The purpose of this study was two-fold. First, comparisons on the psychological and physical attributes of normal weight, overweight, and obese children were conducted. Second, the influence of BMI and physical fitness interaction on psychological adaptation in children with obesity was explored. Participants were 245 children between the ages of 9 and 13 years (64.5% males). Data on children considered overweight (n = 45) or obese (n = 78) were gathered from the Korean Obese Children's Physical Activity (KOCPA) projects. Normal weight children (n = 122) were recruited from two Seoul elementary schools. Psychological measurements included Weight Efficacy Life-style Questionnaire (WEL), Physical Self-efficacy Scale (PSES), Child Dietary Self-efficacy Scale (CDSS), Self-concept Inventory (SCI), and the Korean version of the Pediatric Quality of Life Intervention TM Version 4.0 Generic Core Scales (PedsQLTM4.0). BMI (kg/m2) and physical fitness (e.g., aerobic endurance, flexibility) were recorded by experts in exercise physiology. Results showed that children in the high BMI group reported poorer psychological adaption and demonstrated lower physical fitness when compared to the remaining groups. Compared to normal weight children, children considered overweight and obese were found to have lower physical self-efficacy, more negative self-concept, and poorer quality of life. Further, these children also had significantly lower physical fitness levels than their normal weight counterparts. Physical fitness was found to have a significant main effect on weight efficacy (WEL), physical self-efficacy (PSES), and quality of life (PedsQL) in children considered overweight or obese. A significant BMI-physical fitness interaction effect was found for self-concept (SCI) only. Children with higher BMI reported poorer self-concept regardless of fitness level whereas children with lower BMI and higher fitness reported more positive self-concept. Implications and limitations are discussed.
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