Reference values for height, weight and body mass index of German born Turkish children

Turkish children and adolescents born in Northern Europe grow different from native Northern European children, but reference values for height, weight and BMI for these children do not exist. With this study, we intend to provide growth standards for German born Turkish children. Data were obtained from 797 Turkish children and adolescents born in Germany age 0-25.8 years (males), respectively 0-18.3 years (females). We generated synthetic reference values for height, weight, and BMI. The results show that Turkish children and adolescents are heavier after the age of 6 years, and that they remain short after puberty. Eighteen year old Turkish men, and 15-year-old Turkish women are shorter (males 175.2 cm vs. 180.4 cm, p < 0.05; females 159.3 cm vs. 165.0 cm, p < 0.05), and heavier than Germans. Six out of 53 young Turkish men and 9 out of 100 young Turkish women were obese. Twelve out of 53 young Turkish men (23%) and 18 out of 100 young Turkish women (18%) have fallen below the 3rd centile for height. It can be concluded that growth of Turkish children and adolescents born in Germany significantly differs from native children. Reference LMS values for body height, weight and BMI of German born Turkish boys and girls are presented.     

Social jet lag,chronotype and body mass index in 14–17-year-old adolescents

The relationship between sleep duration and obesity in adolescents is inconclusive. This may stem from a more complex relationship between sleep and obesity than previously considered. Shifts toward evening preferences, later sleep–wake times and irregular sleep–wake patterns are typical during adolescence but their relationship to body mass index (BMI) has been relatively unexplored. This cross-sectional study examined associations between sleep duration, midpoint of sleep and social jet lag (estimated from 7 days of continuous actigraphy monitoring), and morningness/eveningness with BMIs (BMI z-scores) and waist-to-height ratios in 14–17-year-old adolescents. Seventy participants were recruited from ninth and tenth grades at a public high school. Participants’ characteristics were as follows: 74% female, 75% post-pubertal, 36% Hispanic, 38% White, 22% Black, 4% Asian and 64% free/reduced lunch participants with a mean age of 15.5 (SD, 0.7). Forty-one percent of the participants were obese (BMI ≥ 95th percentile); 54% were abdominally obese (waist-to-height ratio ≥ 0.5). Multivariable general linear models were used to estimate the association between the independent variables (school night sleep duration, free night sleep duration, midpoint of sleep (corrected), social jet lag and morningness/eveningness) and the dependent variables (BMI z-scores and waist-to-height ratios). Social jet lag is positively associated with BMI z-scores (p < 0.01) and waist-to-height ratios (p = 0.01). Midpoint of sleep (corrected) is positively associated with waist-to-height ratios (p = 0.01). After adjusting for social jet lag, school night sleep duration was not associated with waist-to-height ratios or BMI z-scores. Morningness/eveningness did not moderate the association between sleep duration and BMI z-scores. Findings from this study suggest that chronobiological approaches to preventing and treating obesity may be important for accelerating progress in reducing obesity rates in adolescents.     

Self-perceived body weight status and weight-control behaviors of high school students in a southern city of Turkey

Defining "healthy weight" is not easy and for an adolescent with all concerns about newly developing physiognomy it is even harder. The aim of this study was to find out the frequency of obesity and the association between the body mass index (BMI), weight-control behaviors and self-perceived body weight status in high school students of a southern city of Turkey. The students from 10 schools were randomly selected among 46,271 students of 72 high schools in Adana from 1999 to 2000. The response rate was 94.8% (2352/2480). The Turkish version of Youth Risk Behavior Survey Questionnaire (YRBSQ) was completed by the students. The students' weights and heights were measured. The mean age was 16.5 +/- 1.0 years of age (range = 14-21 years). The mean BMI was 21.0 +/- 3.1, 25.5% of students were underweight, 65.7% were normal, 6.4% were overweight and 2.3% were obese (p = 0.0001). Of all students, 24.3% defined themselves as thin, 45.3% as normal, 24.9% as overweight and 5.5% as obese (p = 0.0001). The percentage of girls defining their body weight as overweight and obese was significantly higher than the boys (p = 0.0001). Of all students, 35.5% wanted to lose weight, 22.3% wanted to gain weight, 27.8% wanted to keep their current weight. Intention (p = 0.0001) and interventions to lose weight such as going on a diet (p = 0.0001), provocative vomiting (p = 0.0001) and 24-hours starving (p = 0.0001) were significantly higher in girls than boys. Of students, 26.8% (n=620) were on a diet program either to lose or to keep their body weight. There was significant relationship between being on a diet program and intention to change body weight (p = 0.047). We concluded that adolescents living in Adana have relatively higher risk of being underweight than being obese and have unhealthy weight changing plans due to their misperception of their body images. Adolescents may be unconscious on plans and attempts to change their body weights and nutrition and we suggest that education on nutrition and health is required for adolescents.     

