Adiposity, Self-Concept and Body Size Dissatisfaction Among Cree Schoolchildren

Abstract

Virtually no data exists about the psychosocial aspects of obesity in First Nations children. In this study, 203 school children from Quebec Cree communities had measured weight status determined using World Health Organization references. Multivariate regression models that included child's age and sex were used to assess the association between (a) child's weight status and physical appearance dissatisfaction using pictorial and verbal body rating measures, and (b) BMI z-score and self-concept using Piers-Harris Children's Self-Concept Scale. Most (73%) children were overweight or obese. Based on the pictorial figures children chose to represent their perceived and ideal body sizes, 63% of children desired to be smaller, with overweight and obese children more likely desiring to be smaller than normal weight children (OR=4.3 and 19.8, respectively). In response to ‘What do you think of your body size?’ overweight and obese children were more likely to say their body size was too big compared to normal weight children (OR=7.7 and 30.6, respectively). Overweight and obese children were also more likely than normal weight children to respond “no” to ‘Do you like the way you look now?’ (OR=2.4 and 7.8, respectively). BMI z-score was associated with lower scores for global self-concept (β=-1.3), intellectual and school status (β=-1.5), and physical appearance and attributes (β=-1.3). The poor self-concept and body size dissatisfaction of Cree children with excess weight may lead to disordered eating or psychological outcomes such as depression. The psychosocial implications of obesity in First Nations children may be as important as chronic disease considerations.