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Walsh Ó, Dettmer E, Regina A, Dentakos S, Christian J, Hamilton J, Toulany A. 'Teenagers are into perfect-looking things': Dating, sexual attitudes and experiences of adolescents with severe obesity. Child Care Health Dev 2022; 48:406-414. [PMID: 34873741 PMCID: PMC9299648 DOI: 10.1111/cch.12940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/19/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND This qualitative study explored the dating and sexual health attitudes and behaviours among adolescents with severe obesity (body mass index [BMI] > 99th%) attending a multidisciplinary weight-management programme. METHODS Semi-structured interviews were conducted with 19 participants (12 females, 7 males; Mage = 16.8) and analysed through reflective thematic analysis. RESULTS Participants described polarized dating behaviours in which dating and sexual relationships were either avoided due to this not being a priority, lack of time, feared rejection, and/or body size as perceived barrier or in contrast, when approached, involved greater sexual risk. CONCLUSIONS These findings have numerous implications including the need for increased education on the romantic developmental challenges faced by adolescents with severe obesity, the importance of ongoing screening of high-risk sexual behaviours and body dissatisfaction from frontline care providers, and the ability to support referrals to psychosocial services when appropriate.
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Affiliation(s)
- Órla Walsh
- Department of General PaediatricsChildren's Health Ireland at Temple StreetDublinIreland
| | - Elizabeth Dettmer
- Department of Psychology, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada,Department of Paediatrics, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | - Andrea Regina
- Department of Psychology, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada,Department of Paediatrics, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | - Stella Dentakos
- Department of Psychology, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
| | | | - Jill Hamilton
- Division of Endocrinology, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada,Institute for Clinical Evaluative SciencesTorontoOntarioCanada
| | - Alene Toulany
- Department of Paediatrics, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada,Institute for Clinical Evaluative SciencesTorontoOntarioCanada,Division of Adolescent Medicine, The Hospital for Sick ChildrenUniversity of TorontoTorontoOntarioCanada
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Ley SL, Zeller MH, Reiter-Purtill J, Kleiner DE, Dixon J, Xanthakos S. Unhealthy Eating, Psychopathology, and Nonalcoholic Fatty Liver Disease in Youth Presenting for Bariatric Surgery. J Pediatr Gastroenterol Nutr 2021; 73:670-676. [PMID: 34321421 PMCID: PMC8604750 DOI: 10.1097/mpg.0000000000003253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Little is known about the behavioral and psychosocial correlates of pediatric nonalcoholic fatty liver disease (NAFLD). Given diet contributes to the development and persistence of NAFLD, we examined (1) the prevalence of unhealthy eating behaviors (UEB), (2) whether these varied by NAFLD or nonalcoholic steatohepatitis (NASH) presence, and explored (3) the association of psychopathology with NAFLD. METHODS Before metabolic and bariatric surgery (MBS), adolescents (N = 159; Mage = 16.4; MBMI = 53.7 kg/m2, 73% girls, 62.3% white) self-reported presence/absence of 10 UEB (Questionnaire on Eating and Weight Patterns-Revised, Night Eating Questionnaire, Look AHEAD). NAFLD and NASH presence was assessed by intraoperative liver biopsy. Height/weight, blood pressure, and blood specimens were obtained. A medical comorbidity index was created (prediabetes/diabetes, dyslipidemia, elevated blood pressure). Psychopathology was assessed in a subgroup completing the Youth Self-Report (N = 98). RESULTS Binge eating disorder symptomatology was associated with higher odds of NAFLD whereas frequent eating out was associated with lower odds of NAFLD. Among those with NAFLD frequent eating out was associated with higher odds of NASH while nocturnal eating was associated with lower odds of NASH. Separate models identified internalizing psychopathology as associated with higher odds of NAFLD after controlling for demographics, number of UEB, and medical comorbidities. CONCLUSIONS Results suggest potential phenotypical differences between adolescents presenting for MBS with/without NAFLD, with implications for behavioral/psychosocial targets for screening and intervention. Replication should occur in a sample with greater gender and ethnic diversity to improve generalizability. Understanding differences in the context of surgical weight loss and comorbidity resolution is indicated.
