SOCIAL AND ECONOMIC CONSEQUENCES OF OVERWEIGHT IN ADOLESCENCE AND YOUNG ADULTHOOD

Background and Methods. Overweight in adolescents may have deleterious effects on their subsequent self-esteem, social and economic characte ristics, and physical health. We studied the relation between overweig ht and subsequent educational attainment, marital status, household in come, and self-esteem in a nationally representative sample of 10,039 randomly selected young people who were 16 to 24 years old in 1981. Fo llow-up data were obtained in 1988 for 65 to 79 percent of the origina l cohort, depending on the variable studied. The characteristics of th e subjects who had been overweight in 1981 were compared with those fo r young people with asthma, musculoskeletal abnormalities, and other c hronic health conditions. Overweight was defined as a body-mass index above the 95th percentile for age and sex. Results. ln 1981, 370 of th e subjects were overweight. Seven years later, women who had been over weight had completed fewer years of school (0.3 year less; 95 percent confidence interval, 0.1 to 0.6; P = 0.009), were less likely to be ma rried (20 percent less likely; 95 percent confidence interval, 13 to 2 7 percent; P<0.001), had lower household incomes ($6,71 0 less per yea r; 95 percent confidence interval, $3,942 to $9,478; P<0.001), and had higher rates of household poverty (10 percent higher; 95 percent conf idence interval, 4 to 16 percent; P<0.001) than the women who had not been overweight, independent of their base-line socioeconomic status a nd aptitude-test scores. Men who had been overweight were less likely to be married (11 percent less likely; 95 percent confidence interval, 3 to 18 percent; P = 0.005). In contrast, people with the other chron ic conditions we studied did not differ in these ways from the nonover weight subjects. We found no evidence of an effect of overweight on se lf-esteem. Conclusions. Overweight during adolescence has important so cial and economic consequences, which are greater than those of many o ther chronic physical conditions. Discrimination against overweight pe rsons may account for these results.