Childhood obesity and self-esteem.

To explore the relationship between obesity and self-esteem, the Piers-Harris Self-Esteem Inventory was administered to black inner-city children (grades 4 through 12). Those with chronic illnesses or in special education were excluded, yielding 851 for the study. Body mass index (BMI) served to estimate adiposity, and Ten State Nutrition Survey (TSNS) data yielded reference growth curves. BMI and BMI relative to TSNS ideals were calculated for each child. Using analysis of variance to compare groups based on relative BMI, small differences in mean self-esteem scores were detected (3 to 4 units or one-third standard deviation). These statistically significant differences are unlikely to be clinically significant. The correlation between BMI and self-esteem was small: BMI accounted for only 1% of the variance in self-esteem score. Moreover, all self-esteem scores fell within the normal range. Neither age nor sex affected the relationship. The consequences of childhood obesity may be less harmful than formerly assumed. Our findings may explain why the promise of enhanced self-esteem fails to motivate weight loss in many children.