Reference Growth Curves for Cypriot Children 6 to 17 Years of Age

Objective: The purpose of the study was to present smoothed percentiles for body weight and height, waist circumference, and body mass index (BMI) in Cypriot children and to compare their BMI 85th and 95th percentiles with those of children in other countries. Research Methods and Procedures: The study was a cross‐sectional study, including a representative sample of 2472 healthy children (49.1% boys) in Cyprus ages 6 to 17 years, who were evaluated during the 1999–2000 school year. Body weight and height and waist circumference were measured using standard procedures. BMI was calculated as weight in kilograms per height in square meters. Smoothed, sex‐specific percentiles for these variables were calculated using polynomial regression models. Crude weight, height, waist, and BMI percentile values are presented in sex‐specific tables and smoothed percentile curves are presented in charts. The 85th and 95th percentiles for BMI were compared with measurements from other countries, because of the concern of the upper limits of BMI in respect to the evaluation of obesity. Results: The 85th and 95th BMI percentile values are higher in Cypriot boys than in Swedish and Iranian boys through all ages and in girls ages 6 to 15 years, whereas after the age of 15 years, both Swedish and Iranian girls’ percentiles are equalized with their Cypriot peers. Discussion: Weight, height, waist circumference, and BMI values and charts are presented for the first time for Cypriot children and adolescents. Much concern should be addressed to the observation that for the majority of the Cypriot sample, the upper BMI limits are higher than the peers of developing and developed countries.     

School level contextual factors are associated with the weight status of adolescent males and females

Objective: To determine whether school context influences the BMI of adolescent males and females. Methods and Procedures: Our sample was 17,007 adolescents (aged 12–19) from the National Longitudinal Study of Adolescent Health (Add Health). We used gender‐stratified multilevel modeling to examine the contribution of schools to the overall variance in adolescent BMIs, calculated from self‐reported weight and height. We then examined the associations of individual attributes with BMI after controlling for the average BMI of the school and the association of two school‐level variables with BMI. Results: Participants attended schools that were segregated by race/ethnicity and socioeconomic status (SES). In females, when controlling only for individual‐level attributes, individual household income was inversely associated (β = ?0.043, P = 0.01) while Hispanic (β = 0.89, P < 0.001) and black (β = 1.61, P < 0.001) race/ethnicity were positively associated with BMI. In males, Hispanic (β = 0.67, P < 0.001) race/ethnicity was positively associated with BMI; there was no difference in the BMIs of blacks compared with whites (β = 0.24, P = 0.085). After controlling for the school racial/ethnic makeup and the school level median household income, the relationship between individual race/ethnicity and BMI was attenuated in both male and female adolescents. Higher school level median household income was associated with lower individual BMIs in adolescent girls (γ = ?0.37, P < 0.001) and boys (γ = ?0.29, P < 0.001) suggesting a contextual effect of the school. Discussion: Male and female adolescents attending schools with higher median household incomes have on average lower BMIs. Resources available to or cultural norms within schools may constitute critical mechanisms through which schools impact the BMI of their students.     

