elementary schools, and reported that concerns about being obese and dissatisfaction with body size were highly prevalent, increased with increasing BMI, and present—although to varying degrees—in all socioeconomic strata and ethnic groups. Furthermore, a study of 4,700 adolescents in Minnesota public schools (grades 7 through 12; mean age was 15 years) found high body satisfaction (versus low or moderate) in only 20 percent of girls and 34 percent of boys (Neumark-Sztainer et al., 2002).

Several studies have examined potential correlates of body image dissatisfaction and weight concerns or dieting practices, particularly gender, ethnicity, and socioeconomic status. Most of the studies that have examined ethnic differences consistently find less weight concern, less body size dissatisfaction, and a heavier ideal body size in African-American girls compared with white girls, but not necessarily boys, and sometimes demonstrate significant differences within African Americans across different socioeconomic levels (e.g., concern was greater at higher levels) (Thompson et al., 1997; Brown et al., 1998; Halpern et al., 1999; Adams et al., 2000; Neumark-Sztainer et al., 2002). These findings in children and adolescents are generally parallel to the numerous studies in adults indicating a relatively lower level of weight concern and higher level of body satisfaction in black women compared to white women; even considering the higher weight levels of the black women (Flynn and Fitzgibbon, 1998).

In contrast to the data for African Americans, available studies suggest that weight concerns in Hispanic and Asian girls are comparable to or exceed those in non-Hispanic white girls (Robinson et al., 2001; Neumark-Sztainer et al., 2002). The finding in Hispanic girls is consistent with data in adults (Serdula et al., 1999). Data for Native Americans in the Minnesota study (which were adjusted for grade level, socioeconomic status, and BMI) indicated a similar level of body satisfaction to that in white girls, but a significantly lower level of concern about controlling their weight (Neumark-Sztainer et al., 2002).

Socioeconomic Status

Socioeconomic status has generally been inversely associated with obesity prevalence (see Chapter 2) and children with obese mothers and low family income were found to have significantly elevated risks of becoming obese, independent of other demographic and socioeconomic factors (Strauss and Knight, 1999). When compared with food-insufficient households of higher income, low-income food-insufficient households had more obese children; however, food insufficiency by itself was not associated with self-reported measures of childhood obesity (Casey et al., 2001). Other studies have not been able to show a clear relationship between childhood



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