Pressure To Be Thin and Insulin Sensitivity Among Adolescents

Abstract

Purpose: Extant research indicates that some of the comorbidities associated with adult obesity may be adversely affected by the stress resulting from negative body image and weight-related stigma. This study examined the association between weight-related pressure and insulin sensitivity in adolescents, who are vulnerable to both weight-based teasing and the onset of metabolic dysregulation.

Methods: Participants were 215 adolescent healthy volunteers (55% female; 59% white; 35% overweight/obese; mean ± standard deviation age = 15.4 ± 1.4 year), who completed a self-report measure of pressure to be thin from parents, friends, and romantic partners. Fasting blood samples were obtained to assess serum insulin and glucose, which were used to calculate insulin sensitivity; fat mass (kg) and fat-free mass (%) were measured with air-displacement plethysmography. Pubertal stage was determined by physical examination.

Results: Pressure to be thin was positively associated with fasting insulin (p = .01) and negatively associated with insulin sensitivity (p = .02), after controlling for pubertal stage, sex, race, height, fat-free mass, and adiposity. Pressure to be thin was associated with a greater odds of having hyperinsulinemia (fasting insulin ≥ 15 μIU/mL; odds ratio (95% confidence interval): 1.65 [1.08-2.50], p = .02), adjusting for the same covariates.

Conclusions: Results indicate that adolescents perceiving more pressure to be thin have greater elevations of fasting insulin and poorer insulin sensitivity above and beyond the effect of fat mass. Future research is warranted to elucidate the mechanisms responsible for this relationship.

Trial registration: ClinicalTrials.gov NCT00631644.

Keywords: Adolescents; Insulin; Insulin sensitivity; Pressure to be thin.

Published by Elsevier Inc.

Figures

Figure 1

Association of pressure to be thin scale with indices of glucose homeostasis. Pressure to be thin was significantly associated with: fasting insulin (A; p = .01), insulin resistance as measured by HOMA-IR (B; p = .02), and insulin sensitivity, as measured by the QUICKI index (C; p = .02). Unstandardized residuals are shown, controlling for covariates as specified in Methods.