Secular changes in height, body weight, body mass index and pubertal development in male children and adolescents in Krakow, Poland

This study examined the secular changes in height, body weight, body mass index and pubertal development in male children and adolescents in Krakow (Poland) over the past 80 years, with an emphasis on the last decade (2000-2010). The survey of the population of Krakow is a continuation of observations conducted in that area for many years. The analysis aims to determine whether in the last decade Krakow still witnessed the secular trend, and what form the trend took. The body height and weight, and body mass index (BMI), of 1862 boys aged 3.5-18.5 years were analysed, against the background of a survey series from the years 1938 (N = 1801), 1971 (N = 2045), 1983 (N = 3124) and 2000 (N = 2328). The mean body height, in almost all age categories, was greater than in the past; however the final height over the last decade remained the same. The mean values of body weight and BMI increased, especially in the last decade. Also, an acceleration of puberty in boys was observed. The last 10 years saw an over 3-month decrease in the age of initial appearance of pubic hair in boys. In conclusion, the last decade saw cessation of the growing taller trend: maximum body height stabilized at approximately 179 cm, but weight and BMI increased. Also, a distinct acceleration of puberty was noticed. Lack of height increase, at the same time as weight gain and puberty acceleration, indicate a progressing developmental disharmony.     

Birth weight and body composition in overweight Latino youth: a longitudinal analysis

To examine the associations between birth weight and BMI, and total body composition, in overweight Latino adolescents. Two hundred and forty-two overweight Latino children (baseline age = 11.1 +/- 1.7 years; BMI >or= 85th percentile) were measured annually for up to 6 years (2.6 +/- 1.4 observations/child, total 848 visits). Birth weight and history of gestational diabetes were obtained by parental interview. Visceral fat and subcutaneous abdominal fat were assessed by magnetic resonance imaging, while total body fat, total lean tissue mass (LTM), trunk fat, and lean tissue trunk mass were measured by dual-energy X-ray absorptiometry. BMI and BMI percentile were calculated using the Centers for Disease Control and Prevention age appropriate cutoffs. Longitudinal linear mixed effects (LME) modeling was used to evaluate the influence of birth weight on subsequent changes in body composition and distribution of fat across puberty. Birth weight significantly predicted BMI (P < 0.001), total trunk fat (P < 0.001), total trunk LTM (P < 0.001), total fat mass (FM) (P < 0.001), and total LTM (P < 0.001), but not subcutaneous (P = 0.534) or visceral fat (P = 0.593) at age 11 years. Longitudinally, as participants transitioned into puberty, birth weight did not significantly predict any of the body composition or fat distribution measures (P > 0.05). Birth weight is significantly associated with increased adiposity and LTM and negatively associated with trunk fat mass and trunk lean mass at baseline; however these relationships did not predict rate of change of any of the variables as the children progress through adolescence.     

Effect of an environmental school-based obesity prevention program on changes in body fat and body weight: a randomized trial

This study tested the efficacy of two school-based programs for prevention of body weight/fat gain in comparison to a control group, in all participants and in overweight children. The Louisiana (LA) Health study utilized a longitudinal, cluster randomized three-arm controlled design, with 28 months of follow-up. Children (N = 2,060; mean age = 10.5 years, SD = 1.2) from rural communities in grades 4-6 participated in the study. Seventeen school clusters (mean = 123 children/cluster) were randomly assigned to one of three prevention arms: (i) primary prevention (PP), an environmental modification (EM) program, (ii) primary + secondary prevention (PP+SP), the environmental program with an added classroom and internet education component, or (iii) control (C). Primary outcomes were changes in percent body fat and BMI z scores. Secondary outcomes were changes in behaviors related to energy balance. Comparisons of PP, PP+SP, and C on changes in body fat and BMI z scores found no differences. PP and PP+SP study arms were combined to create an EM arm. Relative to C, EM decreased body fat for boys (-1.7 ± 0.38% vs. -0.14 ± 0.69%) and attenuated fat gain for girls (2.9 ± 0.22% vs. 3.93 ± 0.37%), but standardized effect sizes were relatively small (<0.30). In conclusion, this school-based EM programs had modest beneficial effects on changes in percent body fat. Addition of a classroom/internet program to the environmental program did not enhance weight/fat gain prevention, but did impact physical activity and social support in overweight children.     

