Adolescent obesity and life satisfaction

Adolescent obesity and life satisfaction:Perceptions of self,peers,family,and schoolRenata Forste *,Erin MooreDepartment of Sociology,Brigham Young University,2008JFSB,Provo,UT 84602,United States1.IntroductionAmerican youth are on track to become the most obese generation of adults in history (Caprio,2006).The Center for Disease Control reports a 12percent increase in obesity prevalence for both children and teens between 1980and 2006(Center for Disease Control and Prevention,2009).The negative effects of obesity are dramatic and extensive,especially for youth.In addition to apparent physical risks,such as diabetes and asthma (Center for Disease Control and Prevention,2009),obesity among youth is associated with negative self-esteem,withdrawal from peer interac-tion,depression,anxiety,and the feeling of chronic rejection (Deckelbaum and Williams,2001;Ge et al.,2001;Strauss and Pollack,2003).All of these factors can negatively influence the overall well-being and life satisfaction of teens.In addition,the negative effects of childhood obesity have implications for future well-being (Cawley and Spiess,2008).Life satisfaction has been defined as an ‘‘overall judgment that one’s life is a good one’’(Diener,1984;Park,2004).Positive or subjective well-being is central to healthy youth development.Because it is a complex psychological entity,examining adolescent life satisfaction requires a comprehensive understanding of the multiple factors that influence adolescents’perceptions of their own lives.The intersection of family,school,and peer contexts provide adolescents with multiple,and sometimes con-flicting messages about themselves.The rejection or internalization of such messages can influence the way adolescents interpret their well-being.A wide body of interdisciplinary research indicates that individuals’self-perceptions are connected to how they believe they are perceived and evaluated by others (Crosnoe and Muller,2004;Leary et al.,2003;Schlenker and Wowra,2003).For adolescents in particular,this internalization of perceived evaluation has an especially profound effect on self-appraisal and overall well-being.Studies of children and adolescents find that life satisfaction is influenced by personal factors (internal control,self-efficacy),as well as by family and peer relationships.In contrast,demographic factors such as age and gender are less influential (Huebner,1991;Park andEconomics and Human Biology 10(2012)385–394A R T I C L E I N F OArticle history:Received 19April 2012Accepted 20April 2012Available online 4May 2012Keywords:Obesity Overweight Satisfaction Adolescents Self-perceptionA B S T R A C TThis study contributes to research on adolescent life satisfaction by considering its association with body weight,as mediated by perceptions of self,peers,family,and school.Data from the Health Behaviors in School-Age Children Survey (2001–2002)and OLS regression techniques are used to examine the association between body weight and life satisfaction.We also model these relationships by gender.Results indicate lower life satisfaction among adolescents that are overweight and obese relative to healthy weight youth,and that most of the negative association operates through perceptions of self,peers,parents,and school.We find little or no gender difference in the association between body weight and perceptions of self,peers,parents,and school;however,we find perceptions of body weight are generally more strongly associated with low life satisfaction among girls compared to boys.ß2012Elsevier B.V.All rights reserved.*Corresponding author.Tel.:+18014223146;fax:+18014220625.E-mail addresses:renata_forste@ (R.Forste),e.moore07@ (E.Moore).Contents lists available at SciVerse ScienceDirectEconomics and Human Biologyj o u rn a l ho m e p a g e :h t t p ://w w w.e l s e v i e r.c o m /l o c a t e /e h b1570-677X/$–see front matter ß2012Elsevier B.V.All rights reserved./10.1016/j.ehb.2012.04.008Huebner,2005;Park,2004).Perceived feedback from parents,peers,and teachers influences the life satisfaction of adolescents through self-evaluation.We expect that such feedback is especially important to the life satisfac-tion of obese adolescents,in part because of the stigmatization of obesity and its effect on relationships (Carmalt et al.,2008;Carr and Friedman,2005).In this paper,we examine the effects of obesity on life satisfaction through the mediating influence of self,peer, parent,and school perceptions.We also consider the moderating effects of gender on the relationships between body weight,perceptions,and life satisfaction.In the following sections,wefirst highlight in Section2the literature outlining the relationship between obesity and life satisfaction and the mediating effects of self,peer, family,and school perceptions among children and teens. Second we present in greater detail in Section3the moderating influence of gender on these relationships.We describe our data and methods in Section4and present our empirical results in Section5.Thefinal section discusses our primary conclusions.2.Mediating factors between obesity and life satisfactionCertain studies have directly connected body weight to life satisfaction.Ball et al.