Path Analysis on the Psychosocial Impact of Obesity or Overweight in Adolescents in Surakarta, Central Java

Yayang Kharistik A, Yulia Lanti Retno Dewi, C.S.P. Wekadigunawan


Background: Worldwide obesity shares 33 percent of adolescents body mass index. The prevalence of obesity has increased threefold since 1980. In Indonesia there are 10.8 percent of children aged 13-15 years who are obese. Obesity and overweight can cause various chronic diseases. Another important impact is psychosocial. Correct intervention and early prevention can reduce the psychosocial impact. This study aimed to determine the psychosocial impact of obesity or overweight on adolescents.

Subjects and method: This was an analytic observational study with cross-sectional design. The study was conducted at 6 junior high schools in Banjarsari and Jebres, Surakarta, Central Java, from October to November, 2017. A total sample of 160 junior high school students were selected for this study by purposive sampling. The dependent variables were depression, self-assessment, body image, eating disorder, and quality of life. The independent variables were obesity or overweight. Body mass index (BMI) was measured by body weight scale and microtoise. Data of other study variables were collected by questionnaire. The data were analyzed by path analysis.

Results: Obesity or overweight was directly associated with depression (b= 1.04; 95% CI= 0.32 to 1.77; p= 0.005) and bad body image (b= -2.35; 95% CI= -3.20 to 1.49; p< 0.001). Depression was directly associated with eating disorder (b= 0.55; CI 95%= -0.87 to 1.18; p=0.091) and poorer quality of life (b= -0.64; 95% CI= -1.34 to 0.69; p= 0.077). Good body image was directly asssociated with positive self-assessment (b= 2.71; 95% CI= 1.89 to 3.52; p<0.001).

Conclusion: Obesity or overweight in adolescents is directly asssociated with depression and bad body image. Obesity or overweight is indirectly associated with negative self-assessment, eating disorder, and poorer quality of life.

Keyword: overweight, obesity, psychosocial, path analysis

Correspondence: Yayang Kharistik Almasith. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta 57126, Central Java.  Email: Mobile: +6281229474445

Journal of Epidemiology and Public Health (2018), 3(2): 105-117 


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Ahrens W, Pigeot I (2015). Risk Factors of Childhood Obesity: Lessons from the European IDEFICS Study. In M.L. Frelut (Ed.), The ECOG’s eBook on Child and Adolescent Obesity.

Alleva JM, Lange W, Jansen A dan Martijn C (2014). Negative Body Evaluation Predicts Overestimation of Negative Social Feedback. Science Direct; 11(3): 228-232.

Alvani SR, Hosseini SMP, Kimura LW (2015). Relationship between Body Weight and Self Esteem: A Study of Young Men and Women in Iran. Journal of Obesity and Overweight; 2(2): 1-8.

Alvarez A, Brodsky JB, Lemmens HJM, Morton JM (2010). Morbid Obesity Peri Operative Management. New York: Cambridge University Press

Anderson SE, Cohen EN, Naumova, PF, Jacques A, Must (2007). Adolescent Obesity and Risk for Subsequent Major Depressive Disorder and Anxiety Disorder: Prospective Evidence. Psychosom Med.; 69(8): 740-7.

Atlantis E, Ball K (2008). Association Between Weight Perception and Psychological Distress. Internatioanl Journal of Obesity; 32: 715-721.

Baghci D dan Preuss HG. 2013. Obesity: Epidemiology, Pathophysiology, and revention, Second Edition. CRC Press Taylor & Francis Group: New York

Braet C, Verbeken S (2015). Psychological Assessment of the Obese Child and Adolescents: Priciples. In M.L. Frelut (Ed.), The ECOG’s eBook on Child and Adolescent Obesity.

Brown BB, Prinstein JM (2011). Encyclopedia of Adolescence. Elsevier’s Science and Technology Rights Department in Oxford: United Kingdom.

Centers for Disease Control and Prevention (CDC). 2015. About Child and Teen BMI. Available from: (Diakses 17 Juni 2017).

Centers for Disease Control and Prevention (CDC) (2017). Childhood Obesity Facts. Available from: (Diakses 17 Juni 2017).

_____ (2016). Health Related Quality of Life Concepts. Available from: (Diakses 17 Juni 2017).

_____(2015). Measuring Children’s Height and Weight Accurately at Home. Available from: (Diakses 17 Juni 2017).

Cherry AL, Baltag V, Dillon ME (2017). International Handbook on Adolescent Health and Development, The Public Health Response. Springer Internatioanl Publishing: Switzerland.

