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To contact Marla E. Eisenberg, Sc.D., M.P.H., call Brenda Hudson at 612/624-5680.

ADOLESCENTS TEASED ABOUT THEIR WEIGHT MAY BE MORE LIKELY TO REPORT SUICIDAL THOUGHTS AND SUICIDE ATTEMPTS

CHICAGO—Adolescents teased about their weight have low self-esteem, are unsatisfied with their bodies and may contemplate and attempt suicide more than their peers who are not teased, according to an article in the August issue of The Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. This association was independent of adolescents' actual weight. The August issue of The Archives of Pediatrics & Adolescent Medicine is a theme issue on obesity.

Bullying and hate-speech have come under scientific and public scrutiny in recent years, but little research has focused on weight-based teasing, according to the article. Weight-based teasing by peers is widespread, especially for overweight individuals, and has been identified as a risk factor for body dissatisfaction and eating disorders. Given the importance placed on body size in the United States, weight-based teasing may pose a serious threat to the health and well-being of young people.

Marla E. Eisenberg, Sc.D., M.P.H., of the University of Minnesota, and colleagues determined the associations of weight-based teasing and body satisfaction, self-esteem, depressive symptoms, and suicidal ideation (thinking about committing suicide) and suicide attempts among a large group of adolescents.

The researchers surveyed 4,746 adolescents in grades 7 to 12 at 31 public middle schools and high schools in the Minneapolis/St. Paul metropolitan area about weight-based teasing, body satisfaction, self-esteem and depression. The researchers also obtained the heights and weights of the adolescents they surveyed.

The researchers found that of students who completed the surveys (81.5 percent), 30 percent of adolescent girls and 24.7 percent of adolescent boys were teased by peers about their weight, and 28.7 percent of the girls and 16.1 percent of the boys were teased by family members about their weight. Approximately 14.6 percent of the girls and 9.6 percent of the boys reported being teased by both peers and family members.

The researchers also found that teasing about body weight was consistently associated with low body satisfaction, low self-esteem, high depressive symptoms, and thinking about and attempting suicide. Teasing from both peers and parents was generally associated with a higher prevalence of emotional health problems than teasing from a single source or no teasing. The association with teasing remained the same, regardless of whether the adolescents were actually overweight or not.

The authors write: "Of particular concern are the alarming rates of suicidal ideation and attempts associated with weight-based teasing, which are [higher] among those who were teased compared with those not teased."

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To contact Richard S. Strauss, M.D., call Kaylyn Dines at 973/972-7276.

OVERWEIGHT TEENS TEND TO HAVE SMALLER SOCIAL NETWORKS THAN THEIR NORMAL-WEIGHT PEERS

CHICAGO—Overweight adolescents are often socially marginalized and isolated, according to an article in the August issue of The Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. The August issue of The Archives of Pediatrics & Adolescent Medicine is a theme issue on obesity.

According to information in the article, few problems in childhood have as significant an impact on emotional development as being overweight. Many studies have been done on the health aspects of overweight and obesity, but few have looked at the emotional consequences of overweight in children and adolescents.

Richard S. Strauss, M.D., of the University of Medicine and Dentistry of New Jersey - Robert Wood Johnson Medical School, New Brunswick, N.J., and Harold A. Pollack, Ph.D., of the University of Michigan, Ann Arbor, Mich., investigated the social networks of overweight and normal-weight adolescents.

The researchers studied 90,118 adolescents aged 13 to 18 years old who were enrolled in the National Longitudinal Study of Adolescent Health (Add Health), of which 17,577 were selected for detailed in-home assessment, including height and weight measurements. The Add Health study is unique because it collected information on participants' social networks and friendships. Overweight was defined as having a body mass index (BMI, a measure of weight in relation to height) above the 95th percentile for age and sex.

