Childhood obesity and adolescent follow-up depressive symptoms: exploring a moderated mediation model of body esteem and gender.

Obesity is a well-recognized risk factor for adolescent depressive symptoms, but mediating mechanisms of this association have scarcely been studied. This study is unique in examining an indirect pathway of this link via body esteem (BE) prospectively from childhood (8-12 years) to adolescence (13-18 years). In addition, potential gender moderation was examined. This study utilized data from a case-control study comparing 100 children with and without obesity matched on important confounders (age, gender, and socioeconomic status). Our findings provide support for the mediating role of BE in the link between childhood weight status and adolescent depressive symptoms at a 5-year follow-up. This mediation effect did not differ between boys and girls. The findings suggest the relevance of specifically targeting children's BE in preventive intervention programs among children with obesity to prevent future mental health problems.

Examining associations between obesity and mental health disorders from childhood to adolescence: A case-control prospective study.

Childhood obesity and mental disorders often co-exist. To date, most of the studies are cross-sectional, involve the assessment of a specific disorder, and rely on self-report questionnaires. This study aimed to provide a comprehensive psychological assessment to examine the concurrent and prospective association between childhood obesity and mental health problems. We compared 34 children with obesity with 37 children with normal weight at baseline, and at a five-year follow-up, to examine the development of mental health disorders from childhood (8-12 years) to adolescence (13-18 years). Both assessments included a clinical interview and self-reported measures of psychosocial and family markers. Findings showed that the obesity group had a higher prevalence of mental disorders, and psychological comorbidity increased in five years. Prospectively, childhood obesity was associated with a psychological diagnosis in adolescence. Moreover, the obesity group displayed higher severity of symptoms at both times. Finally, body esteem contributed to predicting mental health disorders in adolescence regardless of weight status, while eating symptomatology was a specific marker for the obesity group. Therefore, in the management of childhood obesity is suggested to address also psychosocial variables such as weight-related teasing and body esteem, to prevent the onset or development of mental health problems.

Spanish validation of two social media appearance-related constructs associated with disordered eating in adolescents: The Appearance-related Social Media Consciousness scale (ASMC) and the Critical Thinking about Media Messages scale (CTMM).

Appearance-related constructs underlying social media are negatively associated with mental health. However, their impact on the Spanish population is still unexplored. The present study aimed to validate the Spanish versions of two appearance-related scales: (1) the appearance-related social media consciousness (ASMC) scale; and (2) the critical thinking about media messages (CTMM) scale. Translation and cultural adaptation of the scales were carried out. The scales' psychometric properties were assessed using exploratory and confirmatory factor analyses, measurement invariance across gender (boys vs. girls) and age groups (early adolescents vs. middle adolescents), internal consistency, and convergent validity. The sample included 803 Spanish secondary school adolescents aged between 12 and 18 (Mage = 15.1, 47.9% girls, 47.2% boys, 4.9% non-binary gender/others). The exploratory factor analyses replicated original one-factor structures of both scales, which was verified using confirmatory factor analysis. Regarding the ASMC Scale, a re-specified model (allowing for error correlations between Items 1-2) presented an adequate fit. Both models were invariant across gender and age groups. Excellent internal consistency was found. Bivariate correlations between the ASMC and eating disorders related variables (body esteem, disordered eating, self-esteem, sociocultural attitudes towards appearance, and general mental health) supported its convergent validity and proved ASMC to be a potential target for future preventive eating disorder interventions. However, the CTMM scale correlated only with sociocultural pressures, thus, further research is needed to assess the validity of the CTMM in Spanish samples.

Weight bias internalization among adolescents in Spain: psychological correlates across gender diversity and weight status / La internalización de los prejuicios de peso entre los y las adolescentes en España: correlatos psicológicos en función del género y el estatus de peso

Weight bias internalization refers to the negative weight-related attributions applied to oneself, but it does not just occur in the highest weight statuses, but rather exists across the entire weight spectrum. There is a negative impact associated to increase psychological problems in adults, however, it has been less studied among the adolescent Spanish population. In this study, we assess the relationship between the internalization of weight bias, social attitudes towards appearance, body appreciation and self-esteem, and potential differences regarding gender and weight status. A community sample of 1258 Spanish adolescents between 12 and 18 years old (46.3% male gender; Mage = 15.58; SD = 1.59; 49.5% female gender; Mage = 15.59; SD = 1.67; and 4.1% non-binary gender; Mage = 14.86; SD = 2.86) participated in the study. The Modified Weight Bias Internalization Scale (WBIS-M), the Rosenberg Self-Esteem Scale (RSES), and the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ-4) were used. ANOVA’s test and bivariate correlations were performed. The results suggest that females (t = -.55; p ≤ .001) and non-binary adolescents (t = .64; p ≤ .01) have higher levels of WBI-M compared to males. Regarding weight status, the group with obesity (t = 1.39; p ≤ .001) and the group with overweight (t = -.81; p ≤ .001) have higher levels of WBI-M compared to the normal weight group. Significant correlations between WBI-M and the assessed psychological variables were found in the total sample, and across all-gender and weight categories, except for the underweight group. These results are a first approximation to the internalization of weight bias in a Spanish adolescent sample and highlight the need to introduce this concept in prevention and psychological interventions in school context. (AU)