(2004),in a longitudinal study of Australian young women,found weight status to be associated with life satisfaction.Greater body mass (BMI)was associated with less satisfaction and reduced aspirations(Ball et al.,2004).The negative effect of obesity on life satisfaction tends to be stronger for females than males because external pressure to be thin is experienced to a greater extent by females(Dohnt and Tiggemann, 2006;Thompson et al.,1999;Schwartz et al.,1999).But despite some evidence of a direct connection,it is likely that obesity’s negative effect on life satisfaction operates through social factors(Huebner,1991;Park,2004). Prejudice,bias,and discrimination are often experienced by obese individuals through social interaction(Carr and Friedman,2006;Latner et al.,2005;Puhl and Brownell, 2003).Thus,obese individuals encounter different social interactions than non-obese individuals,and these inter-actions will influence their subjective well-being.In this section,we examine how obese individuals’weight is related to their perceptions of self and social interactions.2.1.Obesity and self-perceptionsThe self-evaluations of obese youth include perceptions of attractiveness.These evaluations are centered in part on perceptions of stigmatization.Obesity is a strongly stigmatized state in western cultures,where the associa-tion of thinness with success and attractiveness is pervasive(Klaczynski et al.,2004;Thompson and Stice, 2001).Individuals in stigmatized social statuses receive less social acceptance and experience bias,discrimination, and stereotyping(Latner et al.,2005;Puhl and Latner, 2007).Among adults,this stigmatization is reportedly experienced in all aspects of life(Carr and Friedman,2005, 2006).Given this prominence of negative messages about their condition,it is to be expected that obesity in youth will be connected to negative self-perceptions.Studies rating the attractiveness of varying body types indicate that attractiveness ratings by both men and women observers are strongly correlated with body mass index(BMI)in that the more obese thefigure,the less attractive the rating(Tove´e et al.,2002).Among women observers,attractiveness ratings are influenced by the BMI of the observer;the thinner the observer,the lower the body mass they rate as attractive(Tove´e et al.,2000).Thus, the more obese youth are,the more likely they are to perceive themselves as not attractive(Franklin et al., 2006).Additionally,by the early teen years,obese youth report lower levels of self-esteem compared to their non-obese counterparts(Strauss,2000;Franklin et al.,2006).Self-esteem generally drops during adolescence(especially for girls)and then rises gradually through adulthood;it is relatively stable across the lifespan in that individuals with low self-esteem at one point in time likely have low self-esteem later in life(Robins and Trzesniewski,2005).Obese teens with decreased self-esteem show increased lone-liness,sadness,and nervousness(Ge et al.,2001;Strauss, 2000).Thus,lower self-esteem among obese youth is associated with feeling down or depressed(Baumeister et al.,2003;Grant et al.,1999).The negative consequences of low self-esteem are thought to extend through adulthood;adolescents with low self-esteem are at increased risk for mental and physical health problems in their adult years(Trzesniewski et al.,2006).2.2.Obesity and peersObese teens often encounter stigmatization through interacting with their peers.Prejudice,bias,and discrimi-nation can be part of their daily experience and this negative stigma can result in a social identity that is devalued in social contexts(Puhl and Brownell,2003; Strauss and Pollack,2003).The stigmatization of obesity often leads to further social marginalization during adolescence(Strauss and Pollack,2003).Even among adults,obesity is stigmatized by both the obese and non-obese(Latner et al.,2005).Various studies have identified negative consequences of obesity for peer interactions.Obese youths’devaluation in social contexts is demonstrated by indicators such as lower status attainment and smaller friendship circles (Crosnoe et al.,2008;Merten et al.,2008).Obese children have been described by teachers as more isolated than non-obese children,and are less likely to be nominated by peers as a‘‘best friend’’(Zeller et al.,2008).Studies of teens have also found overweight adolescents to be more socially isolated and on the periphery of social networks compared to healthy weight adolescents(Crosnoe et al.,2008;Strauss and Pollack,2003).The stigmatization of obese children and teens can lead to bullying and rejection from peers(Neumark-Sztainer et al.,1998;Puhl and Brownell,2003),as well as increased psychological distress(Bond et al.,2001;Myers and Rosen,1999).Victims of bullying are more vulnerable and disliked by other peers(Veenstra et al.,2007)and suchR.Forste,E.Moore/Economics and Human Biology10(2012)385–394 386stigmatization and isolation acts to further isolate teens from peer networks(Pellegrini and Bartini,2000).Obese youth perceive not only social isolation