem, body-esteem, and eating attitudes vary by BMI among African American adolescents?

OBJECTIVE

To examine how psychosocial factors vary by body weight and gender among African-American adolescents.

METHODS

A community sample of 235 low-income, predominantly African-American adolescents completed measures of depression, self-esteem, body-esteem, and eating attitudes. Measured weight and height were converted to body mass index (kg/m(2)) age and gender-adjusted z-scores. Data were analyzed using 2-factor multivariate analysis of variance.

RESULTS

Obese youths had significantly worse scores on all psychosocial domains than normal weight youths, with no differences between overweight and normal weight youths. Obese youths had significantly worse scores than overweight youths on body-esteem and self-esteem. Female adolescents had significantly worse scores than males on depressed mood, body-esteem, and eating attitudes.

CONCLUSIONS

Among a community sample of predominantly African-American adolescents, obesity, not overweight, was associated with poor psychosocial health. Findings suggest that overweight may be perceived as normative, and that weight-related programs consider adolescents' psychosocial functioning.

Birth weight, growth and feeding pattern in early infancy predict overweight/obesity status at two years of age: a birth cohort study of Chinese infants

OBJECTIVES

To investigate the early determinants of overweight and obesity status at age two years.

METHODS

A total of 1098 healthy neonates (563 boys and 535 girls) were involved in this community-based prospective study in China. Data on body weight and length were collected at birth, the 3(rd) and 24(th) month. A self-administered questionnaire was used to collect data on social demography and feeding patterns of children, etc. Three multivariable logistic regression models were employed to make various comparisons of weight status, i.e., model 1 (obesity vs. non-obesity), model 2 (combined overweight and obesity vs. normal weight, and model 3 (obesity, overweight and normal weight).

RESULTS

Prevalences of overweight/obesity (95(th) >BMI ≥85(th) p and BMI ≥95(th) p, referring to WHO BMI standards) at 2 years of age are 15.8%/11.2% for boys and 12.9%/9.0% for girls, respectively. Being born with macrosomia (OR: 1.80-1.88), relatively greater BMI increment in the first 3 months (OR: 1.15-1.16) and bottle emptying by encouragement at age two (OR: 1.30-1.57) were found in all three models to be significant risk factors for higher BMI status at 2 years. Pre-pregnancy maternal BMI (OR: 1.09-1.12), paternal BMI (OR: 1.06), and mixed breastfeeding (OR: 1.54-1.57) or formula feeding (OR: 1.90-1.93) in the first month were identified as significant in models 2 and 3. Child-initiated bottle emptying at age two was observed to increase the risk of obesity by 1.31 times but only in model 1.

CONCLUSION

Fetal and early postnatal growth and feeding pattern appear to have significant impacts on early childhood overweight and obesity status independent of parental BMI. Policy-based and multidisciplinary approaches to promote breastfeeding and enhancement of feeding skills of care takers may be promising intervention strategies.

Adapted physical activity programme and self-perception in obese adolescents with intellectual disability: between morphological awareness and positive illusory bias

BACKGROUND

In adolescent with intellectual disability, the management of obesity is a crucial issue, yet also quite complex because of their particular perception of themselves. This study investigated the relationship between self-perception variables and morphological variables and their changes after a 9-month Adapted Physical Activity (APA) programme.

MATERIALS AND METHODS

Twenty-three adolescents with intellectual disability responded to an adapted questionnaire, including the PSI-VSF-ID and a nine-drawing body silhouette scale. Anthropometric and body composition indicators were measured before and after the APA programme.

RESULTS

The main predictor of the adolescents' self-perceptions was the inclination towards positive illusory bias before the intervention; obesity awareness ranked second. Morphological measurements did not contribute in the same way to self-perceptions in the initial and final data.

CONCLUSIONS

This study confirms the interest of weight management programmes for adolescents with intellectual disability and points to the need to take positive illusory bias more fully into account in the study of self-perception.

African American adolescent males living with obesity

OBJECTIVES

The objective was to explore, through the concepts of self-perception and meaning, the lived experience of obesity in African American males between the ages of 13-17 years.

DESIGN AND SAMPLE

Hermeneutic phenomenological design was used to guide the study. Thirteen inner-city African American males were enrolled. All participants had a documented body mass index of >95th percentile and were actively receiving treatment at a medical obesity clinic.

MEASURES

Qualitative data were collected using in-depth semi-structured interviews.

RESULTS

Self-perception and meaning are interrelated and important factors in understanding obesity uniquely from the adolescents view. If individuals do not understand that they are obese then they are unable to assign meaning to obesity within their life. Four main themes were discovered. The main themes were as follows: (1) It Don't Mean Nuthin'; (2) It's Just Me, Who I Am; (3) Something Bad Might Happen; and (4) I'm Confused and I Feel Bad.

