Life Course Body Mass Index and Adolescent Self-Esteem: Evidence from Hong Kong's Children of 1997 Birth Cohort

ObjectiveSelf-esteem is an important determinant of adolescent mental health. Prior adiposity may be a factor in the development of self-esteem. However, the association of adiposity with self-esteem is inconsistent, perhaps because adiposity and self-esteem tend to be socially patterned, making it unclear whether observed associations are biologically based or contextually specific. MethodsMultivariable partial least squares regression was used to assess the adjusted association of birth weight and childhood body mass index (BMI) z-score at 3 and 9 months and at 3, 7, 9 and 11 years and changes in BMI z-score with self-esteem at approximate to 11 years, assessed from the self-reported Culture Free Self-Esteem Inventory in a population-representative Chinese birth cohort, which has little social patterning of adiposity. Whether the associations varied by sex also was assessed. ResultsSelf-esteem score was available for 6,520 girls and boys (78.5% follow-up). Birth weight z-score, BMI z-scores at 3 and 9 months and at 3, 7, 9, and 11 years, and successive BMI z-score changes had little association with self-esteem at approximate to 11 years, adjusted for socio-economic position. ConclusionsIn a developed, non-Western setting, life course BMI does not appear to be a factor in the development of self-esteem in early adolescence, suggesting that observed associations to date may be contextually specific rather than biologically based.