Strauss R S
Division of Pediatric Gastroenterology and Nutrition, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson School of Medicine, New Brunswick, New Jersey, USA.
Pediatrics. 2000 Jan;105(1):e15. doi: 10.1542/peds.105.1.e15.
Although childhood obesity may have detrimental consequences for childhood self-esteem, the prevalence and magnitude of this problem is controversial. In addition, the social and emotional effects of decreased self-esteem in obese children are unknown.
A total of 1520 children, 9 to 10 years of age, born to mothers in the National Longitudinal Survey of Youth were studied. Comprehensive demographic data including race and family income were available in 97% of the cohort. Self-esteem was measured using Self-Perception Profile for Children. The 4-year follow-up Self-Perception Profile for Children scores were available in 79% of the children. Obesity was defined as a body mass index greater than the 95th percentile for age and gender. Additional data include a self-administered questionnaire at 13 to 14 years of age concerning emotional well being, smoking, and alcohol consumption. Data were stratified by race and gender. The data were weighted to reflect a nationally representative sample of children born to mothers 17 to 28 years of age.
Scholastic and global self-esteem scores were not significantly different among 9- to 10-year-old obese and nonobese children. However, over the 4-year period, obese Hispanic females and obese white females showed significantly decreased levels of global self-esteem compared with nonobese Hispanic females and nonobese white females, respectively. Mild decreases in self-esteem also were observed in obese boys compared with nonobese boys. As a result, by 13 to 14 years of age, significantly lower levels of self-esteem were observed in obese boys, obese Hispanic girls, and obese white girls compared with their nonobese counterparts. Decreasing levels of self-esteem in obese children were associated with significantly increased rates of sadness, loneliness, and nervousness compared with obese children whose self-esteem increased or remained unchanged. In addition, obese children with decreasing levels of self-esteem over the 4-year period were more likely to smoke and drink alcohol compared with obese children whose self-esteem increased or remained unchanged.
Obese Hispanic and white females demonstrate significantly lower levels of self-esteem by early adolescence. In addition, obese children with decreasing levels of self-esteem demonstrate significantly higher rates of sadness, loneliness, and nervousness and are more likely to engage in high-risk behaviors such as smoking or consuming alcohol.
尽管儿童肥胖可能对儿童自尊产生不利影响，但该问题的患病率和严重程度仍存在争议。此外，肥胖儿童自尊下降的社会和情感影响尚不清楚。
对全国青年纵向调查中母亲所生的1520名9至10岁儿童进行了研究。97%的队列提供了包括种族和家庭收入在内的综合人口统计数据。使用儿童自我认知量表测量自尊。79%的儿童有4年随访的儿童自我认知量表得分。肥胖定义为体重指数高于年龄和性别的第95百分位数。其他数据包括13至14岁时关于情绪健康、吸烟和饮酒的自填问卷。数据按种族和性别分层。对数据进行加权，以反映17至28岁母亲所生孩子的全国代表性样本。
9至10岁肥胖和非肥胖儿童的学业自尊和总体自尊得分无显著差异。然而，在4年期间，肥胖的西班牙裔女性和肥胖的白人女性与非肥胖的西班牙裔女性和非肥胖的白人女性相比，总体自尊水平显著下降。与非肥胖男孩相比，肥胖男孩的自尊也有轻度下降。因此，到13至14岁时，肥胖男孩、肥胖的西班牙裔女孩和肥胖的白人女孩与非肥胖同龄人相比，自尊水平显著较低。与自尊增加或保持不变的肥胖儿童相比，肥胖儿童自尊水平下降与悲伤、孤独和紧张情绪的发生率显著增加有关。此外，与自尊增加或保持不变的肥胖儿童相比，在4年期间自尊水平下降的肥胖儿童更有可能吸烟和饮酒。
肥胖的西班牙裔和白人女性在青春期早期自尊水平显著较低。此外，自尊水平下降的肥胖儿童悲伤、孤独和紧张情绪的发生率显著较高，并且更有可能从事吸烟或饮酒等高风险行为。
