Psychological well-being and psychiatric disorders in 14- to 15-year-old Finnish school girls and boys with overweight and obesity

The psychological influence of obesity on health is less clear than the physical impacts. Further follow-up studies are needed to examine causality/directionality. To investigate psychiatric disorders in excess-weight adolescents, more studies with diagnostic interviews are required, because the results of previous results have been contradictory, probably reflecting methodological differences. The aim of the study presented in this dissertation was to examine psychological well-being and psychiatric disorders linked to overweight and obesity in a general mid-adolescent population. The study was performed from 2003 to 2005, involving girls and boys aged approximately 14.5 years attending secondary schools in Helsinki. The students completed self-assessments surveying self-esteem (RSES), their thoughts and ideas concerning eating behaviors (EDI), as well as their lifestyle. Both measured and self-reported weights and heights were recorded (Study I sample: 650 girls, 693 boys; Study II sample: 614 girls, 651 boys). A subgroup of adolescents (Study III subsample: 86 girls, 96 boys) was diagnosed by an adolescent psychiatrist using a structured diagnostic instrument (K-SADS-PL). Furthermore, a subgroup (Study IV follow-up subsample: 78 girls, 88 boys) was followed up for one year and completed a questionnaire assessing the self-image (OSIQ-R) both at baseline and on follow-up. In summary, psychological well-being was good in most of the overweight and obese adolescents. However, the excess-weight adolescents significantly more often revealed body dissatisfaction and other symptoms related to eating disorders (p <0.001) and abnormal dietary behavior (p <0.001) than their normal-weight peers. Adolescents with abnormal eating behavior reported significantly greater body dissatisfaction than those with normal eating behavior (p <0.001). The excess-weight adolescents significantly more seldom reported experiences of dating than their normal-weight peers (p <0.001). The boys with excess weight exercised significantly more seldom than their normal-weight peers (p <0.001). The prevalence of lifetime and current psychiatric disorders did not significantly differ between the excess-weight and normal-weight adolescents. The prevalence of one or more current psychiatric disorders was 13.2% among adolescents with excess-weight. The self-image of girls with normal weight developed intensively during the one-year follow-up period compared to girls with excess weight (p <0.024). In component scales, the difference in change scores was largest in sexuality (p = 0.018) and vocational attitudes (p = 0.041).