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Affiliation(s)
- Sanita L Ley
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Meg H Zeller
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
- Department of Pediatrics, University of Cincinnati College of Medicine
| | - Jennifer Reiter-Purtill
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center
| | - David E Kleiner
- Laboratory of Pathology, National Cancer Institute, Bethesda, MD
| | - John Dixon
- Iverson Health Innovation Research Institute, Swinburne University, Melbourne, Australia
| | - Stavra Xanthakos
- Department of Pediatrics, University of Cincinnati College of Medicine
- Division of Gastroenterology, Hepatology & Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Abstract
Background As the prevalence of obesity increases and the age of onset decreases, more women of reproductive age will be living in larger bodies. Research on weight-related efficacy and safety has informed clinical guidelines for routine and emergency contraceptive use by women with a higher body mass index; however, patient perspectives are needed to understand women in larger bodies’ experiences with contraception and contraceptive care. This scoping review summarizes the literature on women in larger bodies’ experiences with contraception with the goal of gaining a better understanding of the nature of these experiences and identifying gaps in the existing research. Methods Following Arksey and O’Malley’s framework, a scoping review of the literature was conducted. Four databases (PubMed, PsycINFO, SCOPUS, and CINAHL) were searched for peer-reviewed, empirical articles published in English between 2010 and 2020, with a focus on North America, Europe, Australia, and New Zealand. Data were summarized by identifying key themes in the reviewed literature. Results Twenty-nine articles meeting the eligibility criteria were reviewed. The literature was predominantly quantitative (n = 27), with only one qualitative study and one systematic review, respectively. Five themes were identified, including (1) use of contraception among women in larger bodies; (2) knowledge, attitudes towards and beliefs about contraception; (3) contraceptive (dis)satisfaction among women in larger bodies; (4) contraceptive counseling; and (5) barriers to contraception. The findings revealed that women in larger bodies may have unmet contraceptive care needs. Despite many articles addressing the need to improve contraceptive counseling for women in larger bodies (n = 26), few explored how women felt about their care (n = 2). Finally, only two articles focused on emergency contraception, indicating a need for further research. Conclusion This scoping review emphasizes the pressing need for qualitative research to explore women in larger bodies’ experiences with routine and emergency contraception, as well as receiving contraceptive counseling and care. Future research exploring the lived experiences of women in larger bodies is necessary to better characterize their contraceptive needs and identify avenues to improve patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01139-2. As obesity becomes more prevalent, more women of reproductive age will be living in larger bodies. This review highlights what is known about women in larger bodies’ experiences with contraception and suggests where future research is needed. We searched four databases for papers published in English from 2010 to 2020. Our review included 29 articles. Nearly all of the studies were quantitative, with one qualitative study and one review. Most articles talked about contraceptive use, but few of them included emergency contraception. Some papers highlighted women’s knowledge and opinions about contraception, whereas others talked about their contraceptive (dis)satisfaction. Many articles discussed contraceptive counseling. Finally, some papers considered potential barriers to contraception. Our findings suggest that women in larger bodies have unmet contraceptive needs. Notably, this review aimed to focus on patient experiences but women’s voices were rarely represented. Future qualitative research on women’s lived experiences will provide a better understanding of women in larger bodies’ contraceptive needs and suggest how care can be improved.
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Affiliation(s)
- Tierney M Boyce
- School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Elena Neiterman
- School of Public Health and Health Systems, Faculty of Health, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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Têtu C, Gaubil-Kaladjian I, Barbe C, Diaz Cives A, Barrois M, Bertin E, Delemer B, Fèvre A. [Contraception after bariatric surgery: Importance of a specific gynecologic course]. ACTA ACUST UNITED AC 2021; 49:709-715. [PMID: 33766790 DOI: 10.1016/j.gofs.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 11/27/2022]
Affiliation(s)
- C Têtu
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France.
