obese chinese primary-school students and low self-esteem: a cross-sectional study

Objectives: the aim of this study was to examine several factors related to low self-esteem among obese chinese primary-school students. methods: a cross-sectional study was conducted between june 2009 and june 2010. a total of 1,410 primary-school students (china grades 4 - 6) in changsha city were divided into normal weight (n = 1,084), overweight (n = 211), and obese groups (n = 115) according to world health organization (who) growth standards for body mass index (bmi). the students were assessed using the self-esteem scale (ses)anda general situation questionnaire. caregivers completed questionnaires about their child’s weight status. self-esteem levels were explored; any factors related to low self-esteem were analyzed using logistic regression analysis. results: the average self-esteem score among overweight or obese primary-school students was found to be lower than that of normal-weight students. the proportion of students with low self-esteem in the obese group was more than that in the normalweight and overweight groups. multiple logistic regression analysis showed that obesity status (odds ratio [or], 3.74; 95% confidence interval [ci], 2.25 - 6.22), overweight status(or, 2.60; 95% ci, 1.71 - 3.95), obesity considered by children’s grandparents(or, 1.76; 95% ci, 1.05 - 2.96), dissatisfaction with height (or, 1.55; 95% ci, 1.11 - 2.18), and dissatisfaction with weight (or, 1.45; 95% ci, 1.05 - 2.01) were the risk factors for low self-esteem for primary-school students, while satisfaction with academic performance was a protective factor (or, 0.22; 95% ci, 0.07 - 0.71). conclusions: for chinese primary-school students, low self-esteem is associated with higher weight status and self-perceived body shape and academic performance. in addition, grandparental opinion of a child’s weight also contributes to low self-esteem.