Effect of gender and age on the mental well-being and self-esteem of adolescents living with obesity: subanalysis from the ACTION Teens global study

Abstract

Background: The ACTION Teens study aimed to identify attitudes, behaviours and perceptions among adolescents living with obesity (ALwO), caregivers of ALwO (CGs) and healthcare professionals (HCPs) who treat ALwO. This subanalysis assessed the mental well-being and self-esteem of ALwO.

Methods: ACTION Teens was a global, cross-sectional study (NCT05013359) that surveyed 5275 ALwO (aged 12–<18 years), 5389 CGs and 2323 HCPs. The mental well-being and self-esteem of ALwO were assessed using the World Health Organization-Five Well-Being Index (WHO-5; score range 0–100: score <50 indicates poor well-being) and Rosenberg Self-Esteem Scale (RSES; score range 0–30: score <15 suggests low self-esteem), respectively. Results were stratified by gender and age. Proportions were compared with a Z-test; # indicates significant difference (p<0.05).

Results: ALwO had a mean age of 14.8 years, and most were classified as obesity class I (65%), followed by class II (21%) and class III (14%). A total of 2971 (56%) ALwO were male and 2304 (44%) were female. The mean WHO-5 score for all ALwO was 56.3. More female than male ALwO had a WHO-5 score <50 (46 vs 34%#), and the percentage with a WHO-5 score <50 was greater among older age groups for both males and females (Table). The mean RSES score for all ALwO was 17.1, and the proportion of ALwO with an RSES score <15 was greater for females than males (34 vs 24%#). Among females, the proportion with an RSES score <15 was greatest in the oldest age group (Table). In contrast, the percentage of males with an RSES score <15 plateaued after age 14–15 years (Table).

Conclusions: A substantial proportion of ALwO had poor mental well-being and low self-esteem, particularly females and older adolescents. HCP awareness of the need for active screening for depression in a substantial proportion of ALwO may improve the obesity care they provide.