Newman, Denise L., Lisa M. Sontag, and Rebecca Salvato. "Psychosocial aspects of body mass and body image among rural American Indian adolescents." Journal of youth and adolescence 35.2 (2006): 265-75.
In this study, Newman and coauthors focused on 134 adolescents, 90% of whom were Lumbee and 10% of whom were American Indian mixed with Black or White. 57% of the adolescents were female. The students were studied in two assessment periods, two years apart. In the first sampling (called Wave 1), most students were in 7th or 8th grade; in the second (called Wave 2), most were in 9th or 10th grade. The students were part of the Teen Pathways Study, an unselected sample of community volunteers. Both the adolescents and their parents filled out questionnaires. What was measured: Height and weight: During Wave 1 and Wave 2, the adolescents' height and weight were obtained through self-report. [Newman notes that in previous studies of adolescents, self-reports tend to be quite accurate, with only slight upward biases in height reports and downward biases in weight reports.] Then, body mass index (BMI) was calculated. Body image: During Wave 2, the adolescents' body image was assessed using a 9-item self-report scale. The scale contained questions from the Body Shape questionnaire and the Eating Attitudes Test. Health and weight control: During Wave 1 and Wave 2, the adolescents health and weight control behaviors were assessed using a 6-question survey adapted from the national longitudinal study of adolescent health (Add-Health). The questions inquired about the adolescents' overall assessment of their health, as well as their smoking, exercise, and dieting habits. Psychosocial adjustment: During Wave 1 and Wave 2, the adolescents were assessed, using self-report measures, for anxiety or depression, somatization, and social problems using subscales of the Youth Self-Report. Global self-esteem: Assessed during both Wave 1 and Wave 2 using the 10-item Rosenberg Self-Esteem Scale. Peer acceptance: Assessed during both Wave 1 and Wave 2 using a 6-item self-report scale. Ethnic identity: Assessed during both Wave 1 and Wave 2 using the Affirmation and Belonging subscale of the Multigroup Ethnic Identity Measure (MEIM). Summary of results: • 18% of the adolescents were overweight, and 23% were obese. These rates are higher than the national average for children and adolescents of all races but are similar to rates in other American Indian communities. 55% of the boys in the study were overweight or obese, as were 31% of the girls. • In girls, a statistically significant association was found between heavier weight and both earlier age of onset for smoking and greater amount of cigarette smoking. • A modest correlation was found between heavier BMI and greater body dissatisfaction. • Body dissatisfaction was related to anxiety or depression, somatization, social problems (such as bullying, teasing, or friendship problems), and not feeling accepted by peers. • The strongest predictor of body image in high school was global self-esteem in middle school. • Overweight status per se, as measured by BMI, in middle school was not a strong predictor of psychosocial functioning in high school. • Peer acceptance in middle school predicted positive body image in high school for both genders. • When middle school boys engaged in positive cultural activities with peers and felt pride and affiliation regarding their American Indian identity, this contributed to positive body image in high school.