| | - I Gaubil-Kaladjian
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - C Barbe
- CHU de Reims, Unité d'aide méthodologique, Pôle recherche et santé publique, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - A Diaz Cives
- Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Service de chirurgie générale digestive et endocrinienne, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - M Barrois
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - E Bertin
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France; Centre spécialisé de l'obésité de Champagne Ardenne (CSO CA), CHU Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - B Delemer
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
| | - A Fèvre
- Service d'endocrinologie diabète nutrition, CHU de Reims, Hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims cedex, France
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Wytrychiewicz K, Pankowski D, Janowski K, Benoit CE, Bargiel-Matusiewicz K, Pisula E, Walicka M. The role of beliefs about the impact of illness on fertility and close relationships for psychopathological symptoms in women treated for hypothyroidism. J Clin Psychol 2020; 76:2314-2328. [PMID: 32592617 DOI: 10.1002/jclp.23011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 06/08/2020] [Accepted: 06/09/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVE As demonstrated in a pilot study, hypothyroidism has a highly stressful impact on some areas of functioning. This study aims to evaluate the connection between illness-related beliefs (IRBs) and the impact of hypothyroidism on fertility and close relationships, which were the strongest stressors, and the level of depressive, anxiety, and anger symptoms. METHODS Two hundred and thirteen women being treated for hypothyroidism took part in an online survey and completed the modified Hospital Anxiety and Depression Scale, Hypothyroidism Symptoms Severity rating scales, and a measure of IRBs. Other relevant clinical data were also collected. RESULT Mean levels of thyroid-stimulating hormone indicated that the women were euthyroid. Four groups of participants were identified based on IRBs. The group holding a strong IRB about the negative impact of illness only on close relationships scored significantly higher on depressive symptoms than women in the other groups. The group holding strong IRBs about the negative impact of illness on both close relationships and fertility scored significantly higher on anxiety symptoms than the women in the other groups. Regression analysis showed that IRBs about the negative impact of hypothyroidism predicted anxiety, depressive, and anger symptoms. CONCLUSIONS Negative IRBs about the impact of illness on fertility and close relationships contribute to increased levels of emotional distress symptoms in women being treated for hypothyroidism.
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Affiliation(s)
- Kinga Wytrychiewicz
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.,Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Daniel Pankowski
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.,Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Konrad Janowski
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | - Charles E Benoit
- Faculty of Psychology, University of Economics and Human Sciences in Warsaw, Warsaw, Poland
| | | | - Ewa Pisula
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - Magdalena Walicka
- Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
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Calabro KA, Harmon CM. Adolescent Bariatric Surgery: Current Concepts and Future Directions. Curr Surg Rep 2019; 7. [DOI: 10.1007/s40137-019-0232-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zeller MH, Brown JL, Reiter-Purtill J, Sarwer DB, Black L, Jenkins TM, McCracken KA, Courcoulas AP, Inge TH, Noll JG; TeenView Study Group., Teen-LABS Consortium. Sexual behaviors, risks, and sexual health outcomes for adolescent females following bariatric surgery. Surg Obes Relat Dis 2019; 15:969-78. [PMID: 31023575 DOI: 10.1016/j.soard.2019.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Adolescents females with severe obesity are less likely to be sexually active, but those who are sexually active engage in risky sexual behaviors. OBJECTIVES To examine patterns and predictors of sexual risk behaviors, contraception practices, and sexual health outcomes in female adolescents with severe obesity who did or did not undergo bariatric surgery across 4 years. SETTING Five academic medical centers. METHODS Using a prospective observational controlled design, female adolescents undergoing bariatric surgery (n = 111; Mage = 16.95 ± 1.44 yr; body mass index: MBMI = 50.99 ± 8.42; 63.1% white) and nonsurgical comparators (n = 68; Mage = 16.18 ± 1.36 yr; MBMI = 46.47 ± 5.83; 55.9% white) completed the Sexual Activities and Attitudes Questionnaire at presurgery/baseline and 24- and 48-month follow-up, with 83 surgical females (MBMI = 39.27 ± 10.08) and 49 nonsurgical females (MBMI = 48.56 ± 9.84) participating at 48 months. RESULTS Most experienced sexual debut during the 4-year study period, with a greater increase in behaviors conferring risk for sexually transmitted infections (STIs) for surgical females (P = .03). Half (50% surgical, 44.2% nonsurgical, P = .48) reported partner condom use at last sexual intercourse. The proportion of participants who had ever contracted an STI was similar (18.7% surgical, 14.3% nonsurgical). Surgical patients were more likely to report a pregnancy (25.3% surgical, 8.2% nonsurgical, P = .02) and live birth (16 births in 15 surgical, 1 nonsurgical), with 50% of offspring in the surgical cohort born to teen mothers (age ≤19 yr). CONCLUSIONS Bariatric care guidelines and practices for adolescent females must emphasize the risks and consequences of teen or unintended pregnancies, sexual decision-making, dual protection, and STI prevention strategies to optimize health and well-being for the long term.
