Abstract
Evidence of associations between psychopathology and obesity in childhood remains inconsistent, and most studies have been conducted in Western countries. This study investigated psychological and physiological correlates of obesity in a community sample of children in Taiwan. In total, 302 children (157 overweight/obese and 145 healthy-weight children) were selected from first- and fourth-grade schoolchildren in eight elementary schools in 2009. These children participated in a comprehensive health examination, including a physical examination, blood sample analysis, and questionnaire administration. We found that regarding physiological characteristics, compared with the healthy-weight children, the overweight/obese children had significantly higher values for body fat estimated using the bioelectrical impedance method (p < 0.001), systolic blood pressure (p < 0.001), and diastolic blood pressure (p = 0.001); lower values for high-density lipoprotein (p < 0.001); and worse values for glutamic-pyruvic transaminase (p < 0.001), triglycerides (p < 0.001), and fasting blood glucose (p = 0.049). In logistic models adjusted for parental and child traits and physiological characteristics, children’s overweight/obesity was significantly associated with lower self-concept (odds ratio [OR] = 0.96, 95% confidence interval [CI] = 0.93–0.99) and less disruptive behavior (OR = 0.96, 95% CI = 0.92–0.99). Less disruptive behavior and the lack of a higher prevalence of anxiety and depression in childhood obesity appear to be a unique pattern in Taiwan that warrants further investigation.
Highlights
Intervention should be emphasized in younger children
Consistent with studies in Western countries, recent studies in Asia have demonstrated that obese children exhibit body dissatisfaction and lower self-esteem; no relationship was observed between obesity and higher levels of depressive symptoms in children[19]
We found that compared with the healthy-weight children, the overweight or obese children were more likely to be male (p = 0 .04)
Summary
Intervention should be emphasized in younger children. most studies have focused on the psychosocial aspects of childhood obesity in older children or adolescents[3,18]. A strong relationship between self-perception and behavior may not be observed in Taiwanese children because of the emphasis on the Confucian ideology of filial piety and obedience that pervades Taiwanese culture, in which children are expected to respect and obey their parents and elders instead of expressing their true selves[20]. This practice may affect the psychological impact of obesity on children. Patterns of association among Taiwanese children may differ from those observed among Western children
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