but direct discrimination and harm because of their appearance; these youth are more likely to report both verbal and physical bullying than their normal weight peers(Janssen et al.,2005;Wills et al.,2006).2.3.Obesity and the family and schoolThe family context is a complex,multidimensional construct with patterns of interactions that provide context for child development and socialization(Kitzmann et al.,2008).There is some evidence that overweight and obese children experience more negative family interac-tions than normal weight children,such as nonauthor-itative parenting and more frequent family conflict;the causal direction of this relationship is unclear,as the family context may contribute to negative health among children, but it is also possible that the child’s overweight condition has negative effects on his or her family interactions (Haworth-Hoeppner,2000;Kitzmann et al.,2008).Child obesity status has been linked to increased maternal distress and less positive family mealtime interactions (Zeller et al.,2007).Additionally,some overweight youth report being harassed by family members about their weight and eating habits(Wills et al.,2006)or experience pressure from parents to diet(Neumark-Sztainer et al., 2008).Building on the work of Cawley(2004)which uncov-ered a negative relationship between obesity and wages, Sabia(2007)found a negative relationship between body mass index and grade point average among white adolescent girls,but not among nonwhite females or males.He argues that this negative relationship may be the result of lower self-esteem or psychological stress among obese white girls,or it could be that teachers discriminate against overweight girls by giving them lower grades (Sabia,2007).Thus,poorer academic achievement may reflect discrimination or stigmatization by teachers or school peers and lead to negative attitudes towards academic success and school among obese adolescents.3.Moderating influence of genderWe expect that the relationship between obesity and young people’s evaluation of their lives is related to their perceptions of themselves,and their interactions and perceptions of peers,families,and schools.However,we suspect that this relationship may not be universal. Research suggests that gender may moderate the associa-tion between obesity and life satisfaction;studies of adolescentsfind an association between obesity and depressive symptoms or lower levels of status attainment among teenage girls,but not among teen boys(Merten et al.,2008).Extensive literature also documents the tendency for females to internalize the pressure to be thin and experience negative body image and body dissatisfac-tion(Thompson et al.,1999;Thompson and Stice,2001), and girls are more likely than boys to dislike themselves (Crosnoe,2007).We anticipate similar gender differences in our analysis,in that the way in which perceptions mediate the relationship between obesity and life satisfac-tion will differ for girls and boys.In particular,we expect the negative relationship between obesity and self,peer, family,and school perceptions to be stronger for girls than boys,and that these factors will be more predictive of life satisfaction for girls than boys.In summary,adolescents’self-evaluations are largely dependent on perceptions that develop through social interactions.As part of a socially stigmatized group, overweight and obese individuals experience different social interactions relative to healthy weight individuals and these differences are associated with lower life satisfaction.In the following analysis,we use a nationally representative sample of middle and high school students to explore the relationship between obesity and life satisfaction as mediated through their perceptions of self, peers,parents,and school.We expect a negative relation-ship between body size and life satisfaction and anticipate that much of this association will be mediated by negative perceptions of self,parents,peers,and school.Wefirst examine how the association between body size and life satisfaction is mediated by perceptions,and then we examine the association between obesity,perceptions,and life satisfaction as moderated by gender.4.Data and methods4.1.SampleData for this study come from the Health Behavior in School-Aged Children(HBSC),2001–2002.This is a nationally representative sample of students in grades6 through10during the2001–2002school year in the US. Data collection was conducted by the United States Department of Health and Human Services in collaboration with the World Health Organization.Students were asked questions about nutrition,physical activity,violence, relationships with family and friends,perceptions of school,alcohol and tobacco use,and the community in which they lived.The total student sample is14,817 children and adolescents in middle and high school.The data are weighted to adjust for the school selection sampling frame and non-response.Height and weight measures are self-reported.Based on the formula:[weight(lbs)/height(in.)Âheight(in.)]