Relationship of parity and body condition score to pregnancy rates in Florida beef cattle

Pregnancy rates, determined by per rectum palpation, were analyzed with respect to cow parity (range 1 to >8 calvings) and body condition score (BCS, 1=thin to 9=fat) at pregnancy examination for 3734 beef cattle females on 3 commercial beef operations (8 herds) in 3 Florida counties in 1989 and 1990. The means and standard deviations for the herds were the following: pregnancy rate, 81.3 +/- 39% (range 62.1 to 91.5%); BCS, 4.7 +/- 0.6 (range 4.3 to 4.9); and parity, 3.9 +/- 2.3 (range 2.8 to 4.8). Significant associations were found between pregnancy rate, parity, BCS and herd (P < 0.001); and between the variable interactions, parity with BCS, herd with BCS, and herd with parity (P < 0.001). Cows with a BCS /=5 had a pregnancy rate of 90%. Cows having a parity of <4 had a PR of 80%, while cows having a parity >/=4 had a PR of 85%. The interaction of parity with BCS was significant, resulting in pregnancy rates as follows; parity <4 and BCS /= 5 was 88%; parity >/=4 and BCS /=5 and BCS >/= 5 was 93%. Body condition, parity, and the interaction of body condition and parity play important roles in the reproductive performance of commercial beef cows in Florida.     

Associations of adiposity with measured and self-reported academic performance in early adolescence

Objective: To examine the associations of adiposity with measured and self‐reported academic performance independently of demographics and physical activity among U.S. adolescents. Research Methods and Procedures: We surveyed 666 students 11 to 14 years old from seven middle schools in Los Angeles, CA. Weight and height were measured. Actual grade point average was obtained from school records. Self‐reported school grades and physical activity time were measured by questionnaire. Adiposity measures included BMI, BMI percentile (≥85th percentile defined as at‐risk‐of‐overweight), and percentage body fat (bioimpedance). Results: After adjusting for gender, ethnicity, age, and physical activity time, overweight at‐risk status, BMI, and percentage body fat were negatively related to only self‐reported (p < 0.01) but not measured grades. Level of moderate‐to‐vigorous physical activity time was negatively related to measured and self‐reported grades, independently of adiposity (p < 0.01). Discussion: To our knowledge, this is the first study to examine both body mass and body fat in relation to measured and self‐reported school grades. Adiposity did not relate to actual academic performance in a sample of predominantly Latino and Asian‐American adolescents. The use of measured vs. self‐reported academic outcomes may represent different constructs and influence study conclusions. Cultural factors may also play a role in our findings, but this requires further study.     

Menarcheal onset is associated with body composition parameters but not with socioeconomic status

In the present study the menarcheal status (pre-or postmenarcheal), body composition, weight status, and socioeconomic parameters such as type of school and parental educational level as of 1752 female adolescents ageing between 12 and 18 years (x = 14.6) from rural areas of Eastern Austria were documented. Furthermore the association patterns between body composition, socioeconomic parameters and menarcheal status were analyzed. It turned out, that body composition parameters such as BMI, lean body mass and absolute and relative fat mass were significantly associated with menarcheal status. Postmenarcheal girls were taller and exhibited a higher weight status, a higher absolute and relative amount of fat mass and a higher amount of lean body mass than their premenarcheal counterparts of the same age. In contrast to the significant association between body composition and menarcheal status, no significant impact of educational level on menarcheal status, indicating socioeconomic status could be documented.     

