Girls with obesity in adolescence are associated with lower educational attainment and income-related outcomes and are less likely to be married in young adulthood compared with girls without adolescent obesity, according to a study published in Obesity. The effects of childhood obesity on adult education, income, and partnership may be partially mediated by psychosocial variables, including depression.
The investigators of this prospective cohort study sought to examine the associations between obesity in adolescence and social and economic outcomes in adulthood, such as educational attainment, income, and partnered status. Furthermore, the investigators explored psychosocial variables that may have affected the association, including depression, self-esteem, and weight-related teasing.
The study sample included 1796 participants from the longitudinal, population-based Project EAT study (Eating and Activity in Teens and Young Adults); data was drawn from Project EAT time points from 1998 to 1999 (EAT-I) and 2015 to 2016 (EAT-IV). Body weight and height were measured at baseline and demographic and psychosocial factors were self-reported at EAT-I. Outcomes of education, income, and partnered status reported in the follow-up EAT-IV were assessed for associations with baseline obesity using logistic regression modeling. Using multivariate probit regression models, the investigators estimated the mediated effects of self-esteem, depression, and weight-related teasing on the outcome associations. Study analyses were stratified by gender and were adjusted for race, age at baseline, and parental socioeconomic status.
At baseline, the cohort of adolescents had a mean age of 14 years and 13% had obesity, which was more prevalent among boys (16%) than girls (10%). In both primary outcome models and mediated models, all 3 outcomes were significantly associated (P <.01) with baseline obesity in girls. Girls with obesity in adolescence were significantly less likely to have earned a bachelor’s degree (odds ratio [OR], 0.32; 95% CI, 0.18-0.58; P <.001), reach an annual income level of $50,000 or more (OR, 0.57; 95% CI, 0.33-0.99; P <.04), or be partnered in adulthood (OR, 0.45; 95% CI, 0.27-0.75; P <.002) compared with girls without adolescent obesity. No associations between negative adult outcomes and adolescent obesity were observed among boys in the study. In girls, depression was found as a mediating factor for associations between adolescent obesity and educational attainment (8.5%) and between adolescent obesity and income (23.6%).
Limitations of the study included the inability to generalize the findings to other populations, as the respondents were all recruited from school districts in Minnesota. The self-reported data may also have introduced social desirability bias. The number of mediators were limited by the questions available on the survey, and covariables from different time points were not included in mediation analyses. No information on discrimination was collected or analyzed, which may have contributed to lower adult outcomes of education and income.
The investigators concluded that adolescent girls with obesity were less likely to achieve a bachelor’s degree, make more than $50,000 per year, or enter marriage/partnership in young adulthood compared with girls without obesity. “Greater public awareness of the multifaceted causes of obesity and greater public acceptance of obesity might help reduce the discrimination faced by women with obesity in educational, occupational, and social settings,” stated the researchers.
French SA, Wall M, Corbeil T, Sherwood NE, Berge JM, Neumark-Sztainer D. Obesity in adolescence predicts lower educational attainment and income in adulthood: the Project EAT longitudinal study. Obesity. 2018; 26(9):1467-1473. doi:10.1002/oby.22273