title: Are overweight children unhappy?: Body mass index, depressive symptoms, and overweight concerns in elementary school children.
abstract: BACKGROUND
  It is commonly believed that overweight children are unhappy with their weight. However, population-based data addressing this association are lacking.
  
  
  OBJECTIVE
  To evaluate the association between obesity and depressive symptoms in a diverse, school-based sample of preadolescent children, and to examine whether overweight concerns play a role in this association.
  
  
  METHODS
  Third-grade students (N = 868, mean age, 8.4 years) attending 13 public elementary schools in Northern California were measured for weight and height, and were asked to complete self-report assessments of depressive symptoms and overweight concerns.
  
  
  RESULTS
  A modest association between depressive symptoms and body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) was found for girls (r = 0.14, P<.01), but not for boys (r = 0.01, P<.78). Among girls, depressive symptoms were strongly associated with overweight concerns (r = 0.32, P<.001). After controlling for level of overweight concerns, BMI was no longer significantly associated with depressive symptoms among girls. In contrast, after controlling for BMI, overweight concerns remained significantly associated with depressive symptoms.
  
  
  CONCLUSIONS
  This study provides cross-sectional evidence for a relationship between depressive symptoms and BMI in preadolescent girls, but not in preadolescent boys. This relationship seems to be explained by an excess of overweight concerns. Assessing overweight concerns may be a useful method to identify those overweight girls who are at highest risk for associated depressive symptoms.
authors.affiliation: Department of Psychology, Logan Hall, University of New Mexico, Albuquerque, NM 87131-1161, USA. erickson@unm.edu
authors.forename: S J
authors.initials: SJ
authors.lastname: Erickson
authors.forename: T N
authors.initials: TN
authors.lastname: Robinson
authors.forename: K F
authors.initials: KF
authors.lastname: Haydel
authors.forename: J D
authors.initials: JD
authors.lastname: Killen
mesh_terms: D001294:Attitude to Health; D001828:Body Image; D015992:Body Mass Index; D002140:California; D002648:Child; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006240:Happiness; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D002666:Psychology, Child; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D011795:Surveys and Questionnaires