Abstract
Child and adolescent obesity is increasingly the focus of interventions, because it predicts serious disease morbidity later in life. However, social environments that permit weight-related stigma and body shame may make weight control and loss more difficult. Rarely do youth obesity interventions address these complexities. Drawing on repeated measures in a large sample (N = 1443) of first-year (freshman), campus-resident university students across a nine-month period, we model how weight-related shame predicts depressive symptom levels, how being overweight (assessed by anthropometric measures) shapes that risk, and how social connection (openness to friendship) might mediate/moderate. Body shame directly, clearly, and repeatedly predicts depression symptom levels across the whole school year for all students, but overweight youth have significantly elevated risk. Social connections mediate earlier in the school year, and in all phases moderate, body shame effects on depression. Youth obesity interventions would be well-served recognizing and incorporating the influential roles of social-environmental factors like weight stigma and friendship in program design.
Highlights
End of spring semester depression levels (n = 508). *** p < 0.001. These results demonstrate that body shame directly, clearly, and repeatedly predicts depressive symptoms levels in a large sample of first year college students tracked across a full school year
By the final phase of the school year, the effect is not significant as a mediation for either group, some moderation effect is still apparent. This suggests that early engagement in seeking and maintaining peer friendships in the campus environment is protective against the depressing effects of body shame
These findings suggest the benefits of engaging new non-food and non-exercise based interventions at the times students first arrive on campus that could help adolescents manage weight
Summary
There are more immediate negative effects of high body weights of youth related to mental health outcomes, such as depression. A major posited reason is that children’s and adolescent’s high body weights are socially stigmatized, and lead to exposure to multiple forms of weight-related discrimination and mistreatment (such as teasing and rejection) [3,4,5,6,7]. These can emerge even from pre-school (e.g., [8,9,10,11]). Hovell et al documented the rate of weight increase of new college freshman women as 36 times the speed of matched community women [30]
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