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Abstract
PURPOSE OF THE REVIEW Sexual functioning is an important, yet often overlooked, aspect of quality of life for many individuals with obesity. RECENT FINDINGS With the growing recognition of obesity as a significant, international public health issue, a developing body of research has investigated the relationship between obesity and sexual functioning. Several studies have found that obesity is associated with impairments in sexual functioning. The mechanisms of this relationship, whether physiological, psychosocial, or a combination of the two, are yet to be fully elucidated. Other studies have suggested that weight loss, whether induced by bariatric surgery or less intensive interventions, is associated with significant and clinically meaningful change in sexual functioning and relevant reproductive hormones. This chapter reviews the research in these areas and provides recommendations for future research on these relationships.
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Affiliation(s)
- David B Sarwer
- College of Public Health, Temple University, 3223 N. Broad St., Suite 175, Philadelphia, PA, 19104, USA.
| | - Alexis J Hanson
- School of Nursing, College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University, Fargo, ND, USA
| | - Jessica Voeller
- Altru Retail Pharmacy, 114 Walnut Street, Grand Fork, ND, 58201, USA
| | - Kristine Steffen
- Department of Pharmaceutical Sciences, College of Pharmacy, Nursing, and Allied Sciences, North Dakota State University, Fargo, ND, USA
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Sung JH, Lee JE, Lee JY. Role of Social Support in the Relationship between Acculturative Stress and Discrimination among Latino Immigrants in the USA. Int J Adv Res Sci Eng Technol 2018; 5:6778-6784. [PMID: 31485463 PMCID: PMC6726399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study aimed to determine both the association between perceived racial discrimination and acculturative stress, and the role of social support in the relationship between discrimination and acculturative stress among three Latino immigrant subgroups. Mexican immigrants had higher acculturative stress (p=0.0007), Puerto Rican immigrants had higher perceived dissemination (p<.0001), and Cuban immigrants had higher social network (p=0.0009) and higher family cohesion (p<0.0001) than their sub-groups counterparts. While family cohesion was negatively associated with acculturative stress among Cuban and Puerto Rican immigrants (p=0.0088 and p=0.0007, respectively), social network was not related to acculturative stress (p=0.3170 and p=0.0971, respectively). However, among Mexican immigrants, social network was negatively associated with acculturative stress (p=0.0285) and family cohesion was not related to acculturative stress (p=0.0833). Among Cuban and Mexican immigrants, while family cohesion moderated the association between discrimination and acculturative stress (p=0.0316 and p=0.0076, respectively), social network did not play a moderating role (p=0.4509 and p=0.1482, respectively). Conversely, social network moderated the relationship between discrimination and acculturative stress among Puerto Rican immigrants (p=0.0086). However, family cohesion did not play a moderating role among Puerto Rican immigrants (p=0.5818). Findings suggest that family cohesion was found to be a moderating factor in reducing acculturative stress associated with discrimination among Latino immigrants. Interventions enhancing social support may reduce acculturative stress among Latino immigrants experiencing high discrimination.
