PSYCHOSOCIAL CONCERNS AND HEALTH-COMPROMISING BEHAVIORS AMONG OVERWEIGHT AND NONOVERWEIGHT ADOLESCENTS

Objective: To compare weight-specific and global psychosocial concerns and health-compromising behaviors among overweight and nonoverweight youth across gender and ethnicity. Methods: A cross-sectional school-b ased survey of 31,122 adolescents in grades 7 to 12. Based on self-rep orted heights and weights, respondents were categorized as nonoverweig ht (body mass index (BMI) <85th percentile), moderately overweight (85 th percentile <BMI <95th percentile), or severely overweight (BMI >95t h percentile). Results: Global psychosocial concerns, such as emotiona l well-being, suicidal ideation, future job concerns, and peer concern s, did not differ greatly between nonoverweight, moderately overweight , and severely overweight adolescents. Substance abuse behaviors were equally or less prevalent among the overweight group. Overweight girls were significantly less likely to consume alcohol, whereas overweight boys were at lower risk for marijuana use. In contrast, overweight yo uth were more likely to perceive their health as only fair or poor and were more likely to express weight-specific concerns and engage in be haviors such as chronic dieting and binge eating than nonoverweight yo uth. Overweight American Indian girls perceived their physical health more positively than nonoverweight American Indian girls. Strong assoc iations were found between overweight status and chronic dieting among African American boys and girls. Conclusions: Nutritional counseling and educational programs need to address the weight-specific concerns and behaviors of overweight adolescents. However, assumptions regardin g global psychosocial concerns and health compromising behaviors among overweight adolescents of different genders and ethnicities should be avoided. These broad issues need to be explored in more depth at both the research and intervention levels.