title: A comparison of body-image perception, health outlook and eating behavior in mildly obese versus moderately-to-severely obese adolescents.
abstract: BACKGROUND
  Adolescent obesity is rapidly becoming a majorpubic health concern in Thailand. Factors that contribute to adolescent obesity are increasingly sedentary behaviors, changes in eating habits and physical activity Body-image perception and peer influence are substantial for adolescents. As a result, knowing the obesity-relatedpsychological impacts in adolescent will be the great benefit for health care providers in taking care of obese adolescents.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the impact ofobesity has on the behaviors and attitudes regarding self-perception, health outlook, and eating behavior in the mildly obese and the moderately-to-severely obese Thai adolescents.
  
  
  METHODS
  Participants were obese students who were being followed at the school-based Teen Health Clinic on a regular basis. All participants were followed regularly at their respective school-based Teen Health Clinics. Each participant s percent weight for height was calculated by using Thai National Growth charts. Participants were categorized into 2 groups according to the percent weight for height (% WFH). Those with% WFH below 120% was considered not obese and excluded from the study. The two participating groups were% WFH of 120-140% who are mildly obese (M-O group) and % WFH of greater than 140% who are moderately-severely obese (M-S-O group). A 3-part questionnaire was used to assess the impact of obesity on emotional and psychosocial aspects of each participant, their eating and nutritional attitude and their level of physical activity.
  
  
  RESULTS
  Of the 5366 students, grade 7-12 who attended 2 metropolitan Bangkok schools, 678 were diagnosed as overweight or obese. There were 175 obese students who attended the clinic regularly were asked to participate in this study and there were 167 adolescents who completed the questionnaires recruited for this study. Both the M-O and M-S-O groups reported dissatisfaction with their body weight (85.9% and 91.7% respectively) and perceived their need for weight reduction. The M-S-O groups expressed more concerns to lose their weight for medical reasons than the M-O group (52.1% vs. 35.2%, p-value < 0.03). Being obese was shown to have more significant impact to their confidence in M-S-O group than the M-O group (71.9% vs. 50.7%, p < 0.005). The students in M-O group eat lunch regularly otherwise M-S-O group, few of them, skips lunch meal (100% vs. 93.8%, p < 0.032).
  
  
  CONCLUSIONS
  From our study, significant obese adolescents were shown to have poorer self-image with greater prevalence being shown in the significantly obese group.
authors.affiliation: Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Supinya
authors.initials: S
authors.lastname: In-iw
authors.forename: Boonying
authors.initials: B
authors.lastname: Manaboriboon
authors.forename: Chulathida
authors.initials: C
authors.lastname: Chomchai
mesh_terms: D000293:Adolescent; D044466:Asian People; D001294:Attitude to Health; D001828:Body Image; D015992:Body Mass Index; D015331:Cohort Studies; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D012649:Self Concept; D012720:Severity of Illness Index; D013785:Thailand