• Decreased body mass index; increased physical activity
  

• Improved self-esteem; improved depression scale score; decreased risk-taking behavior
  

How adolescents view (self-concept) and value themselves (self-esteem) may predict future adjustment and success in life. Self-concept comprises assessment of scholastic, athletic and job competence, social acceptance, physical appearance, romantic appeal, behavioral conduct, close friendship, and global self-worth. Self-esteem is the feeling of self-acceptance, goodness, and worthiness. It influences daily activities, motivation and behavior.

Adolescents are very vulnerable to low self-esteem. Generally, boys have higher self-esteem than girls; higher weight students have lower self-concept; and post-menarcheal females have the poorest opinion of their physical appearance. Higher body mass index (BMI) predicts more negative self-concept. Body image and physical appearance contribute to general physical self-concept and self-esteem.

Regardless of race, gender, age, and socioeconomic status individuals are discriminated against on the basis of weight. Weight-based stigmatization influences self-perception and the perceptions of significant others. Sustained low self-esteem may precipitate anxiety, depression, under achievement, poor motivation and inadequate interpersonal relations.

Obese adolescents are stigmatized by peers. They may attempt to protect their self-image by participating in high-risk behaviors. Obese adolescent girls are more likely to report adverse social, educational and psychological correlates than obese boys. Overweight girls, but not overweight boys, manifest more depressive symptoms than their normal-weight peers. Gender differences in clinical depressive syndromes may emerge in early childhood as opposed to puberty as previously thought.

Early stigmatization of obese children may explain their lower self-esteem and greater shame, humiliation, and perceived teasing compared with their nonobese peers. Studies have found increased psychopathology among clinical samples of obese children and demonstrated improvements in psychological functioning with weight loss. Implementing lifestyle changes during early adolescence, ages 10 to 13 years, and middle adolescence, ages 14 to 16 years, may hold the key for preventing obesity and depression.

The study population will consist of approximately 100 overweight or at-risk for overweight female volunteers, 10 - 14 years old.