CONCLUSIONS

Patterns emerged that will allow health care workers to engage adolescents on a personal level, thereby increasing the potential for treatment outcomes consistent with weight management clinic goals. To realize successful outcomes for these adolescents, health care providers must incorporate the adolescents' understanding, knowledge, and values related to obesity in treatment planning.

Determinants of high weight gain and high BMI status in the first three months in urban Chinese infants

OBJECTIVES

Investigate the potential factors associated with high weight gain and high BMI status in the first three months of life.

METHODS

Totally, 930 healthy neonates (489 boys and 441 girls) were involved in this community-based, prospective study in China. Data on body weight and length were collected at birth, and the 1st and 3rd months. A self-administered questionnaire was used to collect data regarding social demography, gestational status, delivery, and the feeding patterns of children.

RESULTS

Prevalences of high BMI status (BMI = 85th p, re WHO BMI standards) increased over time in both sexes, reaching 24.5% and 12.0% for boys and girls, respectively. General linear mixed models indicate high BMI status at 3 months is significantly and inversely associated with breastfeeding, as a proportion of feeding occasions [OR 0.74 (95%CI: 0.56-0.98)] and positively with lower birth weight [OR 2.07 (95%CI: 1.23-3.49)]. High weight gain (=85th p, re WHO velocity standards) in the first 3 months is also significantly associated with breastfeeding [OR 0.76 (95%CI: 0.59-0.96)] and sex, with boys at a higher risk than girls [OR 1.44 (95%CI: 1.07-1.97)]. Living in an extended family is associated with both high weight gain and high BMI status, but with marginal statistical significance.

CONCLUSION

Analyses indicate an increasing trend of high BMI status in early infancy. Breastfeeding provides a protective effect for both high weight gain and high BMI status. The results concerning birth weight suggests a target for intervention.

The impact of weight, sex, and race/ethnicity on body dissatisfaction among urban children

The purpose of the current study was to examine the relative contributions of weight status, race/ethnicity, sex, and age on body dissatisfaction in a large group of diverse children. Participants were 4th-6th graders (N=1212) in ten inner-city schools who participated in an obesity prevention study previously published. Children completed the body dissatisfaction subscale of the Eating Disorder Inventory-2 (EDI-2), and weight status was assessed by measured weights and heights. Multiple regression analyses were conducted. Relative weight status was the strongest predictor of body dissatisfaction, followed by race/ethnicity, and sex. Body dissatisfaction was greatest in obese, Asian, and female children. Overall, results indicated that children's body dissatisfaction varies based on relative weight status, as well as race/ethnicity and sex among urban children. Results highlight the strong need for additional research so that more definitive conclusions may be drawn regarding the development of body image among diverse groups of children.

Body image, body dissatisfaction and weight status in South Asian children: a cross-sectional study

Background

Childhood obesity is a continuing problem in the UK and South Asian children represent a group that are particularly vulnerable to its health consequences. The relationship between body dissatisfaction and obesity is well documented in older children and adults, but is less clear in young children, particularly South Asians. A better understanding of this relationship in young South Asian children will inform the design and delivery of obesity intervention programmes. The aim of this study is to describe body image size perception and dissatisfaction, and their relationship to weight status in primary school aged UK South Asian children.

Methods

Objective measures of height and weight were undertaken on 574 predominantly South Asian children aged 5-7 (296 boys and 278 girls). BMI z-scores, and weight status (underweight, healthy weight, overweight or obese) were calculated based on the UK 1990 BMI reference charts. Figure rating scales were used to assess perceived body image size (asking children to identify their perceived body size) and dissatisfaction (difference between perceived current and ideal body size). The relationship between these and weight status were examined using multivariate analyses.

Results

Perceived body image size was positively associated with weight status (partial regression coefficient for overweight/obese vs. non-overweight/obese was 0.63 (95% CI 0.26-0.99) and for BMI z-score was 0.21 (95% CI 0.10-0.31), adjusted for sex, age and ethnicity). Body dissatisfaction was also associated with weight status, with overweight and obese children more likely to select thinner ideal body size than healthy weight children (adjusted partial regression coefficient for overweight/obese vs. non-overweight/obese was 1.47 (95% CI 0.99-1.96) and for BMI z-score was 0.54 (95% CI 0.40-0.67)).

Conclusions

Awareness of body image size and increasing body dissatisfaction with higher weight status is established at a young age in this population. This needs to be considered when designing interventions to reduce obesity in young children, in terms of both benefits and harms.