Dahlmann BH, Dempfle A, Konrad K, Klasen F, Sieberer UR 2015. Eating Disorder Symptoms Do Not Just Disappear: The Implications of Adolescent Eating Disordered Behaviour for Body Weight and Mental Health in Young Adulthood. European Child and Adolescent Psychiatry Springer Link; 24(6): 675-684.

Danielsen YS, Kjell M, Inger H, Magne, Sand L, Ekornas B, Pallesen S. 2012. Factors Associated with Low Esteem in Children with Overweight. The European Journal of Obesity. 5: 722-733.

Derene JL, Beresin EV (2014). Body Image, Media, and Eating Disorders. Academic Psychiatry; 30(3): 257-261.

Docherty JP, Sack DA, Roffman M, Finch M, Komorowski JK (2005). A Double Blind, Placebo Controlled, Exploratory Trial of Chromium Picolinate in A Typical Depression: Effect on Carbohydrate Craving. J Psychiatr Pract. 11(5): 302-14.

Eddy KT, Tabri N, Thomas JJ, Murray HB, Keshaviah A, Hastings E, Franko DL (2016). Recovery From Anorexia Nervosa and Bulimia Nervosa at 22 Year Follow Up. The Journal of Clinical Psychiatry.

Erermis S, Cetin N, Tamar M, Bukusoglu N, Akdeniz F, Goksen D (2004). Is Obesity A Risk Factor for Psychopathology among Adolescents. Pediatric Int. 46(3): 296-301.

Fabricatore AN, Wadden TA, Sarwer DB, Faith MS (2005). Health Related Quality of Life and Symptoms of Depression in Extremely Obese Persons Seeking Bariatric Surgery. Obesity Surgery; 15: 304-309.

Franklin JG, Denyer KS, Steinbeck, Caterson ID, Hill AJ (2006). Obesity and Risk of Low Self Esteem: A Statewide Survey of Australian Children. Pediatrics.; 118(6): 2481-7.

Jacobi C, Fittig E (2010). Psychosocial Risk Factors for Eating Disorders. In Agras, W.S. (Ed.), Oxford Handbook of Eating Disorders. Oxford University Press: New York.

Keputusan Menteri Kesehatan Republik Indonesia Nomor 1995/ Menkes/ SK/ XII/ 2010 tentang Standar Antropometri Penilaian Status Gizi Anak.

Klaczynski PA, Goold KW, Mudry JJ (2004). Culture, Obesity Stereotypes, Self Esteem, and the Thin Ideal: A Social Identity Perspective. Journal of Youth and Adolescence; 33(4): 307-317.

Kurniawan MY, Briawan D, Caraka RE (2015). Persepsi Tubuh dan Gangguan Makan pada Remaja. Jurnal Gizi Klinik Indonesia.; 11(3): 105-114.

Lubis NL (2016). Depresi: Tinjauan Psikologi. Kencana: Jakarta.

Luppino FS, Wit LM, Bouvy PF (2010). Overweight, Obesity, and Depression: A Systematic Review and Metaanalysis of Longitudinal Studies. Jama Psychiatry; 67 (3): 220-229.

Masdar H, Saputri PA, Rosdiana D, Chandra F, Darmawi (2016). Depresi, Ansietas dan Stres serta Hubungannya dengan Obesitas pada Remaja. Jurnal Gizi Klinik Indonesia.; 12(4): 138-143.

McClain Z, Peebles R (2016). Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth. Pediatric Clinics of North America

McClanahan KK, Huff MB, Omar HA (2009). Overweight Children and Adolescents: Impact on Psychological and Social Development. Pediatrics Faculty Publications. 140.

Mitchell JE, Crow S (2006). Medical Complications of Anorexia Nervosa and Bulimia Nervosa. Current Opinion in Psychiatry.; 19(4): 438-443

Mondimore FM, Patrick K (2015). Adolescent Depression: A Guide for Parents Second Edition. Johns Hopkins University Press: United States of America.

Morgan PJ, Okely AD, Cliff DP, Jones RA, Baur LA (2008). Correlates of Objectively Measured Physical Activity in Obese Children. Obesity. 16(12): 2634-41.

