Method
Discuss about the Prospective Study of the Role of Depression in the Development and Persistence of Adolescent Obesity.
In the contemporary world, obesity has been identified among the major health conditions which should be handled effectively. Obesity is associated with several other conditions such as cardiovascular issues among others. Due to the linkage of obesity and other medical issues, it is a public health concern to develop strategies for reducing its prevalence and effect on the community. Almost all the subgroups in the population-based education, ethnic and racial factors, age and gender among other factors are affected by obesity in the same intensity. However, young adults aged 18 to 29 years are facing an increased risk of obesity compared to the other subgroups and age categories. Therefore, this creates a basis to develop hypothesis and research ground on the reasons behind the increased risk of obesity as compared to the other groups. Research has identified several factors and covariates which expose adolescents to the increased risk of being obese their late teen and their twenties. Due to changes in growth, the adolescents are exposed to psychological issues which possibly affect their physical growth and development.
Despite the medical complications an obese person is exposed to, research has shown that there other social issues. For instance, the economist has established that there are lots of hours lost due to waste of time by obese people, which reverts the costs to the government and the society in general. In addition, obese girls are at a greater risk of finding jobs with lesser pay compared to their counterparts. Also, men who are obese are less likely to get married in their adulthood. Obese children do not receive the same treatment and love from their parents, which in return leads to a poor upbringing that puts to risk the future generation. Although overweight and obesity have been associated with poor diet and physical exercises, research has also focused on understanding psychological effects(Cooke & Wardle, 2006).(Cooke & Wardle, 2006). Further, studies have suggested that obesity is positively associated with low self-esteem, which might also elevate into stress and depression(Puhl & Brownell, 2006; Sacher et al., 2010). As a result of the stigma associated with obesity, the victims might end up suffering from affective disorders – which might further affect their psychological and physical wellbeing. The objective of this study checks the relationship between depression and obesity among adolescents.
Sample
The data was obtained from a school-based study focusing on youths in grades 7 to 12 who were less than 20 years, filled in interviews for both April to December 1995 and April to August 1996, who provided information about their height and weight at both periods and a biological, foster, step or adopted parent. The study sample only included racial groups which had a significant representative because research had shown that there were significant differences in the prevalence of obesity among the races/ethnic groups.
The height of the study participants was recorded in feet and inches and weight in pounds. Since the measure of BMI is in kilograms per square metres, the units of height and weight measurements were transformed into metres and kilograms respectively. Percentiles of the BMI measure were calculated using the 2000 Centres for Disease Control and Prevention growth charts(Centers for Disease Control, 2010).(Centers for Disease Control, 2010). Individuals equal and above 95th percentiles were categorised as obese, those above 85th and below 95th percentiles were categorised as overweight and those below the 85th percentile were categorised as having normal weights.
Using the Centre for Epidemiologic Studies Depression Scale, the symptoms of depression among the study participants were recorded. According to Roberts et al(Roberts, Lewinsohn, & Seeley, 1991)(Roberts, Lewinsohn, & Seeley, 1991), a score of 22 for male and 24 for female are good to maximize the specificity and sensitivity of a study. Therefore, these scores were used to create dummy variables for the purpose of analysis.
Ages of participants were measured as the subtraction of the date of interview and the date of birth. During the first interview, the gender was determined. In data coding, females were used as the reference category. Ethnicity was categorised as white, non-Hispanic; black, non-Hispanic or Hispanic. A number of parents were also recorded as a category and social economic class as an ordinal categorical variable.
Based on previous research, 4 behavioural and psychological covariates were included in the study which includes self-esteem, smoking, low physical activities and delinquent behaviour. Using a 6-item personal image scale, the self-esteem of the participants were measured(Resnick et al., 1997)(Resnick et al., 1997). Smoking was measured by categorizing the participants into 5 level scale. Those who stated that they never smoked were categorized as never smoked, those who smoked less than a cigarette a day were termed as an experimenter and the remaining were categorized according to a number of cigarettes – with the third categories being those who smoked less than a pack per week. The 4 category was for those who smoked a packet per day and per week. The last category were those who smoked at least a packet per day. Adolescents who did not report moderate to vigorous exercise at least thrice per week were categorized as having low physical activity. Finally, delinquent behaviour was measured based on involvement in such behaviours in the last 12 months. These behaviours included stealing, physical fighting, lying to parents among others.
