| Summary: | 碩士 === 臺北醫學大學 === 公共衛生學研究所 === 96 === With a transition from childhood to adulthood, adolescence is marked by a rapid and dramatic growth in life. During the significant progression on physical, psychological, and social development, youths concern considerably on their own weight, body-shape, and appearance. Thus, dissatisfaction on one’s own body-shape and appearance, compared to his/her actual or perceived weight status, would be more significantly linked with the psychological well-being status and personal health-related behaviors.
Most of the previous literatures examined the effects of a single factor, either body mass index (BMI) or body image, on adolescents’ psychological status or health-related behaviors. In this study, in addition to the consideration of BMI (i.e., binary classification of “normal” and “overweight/obesity” groups) status, youths’ self-evaluation on appearance satisfaction (i.e., binary classification of “satisfied” and “unsatisfied” groups) was further combined to generate a “weight status” factor with four categories. This cross-sectional study was thus aimed to investigate the effects of the “weight status” on psychological factors (i.e., depression and self-esteem) and health-related behaviors (i.e., sleeping hours, sleeping quality, breakfast eating behaviors, sedentary lifestyle, and weight reduction behaviors). Boys and girls would be evaluated separately to assess specific gender effects.
For each of the bi-districts in Taipei city, one community high school was selected for participation. A total of six municipal high schools were recruited, with 84 classes or 1,090 students completing the in-class and self-reported questionnaires from December, 2007 to March, 2008. In the beginning of the second semester in the 2007 academic year, school nurses measured the height and weight of each student, with the BMI being further calculated. Multivariate linear and logistic regression models were carried out for analyses by gender.
It was observed that 56.3% (n=519) of the Taipei municipal high school students possessed a normal weight status, while 15.5％(n=169) and 15.1％(n=165) were overweight and obese, respectively. For the BMI status, after adjusting for sociodemographics and other listed variables, overweight and obese males were more likely to possess sedentary lifestyle (OR=2.04,95％CI=1.15,3.63) and to have tried to lose weight (OR=5.38,95％CI=3.34,8.66), compared to those with a normal weight status. On the other hand, females with overweight and obese BMI status were more likely to eat breakfast everyday (OR=0.29,95％CI=0.09,0.97) and to have tried to lose weight (OR=3.96,95％CI=1.70,9.21). For the “weight status” factor, after adjusting for sociodemographics and other listed variables, normal-weighted boys who were unsatisfied with their appearance, compared to those who were satisfied, were more likely to have higher levels of depression (OR=3.93,95％CI=1.70,9.06), lower levels of self-esteem (OR=3.08,95％CI=1.50,6.34), worse sleeping quality (OR=1.72,95％CI=1.01,2.94), more sedentary lifestyle (OR=5.07,95％CI=1.51,17.00) and more weight-reduction behaviors (OR=1.93,95％CI=1.02,2.10). Similar trends were not identified for girls.
The study results could be applied to the future design and implementation of a prevention-intervention program on youth’s psychological well-being and health-related behaviors. Because dissimilar trends were identified for boys and for girls, more studies should be administered to investigate the possible explanation or mechanism on the gender differences. Besides BMI status, future studies are suggested to investigate adolescents’ self perception on body image or body-shape in order to examine the effects of weight perception on both physical and psychological aspects in youth.
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