Â703, the US Department of Health and Human Services computed the body mass index(BMI)for each student with complete height/weight data.BMI percentiles were then calculated according to gender and age.Our analyses are based on 12,493middle and high school students in the US aged 10–17.The mean age of students in the sample is13.5years of age.Thus,the sample is primarily of younger teens,aged 12–15(78percent of the sample).Data are weighted to adjust for non-response.The sampling weights were computed based on the probabil-ities of selection at each sampling stage and then adjusted for both school and student non-response;the sampling weights were also normalized before being applied in the analyses.The individual student sampling weight utilizes the probability of having selected the respondent’s schoolR.Forste,E.Moore/Economics and Human Biology10(2012)385–394387and classroom,adjusted for school non-response and student non-response within classrooms.Thus,the data are nationally representative of middle and high school students.Multiple imputation was used to estimate values for missing data in IBM SPSS Statistics19.The purpose of multiple imputation is to create multiple imputed data sets for a data set with missing values based on variables that contain complete data.The multiple analyses are then combined to yield a set of results(Royston,2004).In general,multiple imputation techniques require that missing observations are missing at random.All of the variables missing data were missing less than4percent of cases.4.2.Model specificationsTo measure life satisfaction students were asked,‘‘Here is a picture of a ladder.The top of the ladder‘10’is the best possible life for you and the bottom‘0’is the worst possible life for you.In general,where on the ladder do you feel you stand at the moment?’’Thus,our dependent variable is a scale ranging from0to10indicating how satisfied students are with their life in general.Student characteristics include BMI category,gender, age,race,and whether or not the student had entered puberty.BMI categories are coded according to the Center for Disease Control categories as follows:(1)underweight (<5th percentile);(2)healthy weight(between5th and 85th percentile);(3)overweight(between85th and95th percentile);and(4)obese(>95th percentile).Healthy weight is the reference category.Gender is dichotomous and coded1for boys and0for girls.Race is measured by dummy variables according to the following categories: white,black,or other race.White is the reference category. Puberty is also a dichotomous measure coded1if girls indicated that they had begun to menstruate,and0 otherwise;for boys puberty it is coded1if they reported having facial hair,and0otherwise.Student self perceptions measure how attractive they perceive themselves to be,and how often they feel low. Attractiveness ratings are based on responses to the question:‘‘Do you think you are..?’’–reverse coded as: 1=not at all good looking,2=not very good looking, 3=about average,4=quite good looking,and5=very good looking.Students were also asked to report how often in the past six months they had felt low.Reponses were reverse coded:1=rarely or never,2=about every month, 3=about every week,4=more than once a week,and 5=about every day.Perceptions of peers are measured by reports of being bullied,and feelings of peer acceptance at school.Students were asked about being bullied in the last couple of months at school.Questions asked how often(1)they were bullied in general,(2)they were called mean names,made fun of, or teased in a hurtful way,(3)they were left out of things on purpose by other students,excluded by their group of friends,or completely ignored,(4)they were hit,kicked, pushed,shoved,or locked indoors,or(5)they had lies told about them or false rumors spread about them by students trying to make others dislike them.Reponses to these questions were based on the following scale:1=I have not been bullied in this way in the past couple of months, 2=only once or twice,3=2or3times a month,4=about once a week,and5=several times a week.Responses were averaged across thefive questions to create a composite measure of being bullied.The Cronbach’s alpha was.84for this measure.Student acceptance is based on agreement with the statement:‘‘Other students accept me as I am’’–reverse scaled as1=strongly disagree,2=disagree, 3=neither agree nor disagree,4=agree,and5=strongly agree.Perceptions of family indicate how easy teens report it is to talk with their parents.Ease of talking to parents is measured by the question:‘‘How easy it is to talk to the following persons about things that really bother you?’’Questions are asked separately for mother,father,step-mother,and stepfather.If students indicated they did not have or see their mother or father,but indicated having a step parent,the step parent response was used for the relationship with mother or father.The response cate-gories are reverse coded as:1=very difficult,2=difficult, 3=easy,4=very easy.Teen perceptions of school are measured by how they think their teachers view their academic success,and how much they like school.Students reported their academic achievement by responding to the question:‘‘In your opinion,what do your class teachers think about your school performance compared to your classmates?’’