Weight-Related Teasing of Adolescents Who Are Primarily Obese: Roles of Sociocultural Attitudes Towards Appearance and Physical Activity Self-Efficacy.

Adolescents who are obese are at risk for being teased about their appearance with the concomitant negative psychological sequelae. Identifying modifiable variables associated with teasing could inform pediatric weight-management interventions. Characterizing society's role in the victimization of these at-risk individuals could guide anti-bullying programs for schools and broader public health efforts. This study aims to examine novel societal and cognitive factors associated with weight-related teasing frequency. Participants were adolescents (N = 334) being evaluated for a hospital-affiliated weight-management program. The outcome was perceived weight-related teasing frequency. Predictors were sociocultural awareness and internalization of appearance-related attitudes, physical activity self-efficacy, and psychological functioning. Multivariate regressions controlled for demographics and body mass index (BMI) z-scores with separate regressions testing interactions of BMI z-scores with all predictors. In adjusted analyses, higher physical activity self-efficacy and fewer depressive symptoms related to lower teasing frequency. Interactions indicated that less awareness/internalization of sociocultural attitudes towards appearance, more positive body image, and higher self-esteem related to lower teasing frequency regardless of BMI. Targeted interventions and public health campaigns should be developed and tested for adolescents that improve body image with promotion of diverse views about attractiveness, bolster confidence in overcoming physical activity barriers, and identify and treat mood symptoms.

Metabolic bone disease: a continued challenge in extremely low birth weight infants.

BACKGROUND: Metabolic bone disease (MBD) is an important prematurity-related morbidity, but remains inadequately investigated in extremely low birth weight (ELBW) infants, the group most at risk. The objective was to describe the incidence and associated risk factors of MBD in ELBW infants. METHODS: Retrospective analysis of all ELBW infants admitted between January 2005 and December 2010 who survived > 8 weeks. MBD was defined as the presence of osteopenia or rickets in radiographs. RESULTS: Of the 230 infants included in the study, 71 (30.9%) developed radiological evidence of MBD (cases) of which 24/71 (33.8%) developed spontaneous fractures. MBD and fractures were noted at mean postnatal ages of 58.2 ± 28 and 100.0 ± 61 days, respectively. Compared with controls, cases were smaller at birth (664.6 ± 146 g vs 798.1 ± 129 g), more premature (25.0 ± 1.8 vs 26.4 ± 1.9 weeks), more frequently associated with mechanical ventilation, chronic lung disease, parenteral nutrition days, cholestasis, furosemide, postnatal steroids, and antibiotics use (all P < .01). Cases had lower average weekly intake of calcium, phosphorous, vitamin D, protein, and calories during the first 8 weeks of life compared with controls. Cases with MBD, compared with controls, had higher mortality (14.1 vs 4.4%) and longer hospital stay (140.2 ± 51 vs 101.0 ± 42 days; P < .01). CONCLUSIONS: MBD remains an important morbidity in ELBW infants despite advances in neonatal nutrition. Further research is needed to optimize the management of chronic lung disease and early nutrition in ELBW infants.