Background

Some research indicates that youth in weight management (WM) programs report more psychosocial dysfunction compared to youth with overweight/obesity (OO) in the community. However, as WM youth tend to be heavier, it is not clear if psychosocial differences between groups are related to treatment-seeking status or body mass index. This study examined if psychosocial functioning differed between WM and CB youth and if differences persisted after accounting for BMIz.

Methods

Youth with OO from a pediatric WM program and the community completed measures assessing health related quality of life (QOL), depression, anxiety, teasing, thin ideal internalization, and perceived pressures from social agents (i.e., parents, peers, and the media) to meet cultural ideals of beauty. Weight and height were objectively measured, and BMIz was calculated. WM youth were assessed prior to any treatment. T-tests assessed for differences in BMIz and psychosocial functioning between groups (WM vs CB). For psychosocial measures that differed by group, hierarchical linear regressions were conducted with BMIz as the 1st step, group as the 2nd step, and the measure of psychosocial functioning as the outcome. Age and gender were considered as covariates, but were not significant and were excluded.

Results

137 youth (13.6±2.7y; 29.9% WM; 56.9% girls; 38.7% White, 32.1% Black, 19.0% Hispanic; 8.8% Multi-racial; 1.4% Asian) were assessed. BMIz was greater for WM compared to CB youth (p<.001). WM youth reported poorer QOL and greater school-related anxiety, thin ideal internalization, and perceived pressures from family and peers to meet cultural ideals of beauty (ps<.05). After accounting for BMIz, group differences remained for school-related anxiety (p<.01), but not for QOL, thin ideal internalization, or perceived pressures from family and peers to meet cultural ideals of beauty.

Conclusions

With the exception of school-related anxiety, psychosocial differences that exist between WM and CB youth are attenuated by BMIz.