Psychosocial predictors of 4‐year BMI change in overweight and obese children in primary care12. (16th April 2013)

• Record Type: Journal Article
• Authors: Incledon, Emily; Gerner, Bibi; Hay, Margaret; Brennan, Leah; Wake, Melissa
• Is Part Of: Obesity. Volume 21:Number 3(2013:Mar.)
• Page Start: E262
• Page End: E270
• Publication Date: 2013-04-16
• Subjects: Obesity -- Periodicals; 616.398005
• DOI: 10.1002/oby.20050
• Languages: English
• ISSNs: 1930-7381

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="abs1-1" sec-type="section"> <title>Objective:</title> <p>This study aimed to determine whether (<xref ref-type="link" rid="bib1">1</xref>) initial and/or (<xref ref-type="link" rid="bib2">2</xref>) changes in psychosocial functioning predict body mass index (BMI) <italic>z</italic>‐score change over 4 years in overweight/mildly obese 5‐ to 9‐year old children presenting to primary care.</p> </sec> <sec id="abs1-2" sec-type="section"> <title>Design and Methods:</title> <p>Eligible participants (<italic>n</italic> = 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 <italic>z</italic>‐score change from baseline to 4 years.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>Results:</title> <p>The 189 respondents (61% female; 73% retention) showed little mean change in BMI <italic>z</italic>‐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 <italic>z</italic>‐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 <italic>z</italic>‐score change scores. The strongest predictors of decreases in BMI <italic>z</italic>‐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, <italic>P</italic> < 0.01) and declines in Desire to be Thinner (β = 0.33, 95% CI 0.04 to 0.23, <italic>P</italic> < 0.01).</p> </sec> <sec id="abs1-4" sec-type="section"> <title>Conclusions:</title> <p>At presentation to primary care, it seems unlikely that targeting the psychosocial factors measured in this study would influence BMI <italic>z</italic>‐score change in overweight/mildly obese children. Subsequent change in psychosocial well‐being covaries with BMI <italic>z</italic>‐score change and may have important adolescent ramifications; the causal directions for these associations require further research.</p> </sec> </abstract>