Depressive symptoms & perceived weight among middle-school students Lauren Whetstone Susan Morrissey Joe Garry Skip Cummings Department of Family Medicine

Introduction 8% of adolescents suffer from depression Relationship between body weight and depressive symptoms inconclusive Some studies show relationship between perceived body weight and depressive symptoms Racial differences unknown We found that weight perception was a significant predictor of suicidal thoughts and actions (2000) and depressive symptoms (2001)

Purpose Explore the relationship between perceived body weight and depressive symptoms Focus on potential race and gender differences

Design & Participants Cross sectional survey - 2001 Participants CDC’s Youth Risk Behavior Survey Middle School Version Participants 2,126 middle school students 22.5% African American males (n=478) 31.5% White males (n=668) 18.7% African American females (n=398) 27.3% White females (n=579) 4 eastern North Carolina counties

Outcome Measures Dependent variable Independent variables Depressive Symptoms Index (DSI) Independent variables Body Mass Index (BMI) Calculated from self-reported height and weight Categorized into normal weight or overweight (greater than the 85th percentile for age and gender) Perceived body weight Categorized into under/normal weight or overweight Race African American or White Gender

Weight Status by BMI Male * African American 60.7 39.3 White 66.9 33.1 % Normal weight Overweight Male * African American 60.7 39.3 White 66.9 33.1 Female *** 65.1 34.9 83.9 16.1 * p < .05, *** p < .001

Perceived Weight Status % Under/normal weight Overweight Male ** African American 82.6 (60.7) 17.4 (39.3) White 75.4 (66.9) 24.6 (33.1) Female 77.2 (65.1) 22.8 (34.9) 75.7 (83.9) 24.3 (16.1) ** p < .01

Normal weight BMI Male African American (n=283) 6.0 White (n=439) 10.3 % perceive as overweight Male African American (n=283) 6.0 White (n=439) 10.3 Female * African American (n=256) 9.8 White (n=482) 16.0 * p < .05

Overweight BMI Male *** African American (n=182) 35.2 White (n=215) % perceive as overweight Male *** African American (n=182) 35.2 White (n=215) 54.0 Female ** African American (n=138) 47.1 White (n=93) 67.7 ** p < .01, *** p < .001

Depressive symptoms index Quality of life Feel good about self Feeling sad or hopeless every day for 2 weeks or more in a row Seriously thought about killing yourself Ever made a plan to kill yourself Ever tried to kill yourself Range 0 – 24 Internal consistency (=.72)

Depressive symptoms Variable Mean DSI Score BMI Normal 3.91 Overweight 4.49 Perceived body weight * Under/normal 3.85 Overweight 4.90 Race African American 4.28 White 3.95 Gender * Male 3.75 Female 4.46 * p < .05

Mean DSI Score by Weight Perception, Race, and Gender

Conclusions Significant relationship between body weight perception and depressive symptoms This relationship does not vary by Race Sex Self-reported height and weight (BMI)

Future Directions Measurement of height and weight Confirm findings with additional measures of childhood depression Expanded measurement of weight perception/body image Explore the development of weight perception