A new longitudinal study led by UCL researchers finds that body dissatisfaction at the age of 11 is associated with an increased risk of depression by the age of 14. The findings, published in The Lancet Psychiatry, show that body image concerns explain a large proportion of the relationship between BMI and depression in children, particularly in girls.
The Wellcome-funded study included 13,135 Millennium Cohort Study participants, a UCL-led nationally representative birth cohort study of people born between 2000 and 2002.
The researchers discovered that having a high BMI at the age of seven was associated with increased depressive symptoms (such as low mood, loss of pleasure, and poor concentration) by the age of 14, as well as greater body dissatisfaction at the age of 11. They discovered that body dissatisfaction played a significant role in the link between BMI at age seven and subsequent depressive symptoms, accounting for 43% of the association. All three of these associations were twice as strong in girls as they were in boys.
Many public health strategies seek to reduce weight in childhood. Primary school children are being taught about the importance of calories and exercise, and all young people in England are being weighed at school to determine whether weight loss efforts are needed.
Emma Blundell
Lead author Dr Francesca Solmi (UCL Psychiatry) said: “Depression has become more common among young people, as have having an overweight BMI, and body dissatisfaction. Here we have found strong longitudinal evidence that a high BMI in childhood is linked with an increased risk of depressive symptoms multiple years later.”
“However, we were particularly interested in how much body dissatisfaction could be the driving force behind this link.” We discovered compelling evidence that being dissatisfied with one’s appearance is associated with increased depressive symptoms years later. Our findings suggest that any efforts to reduce childhood obesity should consider the potential mental health consequences, in order to avoid stigmatizing weight and instead support children’s mental health and wellbeing.”
The study did not address what other factors, aside from body dissatisfaction, could explain why children with high BMI are more likely to develop depressive symptoms, but they suggest that other biological (for example, inflammation) or environmental (for example, bullying) pathways could explain a portion of the association.
First author Emma Blundell, trainee clinical psychologist at UCL Psychology & Language Sciences, said: “Many public health strategies seek to reduce weight in childhood. Primary school children are being taught about the importance of calories and exercise, and all young people in England are being weighed at school to determine whether weight loss efforts are needed. Whilst promoting a healthy diet and exercise is important, it may be that some public health messaging could be fostering feelings of guilt or shame.
“It is important to ensure that any interventions to reduce BMI in childhood do not inadvertently increase body dissatisfaction and harm children’s mental health.”
Some strategies for addressing body image concerns in early adolescence have been developed, according to the researchers, such as psychological interventions or media literacy training that could address self-esteem, social comparisons, and social media influences, but more research is needed to more effectively address body image concerns in young people.
Dr. Solmi went on to say: “Reducing body dissatisfaction in young people could be an important way of preventing depression, particularly in girls, at ages when social environments and peer relations become increasingly impactful.”
