Gortmaker S L, Must A, Perrin J M, Sobol A M, Dietz W H
Department of Health and Social Behavior, Harvard School of Public Health, Boston, MA 02115.
N Engl J Med. 1993 Sep 30;329(14):1008-12. doi: 10.1056/NEJM199309303291406.
Overweight in adolescents may have deleterious effects on their subsequent self-esteem, social and economic characteristics, and physical health. We studied the relation between overweight and subsequent educational attainment, marital status, household income, and self-esteem in a nationally representative sample of 10,039 randomly selected young people who were 16 to 24 years old in 1981. Follow-up data were obtained in 1988 for 65 to 79 percent of the original cohort, depending on the variable studied. The characteristics of the subjects who had been overweight in 1981 were compared with those for young people with asthma, musculoskeletal abnormalities, and other chronic health conditions. Overweight was defined as a body-mass index above the 95th percentile for age and sex.
In 1981, 370 of the subjects were overweight. Seven years later, women who had been overweight had completed fewer years of school (0.3 year less; 95 percent confidence interval, 0.1 to 0.6; P = 0.009), were less likely to be married (20 percent less likely; 95 percent confidence interval, 13 to 27 percent; P < 0.001), had lower household incomes ($6,710 less per year; 95 percent confidence interval, $3,942 to $9,478; P < 0.001), and had higher rates of household poverty (10 percent higher; 95 percent confidence interval, 4 to 16 percent; P < 0.001) than the women who had not been overweight, independent of their base-line socioeconomic status and aptitude-test scores. Men who had been overweight were less likely to be married (11 percent less likely; 95 percent confidence interval, 3 to 18 percent; P = 0.005). In contrast, people with the other chronic conditions we studied did not differ in these ways from the nonoverweight subjects. We found no evidence of an effect of overweight on self-esteem.
Overweight during adolescence has important social and economic consequences, which are greater than those of many other chronic physical conditions. Discrimination against overweight persons may account for these results.
青少年超重可能会对其后续的自尊、社会和经济特征以及身体健康产生有害影响。我们在一个具有全国代表性的样本中，研究了超重与后续教育程度、婚姻状况、家庭收入和自尊之间的关系，该样本包括1981年随机选取的10039名年龄在16至24岁的年轻人。根据所研究的变量，在1988年获得了原队列中65%至79%的随访数据。将1981年超重的受试者的特征与患有哮喘、肌肉骨骼异常和其他慢性健康状况的年轻人的特征进行了比较。超重被定义为体重指数高于年龄和性别的第95百分位数。
1981年，370名受试者超重。七年后，超重的女性完成的学业年限较少（少0.3年；95%置信区间为0.1至0.6；P = 0.009），结婚的可能性较小（可能性低20%；95%置信区间为13%至27%；P < 0.001），家庭收入较低（每年少6710美元；95%置信区间为3942美元至9478美元；P < 0.001），家庭贫困率较高（高10%；95%置信区间为4%至16%；P < 0.001），与未超重的女性相比，这与她们的基线社会经济地位和能力测试分数无关。超重的男性结婚的可能性较小（可能性低11%；95%置信区间为3%至18%；P = 0.005）。相比之下，我们研究的其他慢性病患者在这些方面与非超重受试者没有差异。我们没有发现超重对自尊有影响的证据。
青少年时期超重具有重要的社会和经济后果，这些后果比许多其他慢性身体状况的后果更为严重。对超重者的歧视可能是这些结果的原因。