–reverse scaled as:1=below average,2=average,3=good,and4=very good.Students were also asked,‘‘How do you like school at present?’’–reverse scaled as:(1)I don’t like it at all,(2)I don’t like it very much,(3)I like it a bit,and(4)I like it a lot.The relationship between body weight,perceptions of self,peers,family,and school and life satisfaction are modeled using ordinary least squares regression.Coeffi-cients in thefinal models represent the change in life satisfaction for every unit increase in the independent variables.Following multiple imputation for missing data, ourfirst analyses examine associations between body weight and the mediating factors:self,peer,family,and school perceptions.Next we consider how self,peer, family,and school perceptions mediate the relationship between body weight and life satisfaction.Finally,we further explore these mediating influences and the relationship between body weight and life satisfaction by gender.Prior to reporting our regression results,we present descriptive statistics for the student,peer,family, and school perception measures for all students,as well as by body size.5.Results and discussionWe present descriptive statistics in Table1.Thefirst column includes all students in the sample.The next three columns are by weight status(healthy weight,overweight, obese).Subscripts in the last column indicate significant mean differences between healthy weight,overweight, and obese students based on post hoc analysis of variance tests.Because our emphasis is on larger body types,we do not include separate analyses for underweight youth. Means presented are weighted to represent the USR.Forste,E.Moore/Economics and Human Biology10(2012)385–394 388population of students,grades6to10,and all mean differences reported in the table were statistically sig-nificant at the p<.01level.5.1.Descriptive statisticsOn average,students report moderately high life satisfaction(7.5on10point scale);although average satisfaction declines somewhat as body weight increases. Only four percent of the students sampled are underweight, with the majority,68percent,reporting healthy weight for their height and age.Sixteen percent are overweight,and11 percent are categorized as obese.Forty-eight percent of the sample are boys,with heavier students being more likely to be boys than girls(62percent of obese students are male). The average age in the sample is13.5years,67percent are white and15percent are African American.A higher percentage of obese students are African American com-pared to healthy and overweight students.About three fourths of the students had entered puberty,and this percent also increases somewhat with body size.Self perception measures indicate that on average students rate their looks as just above average,however, the mean self ratings decline as body size increases.On average,students report that they feel low about once a month,and overweight teens report feeling low more often than healthy weight teens.Peer perceptions indicate that on average students were bullied less than once or twice in the past couple of months.The mean frequency of being bullied is higher among obese teens compared to lower weight teens.Students generally agree that they are accepted by peers,but agreement is lowest among obese teens.On average students report that it is easy to talk to their parents and they report greater ease talking with mothers than fathers.Obese teens report greater difficulty talking with mothers compared to lower weight teens;in contrast, there are no differences by weight regarding ease of talking to fathers.Students generally report that their teachers rate their academic success as average to good,with overweight teens reporting lower mean achievement than healthy weight teens.Students report liking school a bit on average,and this perception does not differ by body size.These descriptive statistics by weight category suggest that generally self,peer,family,and school perceptions are more negative the larger their body size.In addition, the more overweight the student,the lower their life satisfaction.To consider these relationships more fully,we now turn to the multivariate analyses and the mediating influence of self,peer,family,and school perceptions on the association between body weight and life satisfaction.5.2.Weight weight and perceptions of self,peers,parents,and schoolRegression models werefirst estimated to consider the relationship between body weight and self,peer,parent,Table1Means and standard deviations for student characteristics and self,peer,family,and school perceptions by weight status.All students (n=12,493)Healthy weight(n=8383)Over-weight(n=2066)Obese(n=1506)CharacteristicsLife satisfaction1–107.46(1.99)7.53(1.94)7.38(2.02)7.12(2.12)a WeightUnderweight.04(0.20)Healthy weight.68(0.47)Overweight.16(0.37)Obese.11(0.32)Boy.48(0.50).45(0.50).54(0.50).62(0.48)a Age13.50(1.57)13.56(1.55)13.46(1.56)13.44(1.58)b RaceWhite.67(0.47).69(0.46).63(0.48).60(0.49)a Black.15(0.35).13(0.34).17(0.37).20(0.40)a Other race.19(0.39).18(0.38).21(0.40).20(0.40)a Puberty.76(0.42).76(0.43).81(0.39).80(0.40)b