Tipping the Scale: Examining Perceived Versus Actual Weight Status in Predicting Suicidal Ideation in African American, Latino and Caucasian Adolescents

Background:  Suicide is the third leading cause of death among youth, spurring the U.S. Surgeon General to emphasize the need for an improved understanding of risk and protective factors.  In an increasingly diverse society, the elucidation of pathways to suicidal phenomena in different ethnic groups is critical to advancing culturally-tailored prevention programming.  An emerging body of evidence suggests that actual and perceived weight status may influence suicide risk.  However, the author is not aware of current work examining the impact of actual and perceived weight status on suicidal ideation within African American, Latino and White adolescents by gender. 

Purpose: The current research will aim to examine the influence of actual and perceived weight status on suicidal ideation among subgroups of African American, Latino and White adolescent males and females while controlling for well-established risk factors.

Methods: Secondary data analyses were performed using data from African American (N=3343), Latino (N=2063) and White (N=6117) adolescents that participated in the Youth Risk Behavior Survey. The YRBS consists of a nationally representative sample (N=13,917) of 9^th to 12^th grade high school students. Measures of actual and perceived overweight status, history of victimization, tobacco, alcohol and illicit drug use as well as sadness/hopelessness were derived from items on the YRBS survey.

Using suicidal ideation as the outcome variable, a series of logistic regression analyses were performed to examine the relative contribution of various measures of weight status along with other well-known risk factors from the adolescent suicide literature.  Separate logistic regression analyses were conducted for African American, Latino and White males as well as females, producing six distinct models.

Results:  Among males, both Latinos (OR=2.04, CI=1.16, 3.60) and Whites (OR: 1.78, CI=1.23, 2.57) perceiving themselves to be overweight were more likely to report suicidal ideation than males who did not perceive themselves to be overweight.  No relationship was found among any of the groups for actual overweight status. Among females, both African Americans (OR=1.62, CI=1.07, 2.47) and Whites (OR: 1.73, CI=1.33, 2.27) perceiving themselves to be overweight were more likely to report suicidal ideation than females who did not perceive themselves to be overweight.  Similar to the male groups, no relationship was found among any of the groups for actual overweight status.  There was also evidence of distinct risk profiles for suicidal ideation by race and gender for other well-established factors.

 

Conclusions and Implications: The current work suggests that while actual weight is not associated with suicidal ideation, perceived weight may differentially affect suicidal ideation across ethnic and gender groups.  Broad-based programming may be impractical and poorly targeted programming may be ineffective in addressing cross-cultural youth suicide, prompting the need for cultivated programming that fits the risk profile within different ethnic and gender groups; the present findings can guide such program development.  Increasing obesity in tandem with the marketing of unrealistic body images in our society fosters conditions that may shift the pendulum of perception, thus elevating suicide risk; in such an impressionable population, we cannot afford to wait to understand this phenomenon.