La internalización de los prejuicios de peso hace referencia a las atribuciones negativas relacionadas con el peso aplicadas a uno mismo/a, lo cual no ocurre únicamente en las personas con un estatus de peso elevado, sino en todo el rango de pesos. En adultos, existe evidencia de su impacto negativoasociados a incrementar problemas psicológicos; aunque se ha estudiado en menor medida en la población adolescente. El objetivo de este estudio fue examinar la relación entre la internalización de prejuicios de peso, las actitudes socioculturales hacia la apariencia, la apreciación corporal y el nivel de autoestima, y analizar las posibles diferencias en función del género y del estatus de peso. Participaron 1.258 adolescentes españoles de una muestra comunitaria entre 12 y 18 años (46.3% género masculino; Medad = 15.58; DT = 1.59; 49,5% género femenino; Medad = 15.59; DT = 1.67; y 4.1% género no binario; Medad = 14.86; DT = 2.86). Se utilizaron la escala de internalización de prejuicios de peso modificado (WBIS-M), la escala de autoestima de Rosenberg (RSES) y el cuestionario de actitudes socioculturales hacia la apariencia (SATAQ-4). Se realizó la prueba ANOVA y correlaciones bivariadas. Los resultados sugieren que el grupo identificado con el género femenino (t = -.55; p ≤ .001) y con el no binario (t = .64; p ≤ .01) muestran niveles más altos de internalización del sesgo de peso en comparación con el género masculino. En cuanto al estado ponderal, el grupo con obesidad (t = 1.39; p ≤ .001) y el grupo con sobrepeso (t = -.81; p ≤ .001) presentan niveles más altos de internalización de prejuicios de peso en comparación con el grupo con normopeso. Se encontraron correlaciones significativas entre las puntuaciones del WBIS-M y las variables psicológicas evaluadas en la muestra total yen todas las categorías de género y peso, con la excepción del grupo de bajo peso. (AU)

Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents.

PURPOSE: Weight Bias Internalization (WBI) is pervasive and potentially damaging for health. Little is known about WBI in youth. As negative effects of WBI have been observed when controlling for BMI, measures that allow WBI to be assessed across different weight categories are needed. The Modified Weight Bias Internalization Scale (WBIS-M) is one of the most frequently used scales in this field. Our purpose was to obtain a Spanish validated version of the WBIS-M for adolescents across different weight statuses. METHODS: The data were collected from 298 secondary students (mean age 14.31; 48.32% girls; 18.8% were overweight and 6.4% had obesity). Internal structure was examined by a cross-validation analysis, using both exploratory and confirmatory factor analyses in different subsamples. RESULTS: Item 1 showed a psychometric anomalous functioning and was deleted. The one-factor structure of the 10-item version was confirmed with adequate fit ([EFA (KMO = 0.915, χ2(55) = 1075.633, p < 0.0001)]; [CFA (χ2(35) = 200.515; GFI = 0.995; PGFI = 0.992; NFI = 0.991; SRMR = 0.060)]). Internal consistency was high [Formula: see text] ω = 0.93). Significant correlations with the same set of external variables assessed in the original version (anti-fat bias, self-esteem, mood, body dissatisfaction, drive for thinness, binge eating), all of them correlates of WBI in adolescents, were found. Girls and participants with obesity obtained higher scores. CONCLUSION: The results provide support for the validity and reliability of our WBIS-M version for use with adolescents across weight categories in Spain. LEVEL OF EVIDENCE: Level III, evidence obtained from well-designed cohort studies.

Family-reported barriers and predictors of short-term attendance in a multidisciplinary intervention for managing childhood obesity: A psycho-family-system based randomised controlled trial (ENTREN-F).

OBJECTIVE: This study was aimed to examine patient enrolment in the pre-intervention stage, family-reported barriers, attendance rates and underlying predictors of short-term attendance in a family-system-based randomised controlled trial for managing childhood obesity in children aged 8-12-years-old (ENTREN-F). METHOD: Psychosocial and anthropometric measures were collected through primary health referral. The data were used for descriptive analyses of sample characteristics and linear regression analyses. RESULTS: Low enrolment rates and several family-reported barriers were observed in the pre-intervention stage. Logistical barriers were the most frequent family-reported reason for attrition in the different stages of the study. Having a first face-to-face orientation session with the families and the use of motivational interviewing helped to improve adherence in the initial phases of the study. After 6 months of intervention, family based treatments (FBTs) under consideration achieve greater adherence compared with the standard intervention. Moreover, family involvement was a predictor of success for better treatment adherence rates. By contrast, participants who attended a brief standard intervention, mothers with primary education, greater body mass index, higher levels of depressive symptomatology and more critical comments towards their children, children with higher weight status and lower levels of self-reported depressive symptoms at baseline attended interventions less frequently. CONCLUSIONS: In future programmes a comprehensive screening of modifiable factors related to family and their setting characteristics is paramount prior to intervention, identifying key barriers related to drop-out, especially in the case of less-advantaged families.