The researchers found that overweight adolescents were more likely to be socially isolated and to be peripheral to social networks (less central to groups of friends) than were their normal-weight peers. Although overweight adolescents listed similar numbers of friends as normal weight adolescents, overweight adolescents received significantly fewer friendship nominations (being listed as a friend by a peer) from others than were received by normal-weight adolescents (average number of friendship nominations, 3.39 vs. 4.79 for overweight and normal-weight adolescents, respectively). Overweight adolescents were also about 70 percent more likely to receive no friendship nominations than their normal-weight peers. Additionally, adolescents who nominated overweight peers as their friends tended to be less popular themselves, and friends of overweight respondents received less friendship nominations than did friends of normal-weight peers.

The researchers also found that decreased television viewing, increased levels of sports participation and increased participation in school clubs were associated with significantly more friendship nominations and higher numbers of close friends among both overweight and normal-weight adolescents.

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To contact Virginia R. Chomitz, Ph.D., call Jill Burrows 617/665-3538.

HEALTH REPORT CARD MAY ENCOURAGE PARENTS TO HELP THEIR OVERWEIGHT CHILDREN LOSE WEIGHT

CHICAGO—Parents who received health-based report cards for their elementary school children were more likely to be aware of their child's weight, and were more likely to initiate weight loss activities with their overweight children, according to an article in the August issue of The Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals. The August issue of The Archives of Pediatrics & Adolescent Medicine is a theme issue on obesity.

According to the article, the prevalence of overweight children measured by body mass index (BMI) at or above the 95th percentile has increased dramatically, from 4 percent among those aged 6 to 11 years and 5 percent among those aged 12 to 19 years in 1963 to 1966 to 15 percent in 1999 and 2000. The medical consequences of overweight include high cholesterol, hypertension, and an increased risk for the development of type 2 diabetes mellitus, orthopedic disorders, and respiratory disorders. Overweight children may also experience adverse psychosocial consequences, including discrimination and low self-esteem, and may become isolated and stigmatized.

Some schools are beginning to send information to families via letters or reports in an effort to motivate parents regarding their child's weight issues, according to the authors of the article. Parental involvement in obesity interventions is considered integral to creating an environment that promotes good eating habits and physical activity in children.

Virginia R. Chomitz, Ph.D., of the Institute for Community Health, Cambridge, Mass., and colleagues evaluated the impact of a school-based health report card on family awareness and concern for their child's weight, plans for weight control, and measures to prevent further weight gain.

The researchers' study included 1,396 students in 1,131 familes from 4 elementary schools in an urban area. The children's families were randomly assigned to receive a personal information intervention, or health fitness report card (PI, which included weight and BMI of the child, n=481), general-information intervention (GI, no report card, but some education about weight and weight loss, n=451), and a control group (CG, no intervention, n=464). Telephone surveys were attempted in 793 families (276 PI families, 265 GI families, and 252 CG families) and completed in 399 families.

The researchers found that among overweight students, the PI and GI parents in families with overweight children were more likely to know their child's weight status than the CG parents (PI, 44 percent, GI, 41 percent, CG, 23 percent). The PI parents planned too seek medical service (PI, 25 percent, GI, 7 percent, CG, 8 percent), dieting activities (PI, 19 percent, fewer than 5 cases each for GI and CG), and physical activities (PI, 42 percent, GI, 27 percent, CG, 13 percent) for their overweight children. Most parents of overweight children who read materials requested annual weight and health information on their child (PI, 91 percent, GI, 67 percent).

MORE HIGHLIGHTS FROM THE AUGUST THEME ISSUE ON OBESITY

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LATE ADOLESCENT DEPRESSION IN GIRLS MAY BE LINKED TO OBESITY

To contact Laura P. Richardson, M.D., M.P.H., call Pam Sowers at 206/543-3620.

Laura P. Richardson, M.D., M.P.H., of the University of Washington, Seattle, and colleagues found that depression in late adolescence is associated with later obesity, but only among girls. The researchers found that girls who were depressed in late adolescence were at a more than 2-fold increased risk for obesity in adulthood compared with their non-depressed female peers.

