A prospective study of body image dissatisfaction and BMI change in school-age children.
OBJECTIVE
Body image dissatisfaction (BID) in school-age children is positively associated with weight status in cross-sectional studies; however, it is uncertain whether BID is a risk factor for the development of adiposity over time. The aim of the present study was to examine the association of BID with changes in BMI in school-age children.


METHODS
Longitudinal study. At recruitment, children were asked to indicate the silhouette that most closely represented their current and desired body shapes using child-adapted Stunkard scales. Baseline BID was calculated as the difference of current minus desired body image. Height and weight were measured at recruitment and then annually for a median of 2·5 years. Sex-specific BMI-for-age curves were estimated by levels of baseline BID, using mixed-effects models with restricted cubic splines.


METHODS
Public primary schools in Bogotá, Colombia.


METHODS
Six hundred and twenty-nine children aged 5-12 years.


RESULTS
In multivariable analyses, thin boys who desired to be thinner gained an estimated 5·8 kg/m2 more BMI from age 6 to 14 years than boys without BID (P = 0·0004). Heavy boys who desired to be heavier or thinner gained significantly more BMI than boys without BID (P = 0·003 and P = 0·007, respectively). Thin girls who desired to be heavier or thinner gained significantly less BMI than girls without BID (P = 0·0008 and P = 0·05, respectively), whereas heavy girls who desired to be heavier gained an estimated 4·8 kg/m2 less BMI than girls without BID (P = 0·0006). BID was not related to BMI change in normal-weight children.


CONCLUSIONS
BID is associated with BMI trajectories of school-age children in a sex- and weight-specific manner.
1Department of Environmental Health Sciences,University of Michigan School of Public Health,Ann Arbor,MI,USA.
Ofra
O
Duchin
2Fundación para Investigación en Nutrición y Salud,FINUSAD,Bogotá,Colombia.
Constanza
C
Marin
2Fundación para Investigación en Nutrición y Salud,FINUSAD,Bogotá,Colombia.
Mercedes
M
Mora-Plazas
3Department of Epidemiology,University of Michigan School of Public Health,M5055 SPH II,1415 Washington Heights,Ann Arbor,MI 48109-2029,USA.
Carlos
C
Mendes de Leon
4Division of Pediatric Endocrinology,University of Michigan,Ann Arbor,MI,USA.
Joyce M
JM
Lee
3Department of Epidemiology,University of Michigan School of Public Health,M5055 SPH II,1415 Washington Heights,Ann Arbor,MI 48109-2029,USA.
Ana
A
Baylin
3Department of Epidemiology,University of Michigan School of Public Health,M5055 SPH II,1415 Washington Heights,Ann Arbor,MI 48109-2029,USA.
Eduardo
E
Villamor
D057215:Body Dysmorphic Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D015992:Body Mass Index; D002648:Child; D002657:Child Development; D002664:Child Nutritional Physiological Phenomena / Q000208:ethnology; D002675:Child, Preschool; D015331:Cohort Studies; D003105:Colombia / Q000453:epidemiology; D004032:Diet / Q000009:adverse effects* / Q000208:ethnology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D050177:Overweight / Q000208:ethnology / Q000209:etiology / Q000523:psychology*; D063766:Pediatric Obesity / Q000208:ethnology / Q000209:etiology / Q000523:psychology*; D015995:Prevalence; D012574:Schools; D012737:Sex Factors; D014504:Urban Health / Q000208:ethnology; D015430:Weight Gain
BMI change; Body image dissatisfaction; Childhood obesity