RESUMEN
BACKGROUND: Previous research has related obesity to body dissatisfaction and low self-esteem. This study aimed to evaluate this relation between obesity and distress about appearance. METHODS: We performed a cross-sectional study using data from the Korea Youth Risk Behavior Web-based Survey for 288,390 participants assessed from 2009 to 2012. The participants were categorized according to body mass index; obese, overweight, healthy weight, and underweight. The relation between obesity and distress was analyzed using simple and multiple logistic regression with complex sampling adjusted for age, sex, region of residence, economic level, parental education level, alcohol consumption, and smoking habits as confounders. RESULTS: The adjusted odds ratio (AOR) was higher for participants with obesity (AOR for healthy weight = 1.15 [95% confidence interval {CI}, 1.08–1.22]; AOR for overweight = 1.85 [95% CI, 1.72–1.98]; AOR for obese = 2.45 [95% CI, 2.27–2.64]; reference = underweight, P < 0.001). In males, healthy weight was associated with an AOR below 1 (AOR for healthy weight = 0.92 [95% CI, 0.85–0.99]; AOR for overweight = 1.26 [95% CI, 1.14–1.38]; AOR for obese = 1.66 [95% CI, 1.50–1.84], P < 0.001). In females, higher AORs were associated with obesity (AOR for healthy weight = 1.44 [95% CI, 1.33–1.57]; AOR for overweight = 2.71 [95% CI, 2.45–2.99]; AOR for obese = 3.71 [95% CI, 3.32–4.14], P < 0.001). CONCLUSION: Obesity is related to distress about appearance, and the relation is stronger in girls than in boys.