Are overweight children unhappy?: Body mass index, depressive symptoms, and overweight concerns in elementary school children.

BACKGROUND: It is commonly believed that overweight children are unhappy with their weight. However, population-based data addressing this association are lacking. OBJECTIVES: To evaluate the association between obesity and depressive symptoms in a diverse, school-based sample of preadolescent children, and to examine whether overweight concerns play a role in this association. DESIGN, SETTING, AND PARTICIPANTS: Third-grade students (N = 868, mean age, 8.4 years) attending 13 public elementary schools in Northern California were measured for weight and height, and were asked to complete self-report assessments of depressive symptoms and overweight concerns. RESULTS: A modest association between depressive symptoms and body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) was found for girls (r = 0.14, P<.01), but not for boys (r = 0.01, P<.78). Among girls, depressive symptoms were strongly associated with overweight concerns (r = 0.32, P<.001). After controlling for level of overweight concerns, BMI was no longer significantly associated with depressive symptoms among girls. In contrast, after controlling for BMI, overweight concerns remained significantly associated with depressive symptoms. CONCLUSIONS: This study provides cross-sectional evidence for a relationship between depressive symptoms and BMI in preadolescent girls, but not in preadolescent boys. This relationship seems to be explained by an excess of overweight concerns. Assessing overweight concerns may be a useful method to identify those overweight girls who are at highest risk for associated depressive symptoms.