A Longitudinal Examination of Body Esteem as a Predictor of Eating Behaviors, Physical Activity, and Quality of Life Among Youth with Obesity Attending Canadian Weight Management Programs

<b><i>Background:</i></b> This study explored whether baseline body esteem predicted changes in eating behaviors, physical activity (PA), and health-related quality of life (QoL) over a 24-month period among youth with obesity enrolled in weight management programs. <b><i>Methods:</i></b> Utilizing data from the CANadian Pediatric Weight Management Registry, the study included 415 participants (<i>n</i> = 221 girls, <i>n</i> = 194 boys) aged 10-17 years (mean = 13.2, standard deviation = 2.2). Baseline assessments included a measure of body esteem, while QoL, eating behaviors, and PA were reported at baseline, 12 months, and 24 months. Multilevel modeling was applied to examine the relationships between baseline body esteem and changes in outcomes over time. <b><i>Results:</i></b> Higher baseline body esteem was associated with higher initial QoL scores (β = 0.70, <i>p</i> < 0.001) and healthier eating behavior scores (β = -0.57, <i>p</i> < 0.001). Individuals with lower baseline body esteem exhibited greater improvements in QoL (β = -0.12, <i>p</i> = 0.010) and eating behaviors (β = 0.12, <i>p</i> = 0.004) over time. However, baseline body esteem did not significantly predict changes in PA. <b><i>Conclusions:</i></b> These findings highlight the prospective relationship of body esteem with future health behaviors and outcomes, providing evidence for weight management programs to consider addressing body esteem within pediatric obesity research and treatment.