REDUCED GLYCEMIC LOAD DIET MAY HELP OBESE CHILDREN LOSE WEIGHT

To contact Cara Ebbeling, Ph.D., call Bess Andrews at 617/355-6420.

Cara Ebbeling, Ph.D., of Children's Hospital, Boston, and colleagues write that a reduced glycemic load diet may be more effective in aiding weight loss than a conventional, low-fat diet in overweight adolescents. According to the article, consumption of high glycemic load food (starchy vegetables like potatoes, and flour based foods like bread and pasta) appears to increase hunger and lead to overeating. After 12 months, obese adolescents on the low glycemic load diet reduced their body mass index (BMI) more than adolescents on the reduced-fat diet.

FOOD ASSISTANCE PROGRAMS MAY PROTECT AGAINST OVERWEIGHT IN LOW-INCOME CHILDREN

To contact Sonya T. Jones, Ph.D., call Stephanie Piper at 865/974-2225.

Sonya T. Jones, Ph.D., of the University of Tennessee, Knoxville, and colleagues found that girls aged 5 to 12 years old who participated in all 3 food assistance programs the researchers studied (Food Stamp Program and the national school lunch and breakfast programs) had a 68 percent reduced odds of being at risk for overweight compared to girls whose households did not participate in any food assistance programs.

INCREASED PHYSICAL ACTIVITY NOT ASSOCIATED WITH LESS TELEVISION WATCHING

To contact Debbie Ehrmann Feldman, Ph.D., call Luc Giroux at 514/334-7819.

Debbie Ehrmann Feldman, Ph.D., of Universite de Montreal, Quebec, and colleagues found that physical activity was not inversely associated with watching television or playing video games, but was positively associated with productive sedentary behavior (such as reading or doing homework) and part-time work in high school students.

NEARLY THIRTY PERCENT OF OVERWEIGHT ADOLESCENTS MAY HAVE METABOLIC SYNDROME

To contact Stephen Cook, M.D., call Germaine Reinhardt at 585/275-6517.

Stephen Cook, M.D., of the University of Rochester School of Medicine and Dentistry, Rochester, N.Y., and colleagues found that 4 percent of all adolescents and 28 percent of overweight adolescents (BMI at or above 95th percentile) in the United States meet the criteria for metabolic syndrome (high triglyceride level, low HDL level, waist circumference at or greater than the 90th percentile, high fasting glucose level, and blood pressure at or above the 90th percentile).

For more information, contact JAMA/Archives media relations at 312/464-JAMA (5262) or e-mail mediarelations{at}jama-archives.org.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, AUGUST 11, 2003
To contact Marc N. Potenza, M.D., Ph.D., call Karen Peart at 203/432-1326.

PATHOLOGICAL GAMBLERS' BRAINS RESPOND DIFFERENTLY TO DEPICTIONS OF GAMBLING

CHICAGO—Pathological gamblers' may have decreased activity in areas of the brain involved in impulse control, according to an article in the August issue of The Archives of General Psychiatry, one of the JAMA/Archives journals.

Pathological gambling (PG) is classified as an impulse control disorder and has been described as a drug-free addiction, according to the article. As with other impulse control disorders, urges usually precede engagement in associated self-destructive behaviors and therefore represent important targets for therapeutic interventions.

Marc N. Potenza, M.D., Ph.D., of Yale University School of Medicine, New Haven, Conn., and colleagues investigated the brain function of male pathological gamblers and non-gamblers using functional magnetic resonance imaging (fMRI) while participants viewed videos depicting happy events, sad events and a gambling situation. Participants rated the quality and strength of their emotional responses and any urge to gamble produced by watching the videos.

The researchers found that men with PG (n=10) reported greater gambling urges after viewing the gambling videos than participants without PG (n=11). The two groups of participants did not differ significantly in their response to the happy vs. sad videos.

