Self-esteem and change in body mass index over 3 years in a cohort of adolescents.

Self-esteem has been hypothesized to be lower in obese adolescents relative to their normal weight peers and to be an important factor in preventing or reversing obesity. The present study examined the relationship between obesity and self-esteem cross-sectionally and prospectively over three years in a cohort of 1278 adolescents in grades 7 to 9 at baseline. Cross-sectional analyses revealed an inverse association between physical appearance self-esteem and body mass index in both males and females. In females, body mass index was inversely associated with global self-esteem, close friendship, and behavioral conduct self-esteem. In males, body mass index was inversely associated with athletic and romantic appeal self-esteem. Prospectively, in females, physical appearance and social acceptance self-esteem at baseline were inversely related to body mass index three years later. Baseline self-esteem was unrelated prospectively to change in body mass index in males. All associations were modest in magnitude. These results suggest that in a middle class white sample of adolescents, self-esteem specific to physical appearance is modestly associated with body mass index. Low self-esteem does not appear to predict the development of obesity over time.