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Affiliation(s)
- Jung Hye Sung
- School of Public Health, Jackson State University. Mississippi, USA
- RTRN DTCC, Jackson State University. Mississippi, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
| | - Jae Eun Lee
- School of Public Health, Jackson State University. Mississippi, USA
- RTRN DTCC, Jackson State University. Mississippi, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
| | - Ji-Young Lee
- School of Public Health, Jackson State University. Mississippi, USA
- RTRN DTCC, Jackson State University. Mississippi, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Florida, USA
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Lott L, Sung JH, Lee JE. Association of adolescent obesity with risky sexual behaviors: Results from Mississippi YRBS, 2013-2015. Int J Adv Res Sci Eng Technol 2018; 5:6743-6747. [PMID: 31467941 PMCID: PMC6715318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The purpose of this study is to investigate if obesity is related to sexual risk-taking behaviors which may increase risk for sexually transmitted infections among Mississippi high school students. Black adolescents were more likely to have sexual intercourse and more likely to use condom than white adolescents (p=0.0314 and p<0.0001, respectively). Male adolescents were more likely to have sexual intercourse and more likely to use condom than female adolescents (p=0.0335 and p=0.0099, respectively). While higher grades were more likely to have sexual intercourse than lower grades, there was no difference in condom use among grades. There was an association between sexual intercourse and obesity after controlling for gender, race, and grade (OR=1.218, p=0.0392). While there was an association between sexual intercourse and obesity among male adolescents (OR=1.433, p=0.0429), there was no relationship among other categories (Females: OR=0.965, p=0.871; Blacks: OR=1.306, p=0.0766; Whites: OR=1.072, p=0.7212). Educators and policymakers in Mississippi may need to increase educational interventions designed to increase condom use toward white students in Mississippi.
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Affiliation(s)
- LaTonya Lott
- Mississippi State Department of Health. Mississippi, USA School of Public Health, Jackson State University. Mississippi, USA RTRN DTCC, Jackson State University. Mississippi, USA
| | - Jung Hye Sung
- Mississippi State Department of Health. Mississippi, USA School of Public Health, Jackson State University. Mississippi, USA RTRN DTCC, Jackson State University. Mississippi, USA
| | - Jae Eun Lee
- Mississippi State Department of Health. Mississippi, USA School of Public Health, Jackson State University. Mississippi, USA RTRN DTCC, Jackson State University. Mississippi, USA
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Bauer KW, Marcus MD, Larson N, Neumark-Sztainer D. Socioenvironmental, Personal, and Behavioral Correlates of Severe Obesity among an Ethnically/Racially Diverse Sample of US Adolescents. Child Obes 2017. [PMID: 28650206 PMCID: PMC5724580 DOI: 10.1089/chi.2017.0067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Severe obesity among adolescents, also known as class 2 and 3 obesity, is increasing in prevalence, yet, little is known about adolescents with severe obesity. The objective of this study was to identify the socioenvironmental, personal, and behavioral correlates of severe obesity among an ethnically/racially diverse sample of US adolescents. METHODS A cross-sectional analysis of data from participants in the EAT 2010 study (n = 2706) was conducted. Adolescents completed in-class surveys, and height and weight were measured. Severe obesity was defined as a BMI ≥120% of the 95th percentile or ≥35 kg/m2; class 1 obesity as a BMI ≥95th percentile but below severe obesity cut points, overweight as a BMI <95th percentile but ≥85th percentile, and normal weight as a BMI <85th but >5th percentile. General linear models were used to identify differences between adolescents by weight status, adjusted for covariates. RESULTS Nine percent of adolescents had severe obesity. Compared with peers of other weight statuses, a greater proportion of adolescents with severe obesity reported parental encouragement to diet and peer weight teasing. Adolescents with severe obesity also reported lower self-esteem and body satisfaction. Binge eating was three times as prevalent among adolescents with severe obesity compared with peers of normal weight and twice as prevalent as among peers with class 1 obesity. CONCLUSIONS Adolescents with severe obesity report several unique socioenvironmental, personal, and behavioral concerns that may diminish quality of life and may predict increased weight gain over time.
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Affiliation(s)
- Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Marsha D. Marcus
- Department of Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, PA
| | - Nicole Larson
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
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Affiliation(s)
- Amy L. Christison
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
| | - Sandeep K. Gupta
- Department of Pediatrics, University of Illinois College of Medicine at Peoria, Peoria, Illinois, USA
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