title: Psychosocial concerns and health-compromising behaviors among overweight and nonoverweight adolescents.
abstract: OBJECTIVE
  To compare weight-specific and global psychosocial concerns and health-compromising behaviors among overweight and nonoverweight youth across gender and ethnicity.
  
  
  METHODS
  A cross-sectional school-based survey of 31,122 adolescents in grades 7 to 12. Based on self-reported heights and weights, respondents were categorized as nonoverweight (body mass index (BMI) < 85th percentile), moderately overweight (85th percentile < BMI < 95th percentile), or severely overweight (BMI > 95th percentile).
  
  
  RESULTS
  Global psychosocial concerns, such as emotional well-being, suicidal ideation, future job concerns, and peer concerns, did not differ greatly between nonoverweight, moderately overweight, and severely overweight adolescents. Substance abuse behaviors were equally or less prevalent among the overweight group. Overweight girls were significantly less likely to consume alcohol, whereas overweight boys were at lower risk for marijuana use. In contrast, overweight youth were more likely to perceive their health as only fair or poor and were more likely to express weight-specific concerns and engage in behaviors such as chronic dieting and binge eating than nonoverweight youth. Overweight American Indian girls perceived their physical health more positively than nonoverweight American Indian girls. Strong associations were found between overweight status and chronic dieting among African American boys and girls.
  
  
  CONCLUSIONS
  Nutritional counseling and educational programs need to address the weight-specific concerns and behaviors of overweight adolescents. However, assumptions regarding global psychosocial concerns and health-compromising behaviors among overweight adolescents of different genders and ethnicities should be avoided. These broad issues need to be explored in more depth at both the research and intervention levels.
authors.affiliation: Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454, USA.
authors.forename: D
authors.initials: D
authors.lastname: Neumark-Sztainer
authors.forename: M
authors.initials: M
authors.lastname: Story
authors.forename: S A
authors.initials: SA
authors.lastname: French
authors.forename: P J
authors.initials: PJ
authors.lastname: Hannan
authors.forename: M D
authors.initials: MD
authors.lastname: Resnick
authors.forename: R W
authors.initials: RW
authors.lastname: Blum
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001828:Body Image; D002648:Child; D003430:Cross-Sectional Studies; D003625:Data Collection; D004038:Diet, Reducing; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012309:Risk-Taking; D012649:Self Concept; D012944:Social Support; D015431:Weight Loss