Measures
SPSS statistical software was used to generate the descriptive statistics and SUDAAN package used to analyze the statistical significance tests. Chi-square tests for logistic regression and bivariate and multivariate analysis were used. The relationships between baseline and follow up characteristics were examined using multivariable analysis and the possible factors which affect both depressed mood and obesity were controlled.
There were 12.9% overweight, 9.7% obese and 8.8% had a depressed mood at the baseline. After analysing the baseline data, depressed mood was significantly associated with obesity. After follow-up, 9% of those who were depressed at baseline developed obesity. Of the non-obese participants at baseline, 9.8% were obese after follow-up. Bivariate analysis indicated that baseline depressed mood was significantly associated with obesity at follow-up. Additionally, the depressed mood remained significant after including other variables in the model and controlling for potential confounders.
Discussion and Conclusion
51.4% of the study participants were males for the unweighted sample size. 74.7% were white, non-Hispanic; 13.6% black, non-Hispanic and 11.7% were Hispanic. 29.5% of the parents of the participants had vocational school or some college education, 24.5% had high school degree and equivalent, 16.3% were college graduates, 13.6% had a professional degree and 8.6% had no high school degree and finally 7.5% of the education information was missing.
At baseline, 8.8% had depressed mood, which increased to 8.9% in the follow-up. 77.4%o the participants were of normal weight at baseline, 12.9% overweight and 9.7% were obese, then 9.7% obese at follow-up. The male adolescent has been hypothesized to have a higher prevalence of obesity and in the model, it was found that gender is a significant correlate of obesity Bivariate analysis indicated that baseline depressed mood was significantly associated with obesity at follow-up. Additionally, the depressed mood remained significant after including other variables in the model and controlling for potential confounders.
Discussion and Conclusion
The correlation between depression and obesity affects people differently and gender is not an exception(Dutton & Needham, 2014).(Dutton & Needham, 2014). In the analysis, it was found that male had 77% higher chance of being obese compared to the females. This indicates that there were more male adolescents who were obese than the females.and were obese than the females. This has been affirmed in previous research by Kanter and Caballero (2012) who indicated that males were 100% more likely to be obese if their friends were living with the condition. Therefore, this explains the reason for having more male adolescents who are obese as compared to the females.
Obesity
Further, it was observed that obesity did not vary significantly with age. Therefore, changing the age of an adolescent from on age to another does not significantly affect the risk of obesity for an adolescent. The Hispanic ethnic group was not a significant correlate of obesity compared to the white, non-Hispanic. However, the risk of being obese for the black, non-Hispanic was significantly higher by 50% compared to the white, non-Hispanic. An adolescent who had two parents has had a 6% increased risk of being obese compared to those with one or none of the parents., which concurs to the findings of Reilly et al. (2005). Adolescents whose parents were obese were more likely to be obese compared to their counterparts. This is because children would most likely act as their parents – which means parents who do not eat dieted food and engage in moderate to high exercises would most probably influence their children(Barkley, 2012).(Barkley, 2012). Unexpectedly, depressed mood at baseline was associated with less (10% less) odd of obesity. Education was a significant predictor of obesity at baseline, indicating the increasing the education of the parents reduced the risk of being obese by 24%(Cooke & Wardle, 2006; Goodman & Whitaker, 2002).
Baseline depressed mood was a significant predictor of obesity for the adolescents with an adjusted odds ratio of 2.05 (95% CI; 1.18, 3.56). Low self-esteem, low physical exercises, and cigarette smoking were a significant moderator of the effect of depressed mood at baseline on obesity. However, high delinquency increased the risk of obesity from 2.05 to 2.24 after including the variable in the core model which is included social demographic variables and depressed mood at baseline. Including all the covariates in the model increases the odds ratio associated with depressed mood to 2.17. In conclusion, depression mood at baseline was a significant predictor of obesity and it was associated with two-fold risk of having obesity. Baseline depressed mood was a significant predictor of obesity for the adolescents with an adjusted odds ratio of 2.05 (95% CI; 1.18, 3.56). Low self-esteem, low physical exercises, and cigarette smoking were a significant moderator of the effect of depressed mood at baseline on obesity(Apovian et al., 2013; Dutton & Needham, 2014; Sánchez-Villegas et al., 2010). However, high delinquency increased the risk of obesity from 2.05 to 2.24 after including the variable in the core model which is included social demographic variables and depressed mood at baseline. Including all the covariates in the model increases the odds ratio associated with depressed mood to 2.17. In conclusion, depression mood at baseline was a significant predictor of obesity and it was associated with two-fold risk of having obesity.
Depression
References
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