Self perceptionRating of looks1–5d 3.52(0.97) 3.59(0.95) 3.43(0.96) 3.20(1.00)a Feeling low1–5d 2.04(1.32) 2.00(1.29) 2.13(1.36) 2.21(1.45)b Peer perceptionBullied past couple of months1–5d 1.51(0.80) 1.48(0.76) 1.53(0.84) 1.67(0.93)c Feel accepted1–5d 3.87(1.10) 3.92(1.06) 3.84(1.12) 3.64(1.24)a Family perceptionTalk to mother1–4d 2.94(1.02) 2.95(1.01) 2.92(1.02) 2.86(1.06)c Talk to father1–4d 2.42(1.07) 2.42(1.06) 2.41(1.08) 2.38(1.12) School perceptionAcademic success1–4d 2.85(0.86) 2.87(0.85) 2.80(0.88) 2.77(0.89)b Like school1–4d 2.80(0.90) 2.80(0.90) 2.78(0.90) 2.76(0.92)Notes.Standard deviations reported in parentheses;statistics are weighted to represent population parameters;sample sizes are reported unweighted.a ANOVA,Tukey B post hoc test,all three means differ p<.01.b ANOVA,Tukey B post hoc test,mean for healthy weight differs from other means p<.01.c ANOVA,Tukey B post hoc test,mean for obese weight differs from other means p<.01.d Rating of looks(1=not at all good looking to5=very good lookind);feeling low(1=rarely or never to5=about every day);bullied(1=not bullied to 5=several times a week);feel accepted(1=strongly disagree to5=strongly agree);talk to mother/talk to father(1=very difficult to4=very easy); academic success(1=below average to4=very good);like school(1=I don’t like it at all to4=I like it a lot).R.Forste,E.Moore/Economics and Human Biology10(2012)385–394389and school perceptions;coefficients are presented in Table 2.The models include measures of gender,age,race,and puberty status in addition to body weight.Only the body weight coefficients are presented in the table.With the exception of liking school,obesity was associated with self,peer,family and school perceptions.The more obese the student,the lower they rated their attractiveness,and the more often they reported feeling down or low relative to healthy weight teens.In addition,the more obese the student,the more they reported being bullied and the less they agreed that they felt accepted by their peers.Obese teens,compared to healthy weight teens,reported greater difficulty in talking with parents,as well as lower academic assessment from their teachers at school.Thus,obese teens in particular reported more negative perceptions of self,peers,parents,and school relative to healthy weight teens.Next we examine the mediating influence of these perceptions on the relationship between body weight and life satisfaction.5.3.Weight status,perceptions,and life satisfactionModel estimates predicting life satisfaction are pre-sented in Table 3.The first column includes body weight categories and demographic characteristics of the student.The following columns examine separately the mediating influence of self,peer,family,and school perceptions.The final column is the full model examining all of the student characteristics and perceptions on life satisfaction.Model 1confirms the pattern found in Table 1–life satisfaction decreases as body weight increases.Boys report higher satisfaction than girls,and satisfaction declinesTable 2Association between weight status and self,peer,family,and school perceptions (mediating factors),unstandardized regression coefficients (n =12,493).Weight aSelf perceptionPeer perceptionFamily perceptionSchool perceptionLooksFeeling lowBullied Feel acceptedTalk to motherTalk to fatherAcademic successLike schoolUnderweight À.008À.009.085*À.069À.015.037.031.014Healthy Ref.Ref.Ref.Ref.Ref.Ref.Ref.Ref.Overweight À.206***.159***.042*À.094***À.016À.046À.048*À.009ObeseÀ.475***.281***.180***À.289***À.086**À.117***À.065**À.014Notes .Statistics are weighted to represent population parameters;sample sizes are reported unweighted.aModels include controls for gender,age,race,and puberty.*Significance level for 0.01<p <0.05.**Significance level for 0.001<p <0.01.***Significance level for p <0.001.Table 3Weight status and mediating measures of self,peer,family,and school perceptions associated with life satisfaction,unstandardized regression coefficients (n =12,493).Model 1WeightModel 2SelfModel 3PeersModel 4FamilyModel 5SchoolModel 6FullModel intercept 9.366***8.212***8.187*** 6.695*** 6.076*** 4.660***Characteristics WeightUnderweight .019.018.077.013.000.026Healthy weight Ref.Ref.Ref.Ref.Ref.Ref.Overweight À.175***À.004À.122**À.154***À.151***À.005Obese À.478***À.129*À.297***À.407***À.444***À.098*Boy .326***.098**.351***.176***.481***.190***Age À.125***À.067***À.115***À.070***À.070***À.017Black .205***À.215***.109*.280***.181***À.106*Whiteref.ref.ref.ref.ref.ref.Other race À.179***À.193***À.176***À.094*À.144***À.117**PubertyÀ.374***À.311***À.374***À.293***À.306***À.242***Self perception Rating of looks .425***.304***Feel lowÀ.526***À.383***Peer perception BulliedÀ.359***À.141***Feel accepted .409***.149***Family perception Talk to mother .380***.235***Talk to father .325***.158***School perception Academic success .423***.277***Like school .432***.234***R 2adj.036***.219***.130***.124***.128***.308****Significance level for 0.01<p <0.05.**Significance level for 0.001<p <0.01.***Significance level for p <0.001.R.Forste,E.Moore /Economics and Human Biology 10(2012)385–394390。