The most pronounced differences between the two groups of participants was observed during the initial period of viewing the gambling scenarios. Participants with PG had decreased activity in regions of the brain believed to be involved in impulse control, compared to participants without PG.

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, AUGUST 11, 2003
To contact Karla Zadnik, O.D., Ph.D., call Holly Wagner at 614/292-8310.

PREVALENCE OF COMMON VISUAL DISORDERS IN CHILDREN VARIES BY ETHNIC GROUP

CHICAGO—Visual problems, including nearsightedness and farsightedness, are found in varying percentages among children of different ethnicities, according to an article in the August issue of The Archives of Ophthalmology, one of the JAMA/Archives journals.

Studies of refractive errors (visual disorders including farsightedness, nearsightedness and astigmatisms) have often been conducted among only 1 or 2 ethnic groups, making it difficult to compare the prevalence of refractive errors among children of different ethnic groups, according to the article.

Karla Zadnik, O.D., Ph.D., of Ohio State University College of Optometry, Columbus, Ohio, and colleagues studied refractive errors and eye development in children from 4 different ethnic groups enrolled in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study, which began in the academic year 1997-1998. The researchers studied data from 2,523 children (534 African American, 491 Asian, 463 Hispanic and 1,035 white) in grades 1 through 8 (ages 5 to 17 years old) from 4 regions of the United States. The researchers noted cases of myopia (nearsightedness), hyperopia (farsightedness) and astigmatism (where the outer surface of the eye is not perfectly round, resulting in blurred vision).

The researchers found that overall, 9.2 percent of the children were myopic, 12.8 percent were hyperopic, and 28.4 percent were astigmatic. For myopia, Asians had the highest prevalence (18.5 percent), followed by Hispanics (13.2 percent). Whites had the lowest prevalence of myopia (4.4 percent) which was not significantly different from African Americans (6.6 percent). For hyperopia, whites had the highest prevalence (19.3 percent) followed by Hispanics (12.7 percent). Asians had the lowest prevalence of hyperopia (6.3 percent), not significantly different from the prevalence for African Americans (6.4 percent). For astigmatism, Asians and Hispanics had the highest prevalences (33.6 percent and 36.9 percent, respectively). African Americans had the lowest prevalence of astigmatism (20.0 percent), followed by whites (26.4 percent).

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, AUGUST 11, 2003
To contact John T. Vetto, M.D., call Rachel MacKnight at 503/494-4156.

RESEARCHERS DETECT HIGHER INCIDENCE OF BREAST CANCER IN BREAST CANCER SCREENING PROGRAM

CHICAGO—Women participating in an Oregon breast cancer screening program had greater incidences of breast cancer than women not participating in the screening program, according to an article in the August issue of The Archives of Surgery, one of the JAMA/Archives journals.

According to the article, The Oregon Breast and Cervical Cancer Program (BCCP) was implemented in 1996 as a statewide screening program (SP) for medically underserved low-income women. Researchers studied women in the program to determine incidence and stage of breast cancer, the role of the clinical breast examination (CBE), and patient compliance with treatment.

John T. Vetto, M.D., of Oregon Health & Science University, Portland, Ore., and colleagues investigated compliance and outcomes in participants in the BCCP in whom cancer was detected. The researchers evaluated 15, 730 women who had a total of 23,149 mammograms, 20,396 of whom also had a clinical breast exam from January 1, 1997 to December 31, 2001.

The researchers found that most (20,868) of the 21,296 mammograms that were given an American College of Radiology score (assessed based on guidelines set by the American College of Radiology) were benign, and 428 (2 percent) were suspicious. A rate of 12.3 cancers per 1000 women was found, greater than the rates of other screening programs, the authors write. Compliance with suggested therapies was 97 percent.

"In contrast to some other SPs, the low-income SP we report on detected a higher rate of more advanced cancers, suggesting that (at least in the initial period) such services are used for evaluation and treatment of nonoccult lesions [clearly defined breast cancers as seen on a mammogram] as well as screening," the authors suggest.