Psychosocial predictors of 4‐year BMI change in overweight and obese children in primary care

Objective: This study aimed to determine whether (1) initial and/or (2) changes in psychosocial functioning predict body mass index (BMI) z‐score change over 4 years in overweight/mildly obese 5‐ to 9‐year old children presenting to primary care. Design and Methods: Eligible participants (n = 258) w...

Full description

Saved in:
Bibliographic Details
Published in:Obesity (Silver Spring, Md.) Md.), 2013-03, Vol.21 (3), p.E262-E270
Main Authors: Incledon, Emily, Gerner, Bibi, Hay, Margaret, Brennan, Leah, Wake, Melissa
Format: Article
Language:English
Subjects:
Adiposity
Australia
Behavior
Body Image
Body Mass Index
Body Weight
Child
Child development
Child, Preschool
Children & youth
Families & family life
Female
Follow-Up Studies
Humans
Influence
Intervention
Longitudinal Studies
Male
Mental disorders
Mental health
Nutrition
Obesity
Obesity - psychology
Overweight - psychology
Parents
Primary Health Care - methods
Quality of Life
Regression analysis
Self Concept
Studies
Surveys and Questionnaires
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objective: This study aimed to determine whether (1) initial and/or (2) changes in psychosocial functioning predict body mass index (BMI) z‐score change over 4 years in overweight/mildly obese 5‐ to 9‐year old children presenting to primary care. Design and Methods: Eligible participants (n = 258) were overweight/mildly obese children (IOTF criteria) recruited into the LEAP2 trial (ISRCTN52511065) from 3,958 children visiting general practitioners in Melbourne, Australia from May 2005 to July 2006. Predictors were change scores calculated from repeated measures of parent‐ and child‐reported child health‐related quality of life (PedsQL) and self‐esteem; child‐reported desire to be thinner; and parent‐reported child weight concern. Outcome was measured BMI z‐score change from baseline to 4 years. Results: The 189 respondents (61% female; 73% retention) showed little mean change in BMI z‐score (−0.08) but wide variation (standard deviation 0.50, range −1.32 to 1.20). Only one baseline measure (better parent‐reported PedsQL School Functioning) predicted improving BMI z‐score. However, parents and children consistently reported that changes in psychosocial functioning (i.e., PedsQL Social and Global Self‐esteem) were inversely related to BMI z‐score change scores. The strongest predictors of decreases in BMI z‐scores were changes in child‐reported body‐image variables, i.e., improvements in Physical Appearance Self‐esteem (β =0.40, 95% CI −0.98 to −0.15, P < 0.01) and declines in Desire to be Thinner (β = 0.33, 95% CI 0.04 to 0.23, P < 0.01). Conclusions: At presentation to primary care, it seems unlikely that targeting the psychosocial factors measured in this study would influence BMI z‐score change in overweight/mildly obese children. Subsequent change in psychosocial well‐being covaries with BMI z‐score change and may have important adolescent ramifications; the causal directions for these associations require further research.
ISSN:1930-7381
1930-739X
DOI:10.1002/oby.20050