Exploring weight-related teasing and depression among overweight and obese adolescents

Abstract

IntroductionWeight-related stigma is pervasive and often is founded on the assumption that weight is controllable; therefore, those who are overweight and obese are thought to be weakwilled, lazy, and lacking self-control. As targets of weight stigma, over 30% of overweight and obese youth experience weight-related teasing, which is associated with depression, a serious mental health condition that puts young people at risk for myriad of other health problems. To date, little is known about the psychological mechanisms that underlie the teasing–depression relationship. ObjectiveThus, the purpose of this study was to examine self-esteem and body satisfaction as possible mediators of the association between weight-related teasing and depression among overweight and obese middle school boys and girls. MethodParticipants included 143 girls and 200 boys in grades 6 through 8 with measured BMIs 85th percentile for age and sex. Demographic information and pubertal development were collected via questionnaire. Height and weight were measured during state mandated school-based physical fitness testing. Participants also completed the Weight/Size Teasing subscale of the Physical appearance Related Teasing Scale, Center for Epidemiological Studies—Depression Scale for Children, General Self-Esteem scale from the Self-Description Questionnaire II, and Body subscale of the Body Parts Satisfaction Scale-Revised (girls)/Body Parts Satisfaction Scale for Men (boys). ResultsWeight-based teasing was positively related with depression; teasing and depression were inversely associated with self-esteem and body satisfaction. Bootstrap confidence interval mediation models were tested. Self-esteem and body satisfaction mediated the relationship between teasing and depression, with gender, BMI percentile, race, and pubertal status controlled for in the models. Self-esteem accounted for 48% of the total model, body satisfaction accounted for 9% of the total model. ConclusionThe results of this study extend previous research by identifying self-esteem and body satisfaction as possible psychological constructs that help to explain the nature of the relationship between weight-related teasing and depression among overweight and obese youth. Results indicated that overweight and obese adolescents, self-esteem and body dissatisfaction may play a role in the extent to which weight-related teasing is associated with depression. Low self-esteem and body dissatisfaction may exacerbate the experience of teasing whereas positive general self-evaluations may protect against the deleterious influence of teasing on depression. Although public health efforts often focus on weight loss and behavior change as a way to enhance mental health, these results suggest that intervening on protective mechanisms may offer an alternative approach. Additional research is needed to determine if and how self-esteem and body satisfaction can be enhanced among overweight and obese youth via interventions in order to reduce the possible influence of teasing on depression.