Familism, self-esteem, and weight-specific quality of life among Latinx adolescents with obesity

Authors: ARÉVALO AVALOS, MARVYN - Arizona State University; AYERS, STEPHANIE - Arizona State University; PATRICK, DONALD - University Of Washington; JAGER, JUSTIN - Arizona State University; GONZÁLEZ CASTRO, FELIPE - Arizona State University; KONOPKEN, YOLANDA - The Society Of St Vincent De Paul; OLSON, MICAH - Arizona State University; KELLER, COLLEEN - Arizona State University; SOLTERO, ERICA - Children'S Nutrition Research Center (CNRC); WILLIAMS, ALLISON - Arizona State University; SHAIBI, GABRIEL - Arizona State University

Submitted to: Journal of Pediatric Psychology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 5/17/2020
Publication Date: 7/6/2020
Citation: Arevalo Avalos, M.R., Ayers, S.L., Patrick, D.L., Jager, J., Gonzalez Castro, F., Konopken, Y.P., Olson, M.L., Keller, C.S., Soltero, E.G., Williams, A.N., Shaibi, G.Q. 2020. Familism, self-esteem, and weight-specific quality of life among Latinx adolescents with obesity. Journal of Pediatric Psychology. https://doi.org/10.1093/jpepsy/jsaa047.
DOI: https://doi.org/10.1093/jpepsy/jsaa047

Interpretive Summary: Experiencing obesity in childhood can have social and emotional health consequences in addition to the physical consequences like increased risk for obesity-related diseases like type 2 diabetes or cardiovascular diseases. These social and emotional consequences could be in the form of bullying from peers, social exclusion or marginalization, a negative body image, and decreased self-esteem. These factors can cause youth with obesity to experience a lower quality of life, which can actually make the physical consequences of obesity even worse. The purpose of this study was to identify cultural and social factors that are associated with quality of life in Hispanic adolescents with obesity. We found that youth who reported a higher level of familism, which is a strong desire or commitment to maintain close family relationships, had higher levels of self-esteem, which in turn led to higher levels of reported quality of life, compared to youth who reported lower levels of familism. This finding highlights the important role of family and familial relationships for maintaining social and emotional health in vulnerable youth with obesity. Obesity prevention programs and interventions that include Hispanic youth with obesity should include an emotional well-being component in addition to focusing on health behaviors and metabolic outcomes. In order to achieve improvements in emotional well being, these programs and interventions should consider including families and family-based activities.

Technical Abstract: Obesity is a critical public health condition affecting Latinx adolescents and contributes to health disparities across the lifespan. Childhood and adolescent obesity is associated with reduced quality of life (QoL) and decreased self-esteem. The purpose of this study is to examine the role of cultural (e.g., familism) and psychosocial (e.g., self-esteem) factors as predictors of weight-specific QoL among Latinx adolescents with obesity. Baseline data from 160 Latinx adolescents (ages 14-16 years) with obesity (BMI>95th percentile for age and sex) who were recruited for a diabetes prevention intervention were used. Structural equation modeling tested the relationships between four latent constructs (familism, positive self-esteem, self-deprecation, and weight-specific QoL). The model tested paths from familism to positive self-esteem, self-deprecation, and weight-specific QoL, and paths from positive self-esteem and self-deprecation to weight-specific QoL. Higher familism was positively associated with positive self-esteem but not self-deprecation. In turn, positive self-esteem was positively associated with higher weight-specific QoL, whereas self-deprecation was negatively associated. Furthermore, there was an indirect effect of familism on QoL via positive self-esteem. These data shed light into specific cultural and psychosocial constructs that influence QoL among Latinx adolescents with obesity. This study suggests that familism and positive self-esteem can operate as protective factors associated with higher weight-specific QoL in Latinx adolescents with obesity; whereas self-deprecation may operate as a risk factor for lower weight-specific QoL.