Morrison KM, Shin S, Tarnopolsky M, Taylor VH (2015). Association of Depression and Health Related Quality of Life with Body Composition in Children and Youth with Obesity. Journal of Affective Disorders Science Direct; 172: 18-23.

Mustillo S, Worthman C, Erkanli A, Keeler G, Angold A, Costello EJ (2003). Obesity and Psychiatric Disorder: Developmental Trajectories. Pediatrics.; 111 (4 Pt 1): 851-9.

NEDA Feeding Hope (2016). What is Body Image? Available from: (Diakses 11 Juni 2017).

Nieman P, LeBlanc CMA (2012). Canadian Paediatric Society, Healthy Active Living and Sports Medicine Committee Abridged Version: Paediatric Child Health. 17(3): 205-6

Ozmen D, Ozmen E, Ergin D, Cetinkaya AC, Sen N, Dundar PE, Taskin E, Oryal (2007). The Association of Self Esteem, Depression and Body Satisfaction with Obesity among Turkish Adolescents. BMC Public Health. 7: 80.

Papalia DE, Olds SW, Feldman RD (2008). Human Development (Psikologi Perkembangan Edisi ke 9). Jakarta: Kencana.

Pasquali R dan Vicennati V (2000). Activity of The Hipothalamic Pituitary Adrenal Axis in Different Obesity Phenotypes. International Journal of Obesity; 24: S47-S49.

Perrin EM, Boone Helnonen J, Field AE, Coyne Beasley T, Gordon Larsen P (2010). Perception of Overweight and Self-Esteem during Adolescence. NIH Public Access. 43(5): 447-454.

Pujiastuti E, Fadlyana E, Garna H (2013). Perbandingan Masalah Psikososial pada Remaja Obes dan Gizi Normal Menggunakan Pediatric Symptom Checklist (PSC) 17, Sari Pediatri, 15(4).

Pusat Data dan Statistik Pendidikan Kebudayaan (2017). Kementerian Pendidikan dan Kebudayaan.

Rankin J (2016). Psychological Consequences of Childhood Obesity: Psychiatric Comorbidity and Prevention. Adolescent Health Medicine and Therapeutics. 7: 125-146.

Rie SML, Noordenbos G, Furth EFV (2015). Quality of Life and Eating Disorders. Springer Link Quality of Life Research; 14(6): 1511-1521.

Riset Kesehatan Dasar (2013). Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia

Riset Kesehatan Dasar dalam Angka Provinsi Jawa Tengah (2013). Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan Republik Indonesia.

Roberts RE, Hao DT (2013). Obesity Has Few Effects on Future Psychosocial Functioning of Adolescents. National Institutes of Health. 14(2): 128-136.

Shoelson, Steven E, Herrero L, Naaz A (2007). Obesity, Inflammation and Insulin Resistance. Official Journal of The Aga Institute Gastroenterology; 132(6): 2169-2180.

Smetaina N, Albaviciute E, Babinska V, Karinauskiene L, Albertsson Wikland K, Petrauskiene A, Verkauskiene R (2015). Prevalence of Overweight/ Obesity in Relation to Dietary Habits and Lifestyle Among 7-17 Years Old Children and Adolescents in Lithuania. BMC Public Health. 15: 1001

Stanford Children’s Health (2017). Obesity in Adolescents.. Available from: (Diakses 11 Juni 2017).

Vaidya V (2006). Psychosocial Aspects of Obesity. Adv Psychosom Med. 27: 73-85.

Wahab AS (2000). Ilmu Kesehatan Anak Nelson Volume 1 E/15. Buku Kedokteran EGC: Jakarta.

Washington RL (2011). Childhood obesity: Issues of Weight Bias. Prev Chronic Dis. 8(5): A94.

Wille N, Bullinger M, Holl R, Hoffmeister U, Mann R, Goldapp C, Reinehr T, Westenhofer J, Egmond Froehlich A, Ravens Sleberer U (2010). Healthrelated Quality of Life in Overweight and Obese Youths: Results of A Multicenter Study. Health and Quality of Life Outcomes. 8: 36.

WHO 2017. Adolescent Health. Available from: (Diakses 17 Juni 2017).

_____ (2017). Maternal, Newborn, Child and Adolescent Health. Available from: (Diakses 17 Juni 2017).

_____ (2016a). Adolescents: Health Risks and Solutions. WHO Regional Offices: Media Centre Fact Sheet.

_____ (2016b). Obesity and Overweight. WHO Regional Offices: Media Centre Fact Sheet.


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