Obesity and mental health problems including depression are highly prevalent among indigenous children in Canada (i.e., First Nations, Inuit, and Métis) and the United States (i.e., American Indians and Alaska Natives) [1–4]. Among indigenous children, as in the general pediatric population, obesity and mental health problems are likely entwined, with each exerting cause and effect influences on the other . Considering Western society’s positive valuation of thinness, obese children often experience social rejection and victimization by peers, and have low quality of life indicators, low self-concept and poor self-perception [6–9]. Body image is a child’s internal representation of their own outer appearance  whereas self-concept (also called self-esteem) is how a child feels about all the characteristics that make up his or her person, taking into account, among other things, skills and abilities, interactions with others, and physical self-image . Low self-concept undermines a child’s realization of their full human potential in a range of settings given that children who do not feel good about themselves and their abilities are prone to anxiety and depression .
If indigenous children have internalized the negative values and perceptions of the mainstream society about obesity, then obesity not only potentially predisposes indigenous children to chronic disease but is also a stigmatizing condition which can compromise children’s mental wellbeing by threatening self-concept and creating body size dissatisfaction and poor body image [7–9]. Once self-concept and body image are internalized they tend to remain stable, underlining the importance of efforts in childhood to protect them [7–9, 11]. Research among indigenous children, as with other children, has often lacked an examination of these and other important psychosocial correlates of excess adiposity .
The objective of the present study was to provide an understanding of the association between adiposity and body size satisfaction, body image and self-concept in Cree First Nations schoolchildren living in the Province of Quebec in Canada. The remote communities where these children live are characterized by a high prevalence of obesity and obesity-associated chronic diseases such as type II diabetes mellitus [12, 13]. Virtually no data exists about body size satisfaction or self-concept in indigenous children in Canada. The specific aims of the study were to examine the relationship between (a) weight status and physical appearance satisfaction using both pictorial and verbal body rating measures, and (b) adiposity and self-concept using a validated psychometric scale.