Obesity and substance use: Identifying pathways and processes in adolescence

描述（由申请人提供）：近几十年来，儿童肥胖症的患病率不断增加，引起了人们对身体健康受损、心理社会适应不良和死亡率升高的严重关注。尽管越来越多的关注，物质使用，一个严重的健康风险行为，并没有在很大程度上研究与肥胖。拟议的项目是一项前瞻性纵向研究，探讨青少年肥胖和物质使用之间的关系，并试图确定潜在的途径和过程，肥胖可能会增加物质使用的风险。从生物心理社会的角度来看冒险，拟议的研究将利用来自全国青少年健康纵向研究（添加健康）的第1-3波样本。数据已获得的身体质量指数（BMI）和肥胖状态;社会地位（受害，同伴拒绝，社会耻辱感）;越轨的同伴关系;心理社会适应不良（抑郁症状）和物质使用（酒精，烟草和大麻）11,083青少年之间的11- 19岁在第一波和18-26岁在第三波。这项研究的总体目标是确定是否贫穷的社会地位，越轨的同伴关系和/或心理社会适应不良的肥胖青少年更频繁和更严重的物质使用的风险增加在年轻的成年。此外，肥胖患病率的种族和性别差异以及体型和社会地位之间的种族和性别特异性关联可能会影响物质使用的参与。该研究的具体目的是：（1）确定肥胖和非肥胖青少年的BMI百分位数是否预测了年轻成年人使用药物的频率、严重程度和类型;（2）评估肥胖青少年中社会地位、异常同伴关系和心理社会适应不良的异质性是否为青少年肥胖在年轻成年人更频繁和更严重的药物使用中的作用提供了信息;和（3）从上述目的中识别种族和性别差异，以确定属于BMI和肥胖率较高的群体是否会降低物质使用的风险。由于肥胖和物质使用都是卫生保健系统的严重负担，因此确定青少年肥胖与青年时期物质使用相关的途径可能对旨在减轻物质使用频率和严重程度的预防和干预工作产生重大影响。

DESCRIPTION (provided by applicant): The increasing prevalence of childhood obesity in recent decades has raised serious concerns over impaired physical health, psychosocial maladjustment, and higher mortality rates. Despite growing concerns, substance use, a serious health-risk behavior, has not been largely studied in conjunction with obesity. The proposed project is a prospective longitudinal study that examines relations between adolescent obesity and substance use in young adulthood, and attempts to identify the underlying pathways and processes by which obesity may increase risk for substance use. Taking a biopsychosocial perspective on risk-taking, the proposed study will utilize the sample derived from Waves 1-3 of The National Longitudinal Study of Adolescent Health (Add Health). Data have been obtained on body mass index (BMI) and obesity status; social standing (victimization, peer rejection, feelings of social stigmatization); deviant peer affiliation; psychosocial maladjustment (depressive symptoms) and substance use (alcohol, tobacco, and marijuana) on 11,083 adolescents between 11- 19 years at Wave 1 and 18-26 years at Wave 3. The overarching goal of this research is to determine whether poor social status, deviant peer affiliation and/or psychosocial maladjustment among obese adolescents increase risk of more frequent and severe substance use in young adulthood. Furthermore, ethnic and gender disparities in obesity prevalence and ethnic- and gender-specific associations between body size and social status may influence engagement in substance use. The study's specific aims are to (1) identify whether BMI percentile of obese and non-obese adolescents predicts frequency, severity, and type of substance use in young adulthood; (2) assess whether heterogeneity in social status, deviant peer affiliation, and psychosocial maladjustment among obese adolescents informs the role of adolescent obesity on more frequent and severe substance use in young adulthood; and (3) identify ethnic and gender differences from the above aims to determine whether belonging to groups with higher BMI and obesity rates decreases risk of substance use engagement. As both obesity and substance use are severe burdens on the health care system, identifying the pathways by which adolescent obesity is related to substance use in young adulthood may have significant implications for prevention and intervention efforts aimed at mitigating frequency and severity of substance use.