Eivind Meland1, Hans Johan Breidablik2, Frode Thuen3, Gro Beate Samdal4. 1. Department of Global Public Health and Primary Care, Research Group for General Practice, Årstadveien 17, 5018, Bergen, Norway. eivind.meland@uib.no. 2. Department of Research and Development, District General Hospital of Førde, 6800, Førde, Norway. 3. Center for Evidence-Based Practice, Western Norway University of Science, Inndalsveien 28, 5063, Bergen, Norway. 4. Faculty of Health, VID Specialized University, 5145 Fyllingsdalen, Bergen, Norway.
Abstract
BACKGROUND: Impaired self-rated health (SRH) and self-esteem (SE) in adolescents are associated with increased body mass index (BMI). These associations are often studied using cross-sectional designs; we performed a longitudinal cohort survey to examine them. METHODS: A longitudinal cohort study of 1225 Norwegian high school students, with SRH, SE and BMI as primary outcomes. We reported the results from temporal causal and residual change analyses separately, with odds ratios (ORs) and standardised regression coefficients (b) and 95% confidence limits. RESULTS: Body and weight concerns had unfavourable effects on SRH and SE, which both had favourable effects on each other. Increased BMI had unfavourable effects on SRH, but less so on SE. Body and weight concerns impacted SE change only among girls. Paradoxically, the intention of becoming thinner was associated with an increase in BMI, and the intention of becoming fatter predicted a decrease in BMI during the 2 years. SE and SRH were associated with a leaner body after 2 years. CONCLUSIONS: This study confirms that body concerns had unfavourable effects on subjective health, and that positive self-concepts predicted a leaner body. Health promotion strategies built on body acceptance should be increasingly emphasised in clinical and public health practice.
BACKGROUND: Impaired self-rated health (SRH) and self-esteem (SE) in adolescents are associated with increased body mass index (BMI). These associations are often studied using cross-sectional designs; we performed a longitudinal cohort survey to examine them. METHODS: A longitudinal cohort study of 1225 Norwegian high school students, with SRH, SE and BMI as primary outcomes. We reported the results from temporal causal and residual change analyses separately, with odds ratios (ORs) and standardised regression coefficients (b) and 95% confidence limits. RESULTS: Body and weight concerns had unfavourable effects on SRH and SE, which both had favourable effects on each other. Increased BMI had unfavourable effects on SRH, but less so on SE. Body and weight concerns impacted SE change only among girls. Paradoxically, the intention of becoming thinner was associated with an increase in BMI, and the intention of becoming fatter predicted a decrease in BMI during the 2 years. SE and SRH were associated with a leaner body after 2 years. CONCLUSIONS: This study confirms that body concerns had unfavourable effects on subjective health, and that positive self-concepts predicted a leaner body. Health promotion strategies built on body acceptance should be increasingly emphasised in clinical and public health practice.
Entities:
Keywords:
Adolescence; Body dissatisfaction; Body mass index; Body weight concern; Self-esteem; Self-rated health
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