A Longitudinal Study of Sedentary Behavior and Overweight in Adolescent Girls

The aim of this study is to examine sedentary and light activity in relation to overweight in adolescent girls. Adolescent girls were randomly recruited from 36 schools participating in the Trial of Activity for Adolescent Girls (TAAG). Assessments included age, ethnicity, socioeconomic status, and body composition estimated from weight, height, and triceps skinfold. Sedentary and light activity was measured for 6 days using accelerometry in 6th and in 8th grade among two randomly sampled cross‐sections of girls. Sedentary activity increased from the 6th to 8th grade by 51.5 min/day. In the 8th grade, a significantly higher number of hours in sedentary activity for each of the 6‐days of measurement were evident with higher tertiles of percent body fat (30–35%, >35% fat) (P < 0.05), but not across all increasing tertiles of BMI (5th to 85th, 85th to 95th, and >95th percentiles). The increase in sedentary activity was observed on weekdays, but not on weekends for percent body fat tertiles. In the cohort of girls measured in both 6th and 8th grades, the mean cross‐sectional coefficient estimates were significant for percent body fat, but not BMI for sedentary and light activities. Adolescent girls from the 6th to 8th grade are shifting their time from light to more sedentary activity as measured by accelerometers. In addition, the increase in sedentary activity is not associated with an adverse effect on BMI or percent body fat. The eventual impact of this shift to a more sedentary lifestyle on body composition and other outcomes needs to be evaluated further.     

Physical Activity,TV Viewing,and Weight in U.S. Youth: 1999 Youth Risk Behavior Survey

Objective: To examine the relationship between physical activity, TV watching, and weight in U.S. youth ages 14 to 18 years. Research Methods and Procedures: Data from a nationally representative sample of 15,143 U.S. high‐school students participating in the 1999 Centers for Disease Control and Prevention (CDC) Youth Risk Behavior Survey were examined. Prevalence rates of participation in moderate physical activity (MPA), vigorous physical activity (VPA), and television watching (TV) were determined. The association between MPA, VPA, TV and the body mass index (BMI) and overweight status (BMI ≥85th percentile of age‐ and sex‐specific CDC/National Center for Health Statistics reference values) were examined by analysis of covariance and logistic regression. Results: Overall, 45% reported participating in MPA ≥3 d/wk, 65% reported participating in VPA ≥3 d/wk, and 25% reported watching TV ≥4 h/school day. Boys reporting six to seven bouts of MPA had a significantly lower BMI compared with boys reporting three to five or less than two. The mean BMI differed significantly between the lowest and highest levels of MPA groups in girls. The mean BMI was significantly lower in the highest VPA group compared with the other two groups in both sexes. There was a significant graded response for BMI across all levels of TV. Decreased levels of MPA and 3 to 4 days of VPA were significantly associated with an increased risk of overweight in boys when compared with those engaging in 6 to 7 d/wk (odds ratio = 1.26 to 1.37). A graded response existed between TV and overweight in both sexes. Boys and girls were ～20% to 25% less likely to be classified as overweight if they reported 2 to 3 hours of TV per day and ～40% less likely to be classified as overweight if they reported ≤1 hour of TV per day compared with those who watched ≥4 hours of TV. In general, youth who engaged in less physical activity watched more TV per week. Discussion: Increased levels of physical activity are associated with a lower BMI and less TV watching. However, the relationship between TV watching and weight status is more pronounced.     

Recognition of Childhood Overweight during Health Supervision Visits: Does BMI Help Pediatricians?

Objective: To assess, in diverse pediatric practices, the frequency of overweight/obesity (OW/OB) identification during health supervision visits and its association with BMI curve use. Research Methods and Procedures: Pediatricians in public and private practice in St. Louis, MO, participated in a study of the care of chronic conditions during health supervision visits. Requested information from 30 visits per pediatrician of children 6 to 17 years of age included the visit note, the growth chart, and a one‐page questionnaire about patient demographics and visit content. Pediatricians indicated the presence and discussion of common chronic conditions, including OW/OB. Identification was compared with patient BMI category, and associations between identification and patient and visit characteristics, including BMI curve use, were examined. Results: Twenty‐one (40%) of contacted pediatricians returned information from 557 visits. Pediatricians identified OW/OB in 27% of children with a BMI at the 85th to 94th percentile and 86% of children with a BMI at or above the 95th percentile. Identification was higher in adolescents but was not associated with patient sex or race, practice setting, insurance type, or visit length. Only 41% of growth charts were current, and 6.1% had BMI plotted. BMI plotting was associated with OW/OB identification when the BMI was at the 85th to 94th percentile but not when the BMI was at or above the 95th percentile. After controlling for BMI percentile, OW/OB identification was significantly associated with diet counseling (odds ratio, 7.46; 95% confidence interval, 3.42 to 16.24) and exercise counseling (odds ratio, 5.57; 95% confidence interval, 2.61 to 11.90). Discussion: Despite low BMI curve use, pediatricians recognized most overweight/obese children with a BMI at or above the 95th percentile. BMI plotting may increase recognition in mildly overweight children.     

