Mental health of overweight and obese adolescents taking account of socio-economic status and education

Abstract

Background: International studies showed that overweight and obese adolescents are more likely to have mental health problems compared to normal weight peers. Objectives: This study analyses the relation between overweight/obesity and mental health problems among adolescents in Germany as well as potential modifying factors of this relation. Materials and Methods: Data base was a subsample of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, n = 6,813, 11–17 years) which was conducted by the Robert Koch Institute from May 2003 to May 2006. Body height and weight were measured in a standardised manner and body mass index (BMI) was calculated. Indications of mental health problems and strengths were collected with the Strengths and Difficulties Questionnaire (SDQ) in the following areas: emotional symptoms, conduct problems, hyperactivity, peer relationship problems and prosocial behaviour. Socio-economic status (SES) and education are analysed as modifying variables. Prevalence and odds ratios with 95 % confidence intervals were calculated by binary logistic regression. Conclusion: In adolescence, overweight and especially obesity go along with a higher risk for mental health problems. In the context of prevention measures and care services for overweight and obesity at a young age, psychosocial aspects should be considered. Results: Obese boys and overweight and obese girls showed more indications of mental health problems compared to normal weight peers. The most common problem areas were conduct problems and peer relationship problems. Obese girls were also more likely to show indications of emotional symptoms compared to normal weight girls. The age stratified analysis showed that the differences in the occourrence of mental health problems between normal weight and obese boys as well as between normal weight and overweight/obese girls are more pronounced aged 11 to 13 years than aged 14 to 17 years. The results on the impact of SES and education showed that in girls, SES had a modyfying impact on the relation between overweight/obesity and mental health problems in favour of the high SES group. In boys, SES only had a modifying impact on the relation between overweight and mental health problems, but here in favour of the low SES group. Only in girls education had a modifying impact on the relation between obesity and mental health problems in favour of the low education group.