All ETDs from UAB

Advisor(s)

Marti Rice

Committee Member(s)

Aaron Fobian
Pamela Bowen
Paula Chandler-Laney
Peng Li
Sara Davis

School

School of Nursing

Document Type

Dissertation

Department (new version)

Nursing

Date of Award

9-11-2025

Abstract

Excess adiposity and depressive symptoms are prevalent throughout the United States (U.S.) and can cause health complications later in life. While links between adiposity, or body weight self-perception, self-esteem, and depressive symptoms have been noted, most studies lack an ethnically and racially diverse sample, use poor indicators of adiposity, lack theory driven research, and use a wide range of ages. ​The purpose of this study was to examine the associations among adiposity, or body weight self-perception, and depressive symptoms, in ethnically and racially diverse early adolescents. Further, self-esteem as a mediator in the relationships among adiposity, or body weight self-perception, and depressive symptoms was examined. ​A convenience sample of 78 11–14-year-old adolescents was enrolled; 30.8% males and 69.2 females; 59.0% African American: 23.1% Caucasian, 16.7% Hispanic, and 1.3% Other. Of the participants, 45.1% were obese or overweight, 38.5% had elevated WHtR, and 44.9% had elevated body fat percentage. Increased weight status was associated with decreased depressive symptoms in this sample (ω2=0.14, 95% CI=0.03, 1.00), after controlling for sex, physical activity, and pubertal status. A medium effect size was found for the association between increased self-esteem and increased depressive symptoms. Small effect sizes between self-esteem and adiposity precluded the ability to test for mediation of self-esteem. All other effect sizes were small or negligible. ​The obesity rate (32.1%) was higher than the national average (19.7%); likewise for the rate of depressive symptom (33.3%), versus the national average of 18%. Findings of increased adiposity associated with decreased depressive symptoms and increased self-esteem associated with increased depressive symptoms contrasted with most current literature. Potential explanations could include normalization of larger weight status and covariates or mediators not included in the model. ​With the increase in adiposity and depressive symptoms in the US, the associations among adiposity, body weight self-perception, self-esteem, and depressive symptoms in racially and ethnically diverse early adolescents need to be considered. Screening and treatment for these issues needs to be addressed and improved throughout the US. Policy changes, improvement in care, and continued research are necessary to improve the physical and mental health of early adolescents in the US.

Available for download on Friday, September 10, 2027

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