Body Dysmorphia and Obesity - Greek study reveals risk index in preadolescence

Research from Harokopio University and Australian Universities has revealed the indicator in the first year of a child's Body Mass Index (BMI) in childhood is a predictor of a child's mental health in preadolescence, claims a study by researchers from Greece and Australia.

Children - mainly girls - with a very high BMI (6.4% of the sample) had a greater risk of body dysmorphia and eating disorders compared to average children, according to the findings published in BMC Public Health.

The researchers said that risk for body image disorder was also present in the "high" BMI group (25.2% of children), but not for eating disorders, which is consistent with previous research showing that food restriction is more associated with obesity than overweight.

They added that despite affecting all age groups, most mental disorders begin before the age of 25, with 13% of depressive and 20% of anxiety disorders appearing in mid-adolescence.

The researchers examined data from 1,778 Greek children aged 9-13, while anthropometric data from infancy were drawn from pediatric health records. The sample came from the Healthy Growth Study, a large cross-sectional study that included 2,665 fifth—and sixth-grade students aged 9-13 from the municipalities of Attica, Aitoloakarnania, Thessaloniki, and Heraklion.

BMI trajectories in the first year of life were estimated using group modelling. Preadolescent emotional functioning, self-esteem, body image dissatisfaction, and eating practices were self-reported through validated questionnaires, with questions such as “During the past two weeks, how preoccupied were you with emotional problems such as anxiety, depression, irritability, or melancholy?"

The first study of its kind

According to the researchers, the study is the first to investigate the psychosocial connections of BMI trajectory with preadolescence in the first year of life.

The findings provide new evidence that infant growth patterns in the first year of life may be early risk indicators for poor psychosocial health.

Previous research in pediatric populations, ages 6 to 18, has focused on the psychosocial effects of body weight, concluding that children and adolescents with obesity are at higher risk for body discomfort, disordered eating behaviours, and dietary restrictions.

Obese children 9-13 years old

The researchers showed that infants with very high and high BMI trajectories at 12 months were more likely to become obese children at 9-13 years of age and, consequently, to experience poorer psychosocial health.

In this regard, the findings of the study have important implications for the timing of public health interventions to support long-term mental well-being, particularly given that adult mental disorders often begin in childhood and adolescence, the researchers said.

The financial crisis of 2008

The study found no association of BMI development in infancy with emotional functioning or self-esteem in preadolescence. Although excess body weight was associated with poor emotional functioning, the association was weaker compared to other factors.

However, rates of low emotional functioning and self-esteem were higher than expected, affecting 25% and 66% of all children.

As the researchers explain, the rates could be attributed to social and economic conditions during the data collection period, which coincided with the national financial crisis of 2008–2009.

The significant increase in mental health problems and decrease in self-esteem among young people during the crisis has been supported by a number of studies.

Strengths and limitations of the study

A strength of the study was the large, representative sample of students with anthropometric data from birth to 12 months. However, the study was based on self-reported psychosocial health questionnaires, which have not been specifically validated for the Greek population.

Also, the cross-sectional nature of the study and the retrospective data may have influenced the results, as well as the effect of the financial crisis on mental health being stronger than other factors.

READ MORE: How many times a week should we exercise to see results? A Greek fitness expert answers.