Background and Methods Overweight in adolescents may have deleteriouseffects on their subsequent self-esteem, social and economiccharacteristics, and physical health. We studied the relationbetween overweight and subsequent educational attainment, maritalstatus, household income, and self-esteem in a nationally representativesample of 10,039 randomly selected young people who were 16to 24 years old in 1981. Follow-up data were obtained in 1988for 65 to 79 percent of the original cohort, depending on thevariable studied. The characteristics of the subjects who hadbeen overweight in 1981 were compared with those for young peoplewith asthma, musculoskeletal abnormalities, and other chronichealth conditions. Overweight was defined as a body-mass indexabove the 95th percentile for age and sex.
Results In 1981, 370 of the subjects were overweight. Sevenyears later, women who had been overweight had completed feweryears of school (0.3 year less; 95 percent confidence interval,0.1 to 0.6; P = 0.009), were less likely to be married (20 percentless likely; 95 percent confidence interval, 13 to 27 percent;P<0.001), had lower household incomes ($6,710 less per year;95 percent confidence interval, $3,942 to $9,478; P<0.001),and had higher rates of household poverty (10 percent higher;95 percent confidence interval, 4 to 16 percent; P<0.001)than the women who had not been overweight, independent of theirbase-line socioeconomic status and aptitude-test scores. Menwho had been overweight were less likely to be married (11 percentless likely; 95 percent confidence interval, 3 to 18 percent;P = 0.005). In contrast, people with the other chronic conditionswe studied did not differ in these ways from the nonoverweightsubjects. We found no evidence of an effect of overweight onself-esteem.
Conclusions Overweight during adolescence has important socialand economic consequences, which are greater than those of manyother chronic physical conditions. Discrimination against overweightpersons may account for these results.
Source Information
From the Department of Health and Social Behavior, Harvard School of Public Health (S.L.G., A.M.S.), the Department of Pediatric Gastroenterology and Nutrition, New England Medical Center (A.M., W.H.D.), and the Department of Pediatrics, Harvard Medical School (J.M.P.) -- all in Boston.
Address reprint requests to Dr. Gortmaker at the Department of Health and Social Behavior, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115.
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