title: Pressure To Be Thin and Insulin Sensitivity Among Adolescents.
abstract: OBJECTIVE
  Extant research indicates that some of the comorbidities associated with adult obesity may be adversely affected by the stress resulting from negative body image and weight-related stigma. This study examined the association between weight-related pressure and insulin sensitivity in adolescents, who are vulnerable to both weight-based teasing and the onset of metabolic dysregulation.
  
  
  METHODS
  Participants were 215 adolescent healthy volunteers (55% female; 59% white; 35% overweight/obese; mean ± standard deviation age = 15.4 ± 1.4 year), who completed a self-report measure of pressure to be thin from parents, friends, and romantic partners. Fasting blood samples were obtained to assess serum insulin and glucose, which were used to calculate insulin sensitivity; fat mass (kg) and fat-free mass (%) were measured with air-displacement plethysmography. Pubertal stage was determined by physical examination.
  
  
  RESULTS
  Pressure to be thin was positively associated with fasting insulin (p = .01) and negatively associated with insulin sensitivity (p = .02), after controlling for pubertal stage, sex, race, height, fat-free mass, and adiposity. Pressure to be thin was associated with a greater odds of having hyperinsulinemia (fasting insulin ≥ 15 μIU/mL; odds ratio (95% confidence interval): 1.65 [1.08-2.50], p = .02), adjusting for the same covariates.
  
  
  CONCLUSIONS
  Results indicate that adolescents perceiving more pressure to be thin have greater elevations of fasting insulin and poorer insulin sensitivity above and beyond the effect of fat mass. Future research is warranted to elucidate the mechanisms responsible for this relationship.
authors.affiliation: Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland.
authors.forename: Natasha A
authors.initials: NA
authors.lastname: Schvey
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland; Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado.
authors.forename: Lauren B
authors.initials: LB
authors.lastname: Shomaker
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland; Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado.
authors.forename: Nichole R
authors.initials: NR
authors.lastname: Kelly
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland.
authors.forename: Courtney K
authors.initials: CK
authors.lastname: Pickworth
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland; Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado.
authors.forename: Omni
authors.initials: O
authors.lastname: Cassidy
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland.
authors.forename: Ovidiu
authors.initials: O
authors.lastname: Galescu
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Demidowich
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland.
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Brady
authors.affiliation: Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USUHS), Bethesda, Maryland; Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland.
authors.forename: Marian
authors.initials: M
authors.lastname: Tanofsky-Kraff
authors.affiliation: Section on Growth and Obesity, Program in Developmental Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, DHHS, Bethesda, Maryland. Electronic address: jy15i@nih.gov.
authors.forename: Jack A
authors.initials: JA
authors.lastname: Yanovski
mesh_terms: D050154:Adiposity / Q000502:physiology; D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D005006:Ethnicity; D005215:Fasting; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D009765:Obesity; D013851:Thinness / Q000503:physiopathology* / Q000523:psychology
chemical_list: D001786:Blood Glucose; D007328:Insulin
keywords: Adolescents; Insulin; Insulin sensitivity; Pressure to be thin