Background

Evidence for the association between weight status and anxiety in youth is inconsistent. The current study examined theoretically relevant variables that may explain the association, namely peer victimization and teasing as mediating variables, and perceived sociocultural pressures to meet appearance ideals and internalization of appearance ideals as moderating variables.

Methods

Youth 8-17yo were recruited from four medical clinics. Children completed measures assessing anxiety symptoms, weight- and competency-related teasing, peer victimization, internalization of the thin and muscular appearance ideals, and perceived sociocultural pressures to meet appearance ideals. Parents completed measures assessing child anxiety symptoms. Weight and height were objectively measured, and BMI z-score calculated. Path analysis with full information maximum likelihood estimation was used to examine the mediation and moderation models.

Results

Participants (N=137; 13.1y±2.6; 56.9% girls; 7.2% normal weight, 28.5% overweight, 64.2% obese; 38.7% White, 32.1% Black, 19.0% Hispanic; 10.2% Other) were assessed. Weight-related teasing partially mediated the association between weight status and child reported anxiety (β=0.08, p<.05), but not competency-related teasing or peer victimization. Internalization of the thin (β=.23, p<.05) and muscular (β=.23, p<.05) appearance ideals significantly moderated the association between weight status and anxiety by child report. Analyses using parent report of child anxiety were not significant. Perceived sociocultural pressures to meet appearance ideals were not significant moderators by child or parent report.

Conclusions

Weight status was indirectly related to anxiety through weight-related teasing, and internalization of appearance ideals moderated the association between weight status and anxiety. Understanding the ways in which weight status and anxiety are related paves the way for more effective psychosocial interventions.