Bauer Katherine W, Marcus Marsha D, Larson Nicole, Neumark-Sztainer Dianne
1 Department of Nutritional Sciences, University of Michigan School of Public Health , Ann Arbor, MI.
2 Department of Psychiatry, University of Pittsburgh Medical Center , Western Psychiatric Institute and Clinic, Pittsburgh, PA.
Child Obes. 2017 Dec;13(6):470-478. doi: 10.1089/chi.2017.0067. Epub 2017 Jun 26.
Severe obesity among adolescents, also known as class 2 and 3 obesity, is increasing in prevalence, yet, little is known about adolescents with severe obesity. The objective of this study was to identify the socioenvironmental, personal, and behavioral correlates of severe obesity among an ethnically/racially diverse sample of US adolescents.
A cross-sectional analysis of data from participants in the EAT 2010 study (n = 2706) was conducted. Adolescents completed in-class surveys, and height and weight were measured. Severe obesity was defined as a BMI ≥120% of the 95th percentile or ≥35 kg/m; class 1 obesity as a BMI ≥95th percentile but below severe obesity cut points, overweight as a BMI <95th percentile but ≥85th percentile, and normal weight as a BMI <85th but >5th percentile. General linear models were used to identify differences between adolescents by weight status, adjusted for covariates.
Nine percent of adolescents had severe obesity. Compared with peers of other weight statuses, a greater proportion of adolescents with severe obesity reported parental encouragement to diet and peer weight teasing. Adolescents with severe obesity also reported lower self-esteem and body satisfaction. Binge eating was three times as prevalent among adolescents with severe obesity compared with peers of normal weight and twice as prevalent as among peers with class 1 obesity.
Adolescents with severe obesity report several unique socioenvironmental, personal, and behavioral concerns that may diminish quality of life and may predict increased weight gain over time.
青少年严重肥胖，也称为2级和3级肥胖，其患病率正在上升，然而，对于患有严重肥胖的青少年知之甚少。本研究的目的是在美国青少年的种族/民族多样化样本中，确定严重肥胖的社会环境、个人和行为相关因素。
对EAT 2010研究的参与者数据（n = 2706）进行横断面分析。青少年完成课堂调查，并测量身高和体重。严重肥胖定义为BMI≥第95百分位数的120%或≥35 kg/m²；1级肥胖定义为BMI≥第95百分位数但低于严重肥胖切点，超重定义为BMI＜第95百分位数但≥第85百分位数，正常体重定义为BMI＜第85百分位数但＞第5百分位数。使用一般线性模型来确定按体重状况划分的青少年之间的差异，并对协变量进行调整。
9%的青少年患有严重肥胖。与其他体重状况的同龄人相比，患有严重肥胖的青少年中，有更大比例的人报告父母鼓励节食以及同伴对体重的嘲笑。患有严重肥胖的青少年还报告自尊和身体满意度较低。与正常体重的同龄人相比，患有严重肥胖的青少年中暴饮暴食的患病率是其三倍，与1级肥胖的同龄人相比是其两倍。
患有严重肥胖的青少年报告了一些独特的社会环境、个人和行为问题，这些问题可能会降低生活质量，并可能预示着随着时间的推移体重会进一步增加。
