Are overweight children unhappy? Body mass index, depressive symptoms, andoverweight concerns in elementary school children

Background: It is commonly believed that overweight children are unhappy wi th their weight. However, population-based data addressing this association are lacking. Objectives: To evaluate the association between obesity and depressive symp toms in a diverse, school-based sample of preadolescent children, and to ex amine whether overweight concerns play a role in this association. Design, Setting, and Participants: Third-grade students (N=868, mean age, 8 .4 years) attending 13 public elementary schools in Northern California wer e measured for weight and height, and were asked to complete self-report as sessments of depressive symptoms and overweight concerns. Results: A modest association between depressive symptoms and body mass ind ex (BMI; calculated as weight in kilograms divided by the square of height in meters) was found for girls (r=0.14, P<.01), but not for boys (r=0.01, P <.78). Among girls, depressive symptoms were strongly associated with overw eight concerns (r=0.32, P<.001). After controlling for level of overweight concerns, BMT was no longer significantly associated with depressive sympto ms among girls. In contrast, after controlling for BMI, overweight concerns remained significantly associated with-depressive symptoms. Conclusions: This study provides cross-sectional evidence for a relationshi p between depressive symptoms and BMI in preadolescent girls, but not in pr eadolescent boys. This relationship seems to be explained by an excess of o verweight concerns. Assessing overweight concerns may be a useful method to identify those overweight girls who are at highest risk for associated dep ressive symptoms.