Which Metric of Relative Weight Best Captures Body Fatness in Children?

Objective: To evaluate the relative merits of BMI (kilograms per meter squared) and age‐ and gender‐adjusted BMI, age‐ and gender‐specific z score of BMI, and age‐ and gender‐specific percentiles of BMI as surrogate measures of body fatness among a sample of youth. Research Methods and Procedures: The sample comprised 596 children and adolescents 5 to 18.7 years old and was 40% male and 55% white. Height and weight were measured by trained research staff. DXA was used to determine body fat mass. BMI, age‐ and gender‐specific percentile of BMI, and age‐ and gender‐specific z scores of BMI were computed, and these metrics were compared with measured body fatness. Results: The BMI values in the sample ranged from 12.9 to 55.0 kg/m², with a mean of 24.9 kg/m². The Spearman correlations with percentage body fat were similar for all of the BMI metrics (r = 0.82 to 0.88). Linear regression models with age‐ and gender‐specific percentiles of BMI explained significantly less of the variance (65%) than models with log‐transformed BMI (81%) or age‐ and gender‐specific z scores of BMI (75% to 79%). z scores were the most accurate at classifying children who were overfat (sensitivity = 0.84, specificity = 0.96 for z score ≥1). However, using a BMI ≥85th percentile or a BMI ≥20 kg/m² was also accurate at classifying youth. Discussion: The BMI metrics had similar correlations with body fatness, but age‐ and gender‐specific percentiles of BMI were the least accurate proxy measure of body fatness. However, a BMI z score ≥1, BMI percentile ≥85, and BMI ≥20 kg/m² are all useful for identifying children who may be overfat.     

The effect of maternal obesity on self-esteem and body image

Abstract stress, dissatisfaction and the feeling of inadequacy experienced as a result of the change in appearance caused by weight gain affects self -esteem and body image of pregnant women negatively. The aim of this study was to determine the relationship between maternal obesity, self-esteem and body image. The study was performed through a questionnaire in a state hospital in Trabzon, Turkey with 300 unselected pregnant women who were recruited from the delivery unit. As data collection tools, Body Image Scale (BAS) and Coopersmith Self-Esteem Scale (GIS) were used between April and May 2016. According to BMI variables, 12.3%, 57.0% and 30.7% of the pregnant women were normal, overweight and obese respectively and gained an average of 12.11?±?3.03?kg during pregnancy. Accordingly, the majority of pregnant women who participated in this study were found to be overweight and obese. While the body image of pregnant women surveyed in this study was at a high level (158.84?±?21.34), their average self-esteem was found at a moderate level (64.01?±?15.88). Based on BMI, 56.8% of the women with normal weight perceived themselves as normal, 48.0% of overweight women perceived themselves as normal and 53.3% of obese women perceived themselves as overweight. There was a positive significant relationship between participants' body image and their BMI (r?=?0.119 p?<?0.05). The pregnant women with normal BMI were more likely to feel satisfied. While 56.8% of the pregnant women at normal weight based on BMI were found to feel satisfied and 43.3% of those overweight felt satisfied, 54.3% of obese ones did not feel satisfied. A weak positive significant correlation was found between body image and self-esteem (r?=?0.172; p?=?0.003?<?0.05). As the self-esteem increases, body image increases, too. It was found that the majority of pregnant women were overweight and obese according to BMI and their average body image and self-esteem were high and medium level respectively.     

