SELF-ESTEEM AND ADIPOSITY IN BLACK-AND-WHITE GIRLS - THE NHLBI GROWTHAND HEALTH STUDY

PURPOSE: Obesity is assumed to have a negative impact on self-esteem b ecause of the associated social stigmatization in Western society. Stu dies of the psychological effect of obesity in children are inconclusi ve and limited, particularly pertaining to minority populations. Most studies have assessed global rather than domain-specific measures of s elf-esteem and hence, may have lacked specificity to detect impairment of certain aspects of self-esteem most closely associated with obesit y. The purpose of this study is to examine the effect of adiposity and other environmental factors on measures of perceived competence and s elf-adequacy in 2205 black and white girls aged 9-10 years. METHODS: D omain specific measures of self-esteem were studied by race and degree of adiposity, using Harter's ''Self-Perception Profile for Children'' . Three Harter scales deemed more relevant to obesity (social acceptan ce (SA), physical appearance (PA), and global self worth (GSW)) were s elected for univariate and multivariate linear regression models to ex amine relationships between self-esteem level and adiposity (measured by the sum of triceps, subscapular, and suprailiac skinfolds (SSF)), r ace, pubertal maturation, and parental education. The relationship bet ween adiposity and Harter scores was further examined with LOESS curve s and also by comparing the mean scores of each quintile of SSF by rac e, as well as inter-quintile differences within race. RESULTS: Adiposi ty in general impacted negatively on the scores of all three selected Harter scales. There was also racial variation in the relationship bet ween the scores and adiposity, with the magnitude of the effect somewh at less in black girls. White girls exhibited a significant inverse re lationship between SSF and SA scores while, in striking contrast, ther e was no variation in scores iii black girls across all ranges of adip osity. Although there was a significant inverse relationship between a diposity and PA and GSW in both groups, the slope was steeper in white girls, particularly at higher ranges of SSF. Non linearity in the rel ationship between SSF and the scores was seen in SA and PA scales. CON CLUSIONS: The present study demonstrated a significant negative associ ation between adiposity and the level of self-esteem in girls as young as 9 to 10 years. There were also intriguing racial differences in th e selected domains of esteem. These results may help better understand cultural differences regarding the psychological impact of obesity an d could be used to formulate appropriate strategies for public health policy. (C) 1997 Elsevier Science Inc.