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Body Mass Index, Depressive Symptoms, and Overweight Concerns in Elementary School Children

Sarah J. Erickson, PhD; Thomas N. Robinson, MD, MPH; K. Farish Haydel; Joel D. Killen, PhD

Arch Pediatr Adolesc Med. 2000;154:931-935.

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.

From the Department of Psychology, Logan Hall, University of New Mexico, Albuquerque (Dr Erickson); the Departments of Pediatrics (Dr Robinson) and Medicine (Dr Killen), Stanford University, and Youth Studies Division, Stanford Center for Research in Disease Prevention (Ms Haydel), Stanford University, Palo Alto, Calif.

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