Independent effects of social position and parity on body mass index among Polish adult women

This study evaluated the strength of the independent effects of social position (expressed by educational level) and number of childbirths on body mass index (BMI) variation of Polish adult females. The material comprised 2045 pre-menopausal women aged 35-50, who were healthy and occupationally active inhabitants of the city of Wroc?aw, Lower Silesia, Poland. Two-way analysis of variance (ANOVA) revealed that both educational level (F = 34.7; p = 0.0001) and parity (F = 5.6; p = 0.001) exerted independent significant effects on BMI. The mean BMI of women who had attended basic vocational or trade school at the very most (27.0 kg/m2) was greater than that of women who had completed secondary school education or had graduated from university (25.3 kg/m2). However, it is worthy of note that there were no social differences in BMI values between childless women. Nevertheless, an increasing number of childbirths was essentially related to increasing female BMI in each social group, and this tendency was most marked among women of lower social position. Regardless of educational level, the highest prevalence of obesity (BMI exceeding 30 kg/m2) was found among females with at least three children (15.6%, and 26.4% of women from higher or lower social groups, respectively).     

Weight reduction in obese adolescents with and without binge eating

Little is known about binge eating (BE) in adolescents. The primary aim of the present study was to examine the relationship between BE and weight loss in adolescents (BMI ≥95th percentile) enrolled in a randomized controlled trial of behavioral and pharmacologic treatment of obesity. Participants were 82 treatment-seeking adolescents (BMI = 37.9 ± 3.8 kg/m(2); age = 14.1 ± 1.2 years; 67% females; 42% African American, 55% white). Participants completed the Children's Depression Inventory (CDI), the Piers Harris Self-Esteem Questionnaire, and the Eating Inventory (including cognitive restraint, disinhibition, and hunger scales). BE was assessed by a questionnaire and a confirmatory interview. At baseline, 24% of participants met criteria for BE (N = 13 met full BE disorder (BED) criteria; N = 7 met subthreshold BE). There were no significant differences in percentage reduction in initial BMI between participants with or without BE at month 6 (-7.0 ± 1.6 vs. -6.9 ± 0.9%) or month 12 (-8.8 ± 2.4 vs. -8.3 ± 1.3%) (omnibus main effect BE P = 0.89, interaction BE × time P = 0.84, interaction BE × drug P = 0.61). The rate of BE declined significantly over time from 24% (n = 20) at baseline to 8% (n = 6) at month 6 and 3% (n = 2) at month 12 (P = 0.003). There were significant decreases in hunger and disinhibition as well as an increase in cognitive restraint over time (all P ≤ 0.0001). Findings suggest a combination of behavioral and pharmacologic therapy may produce both weight loss and improvement in BE.     

Weight Loss Surgery Eligibility According to Various BMI Criteria Among Adolescents

A BMI cutoff point at the 99th percentile for age and gender or at 40 kg/m² has been suggested for more aggressive treatment of adolescent obesity. The main objective of this study was to determine the proportion of adolescents eligible for weight loss surgery (WLS) based on various BMI cutoff points. Data was extracted from the electronic medical record database of an urban pediatric ambulatory care center over 4 years. National data were used to calculate BMI percentiles (Centers for Disease Control and Prevention (CDC), 2000). Eligibility for WLS was based on a BMI percentile criterion (≥99th percentile) or the adult WLS cutoff point (≥40 kg/m²). The sample consisted of 3,220 adolescents aged 12–17.9 years, of which 53% were female, 55% were of black race, and 17% of Hispanic ethnicity. Overall, 88 (3%) adolescents had a BMI ≥40 kg/m² and 236 (7%) had a BMI ≥99th percentile (P < 0.001). All adolescents with BMI ≥40 kg/m² had a BMI ≥99th percentile. A total of 159/2,007 (8%) of 12–14.9‐year olds had a BMI ≥99th percentile compared with 77/1,213 (6%) 15–17.9‐year olds (P = 0.10), whereas 43/2,007 (2%) of 12–14.9‐year olds had a BMI ≥40 kg/m² compared with 45/1,213 (4%) 15–17.9‐year olds (P = 0.003). In summary, a relatively large proportion of adolescents from a diverse urban population would qualify for WLS based on the percentile criterion. Fewer adolescents would be eligible based on the adult WLS criterion, and younger adolescents would be less likely to be eligible for WLS than older adolescents.