Adolescents' perceptions of relative weight and self-reported weight-loss activities: analysis of 1990 YRBS (Youth Risk behavior Survey) national data

Interactions between Self-Perceived Weight Status and Lifestyle Behaviors and Their Associations with Childhood Obesity: Results from the Childhood Obesity Study in China Mega-Cities

This study investigated the interactions between self-perceived weight status and lifestyle behaviors, and their associations with childhood obesity among school children. Methods: Cross-sectional study data from a nationwide sample of 3258 participants (aged 8-15 years old) during 2015-2017 were used. Self-perceived weight status and lifestyle factors (dietary intake and physical activity) were assessed using self-administered questionnaires. Multivariable mixed-effects models tested the effect of interactions between weight self-perception and behavioral factors on overweight and obesity (ow/ob). Results: Overall ow/ob prevalence based on BMI was 30.9% (38.5% for boys, 23.0% for girls). Based on self-perceived weight status, ow/ob prevalence was 37.7% (35.8% for boys, 39.7% for girls). 41.2% of boys and 25.9% of girls underestimated their actual weight status. The interaction between self-perceived weight status and meat consumption was associated with ow/ob in boys, while the interaction between self-assessed weight status and protein foods and sedentary lifestyle were associated with ow/ob in girls. The attributable proportions of these three factors were 39.8%, 48.2%, and 34.6%, respectively. Conclusions: The self-perceived weight status was different from their actual weight status in children. The interactions between self-perceived weight status and lifestyle behaviors were associated with ow/ob. Health promotion programs that empower children to have appropriate self-awareness of weight status, eating, and physical activity behaviors need to be developed and implemented.

The mirror's curse: Weight perceptions mediate the link between physical activity and life satisfaction among 727,865 teens in 44 countries

PURPOSE

The present study aimed to examine the link between physical activity (PA) and life satisfaction in a large international study of adolescents. We also aimed to test whether overweight and underweight perceptions act as mediators and whether age and sex acted as moderators.

METHODS

For this purpose, we analyzed data from the Health Behavior in School-aged Children study, which comprises 727,865 observations from 44 nations at 4 measurement occasions.

RESULTS

Multilevel analyses revealed a positive link between PA and life satisfaction. In addition, underweight and overweight perceptions mediated the effect of PA on life satisfaction. We further found that age and sex acted as moderators. In older adolescents, stronger effects were found in the links between PA and life satisfaction, PA and overweight perception, and both weight perceptions and life satisfaction. In addition, in female adolescents, the link between overweight perception and life satisfaction was stronger. Conversely, the links between PA and both weight perceptions were stronger for boys.

CONCLUSION

The results suggest that weight perception explains part of the relationship between PA and life satisfaction in adolescents and that these effects vary as a function of age and sex.

Suicidal behaviors and depression "among adolescents in Hanoi, Vietnam: A multilevel analysis of data from the Youth Risk Behavior Survey 2019

This study described the prevalence of suicidal behaviors and depression among adolescents in Hanoi, Vietnam, and examines the associated factors. In 2019, a school-based survey was conducted in three high schools in Hanoi and 661 high students were included into the study. We found that the prevalence of 12-month suicidal thoughts, suicide plans, and suicide attempts were 14.2%, 5.5%, and 3.0% respectively. Notably, the depression score mean was 16.1±4.9, among major predictors of suicidal ideation. Therefore, developing psychological care services in school is imperative to the early detection of mental disorders and the prevention of suicidal behaviors for the students.

Prevalence and correlates of depressive symptoms in secondary school children in Dhaka city, Bangladesh

Objectives: Depression is a leading contributor to the global burden of disease, and often starts at a young age. Depression in young people can increase the risk of unhealthy lifestyle behaviour and can lead to substantial disability, social problems, poor health, and suicide. Other research has examined depressive symptoms among adult populations in Bangladesh, but little is known about other age groups. The aim of this study was to assess the prevalence and socio-demographic correlates of depressive symptoms among secondary school children of Dhaka city, Bangladesh.Design: A self-completed questionnaire was administered to 898 students from eight secondary schools of Dhaka, the capital City of Bangladesh. Of the respondents, 755 (372 males, 383 females; average age 14.26 years; SD 1.15) completed the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). A score of 10 or more was used to indicate depressive symptoms. Parents completed a separate questionnaire to provide individual and household/family-level data. Generalized Estimating Equations (GEE) was used to assess sociodemographic and lifestyle factors associated with adolescent depressive symptoms.Results: Among the responding adolescents, 25% reported depressive symptoms with prevalence more common among females than males (30% vs. 19%). Factors significantly associated with symptoms of depression included being female, aged 15-16 years, self-perception of non-normal weight, feeling unsafe at school, sleep disturbance, low life satisfaction, high intake of sugary drinks, and regularly skipping breakfast.Conclusion: Depressive symptoms are prevalent among secondary school children in urban Bangladesh. Interventions for adolescents with depressive symptoms could focus on lifestyle practices such as weight management, personal safety, sleep hygiene and healthy eating.

Body Weight Misperception and Weight Disorders among Chinese Children and Adolescents: A Latent Class Analysis

Body misperception plays an important role in the development of weight and dietary disorders among children and adolescents. A school-based health promotion program (2014-2015) was conducted to promote the school health education and improve the teenagers' physical health among Chinese children and adolescents. Based on this program, we intended to examine weight status and weight misperception among Chinese children and adolescents and to explore the relationship between weight misperception and lifestyle behaviors. A total of 10 708 Chinese children and adolescents in 3rd and 7th grade from Shandong and Qinghai province participated in the program. The participants' dietary and activity patterns were clustered by latent class analysis (LCA). Logistic regression analysis was undertaken to explore the relationship between weight perception and demographic factors or dietary and activity patterns. Given the gender-specific difference of children and adolescents, analyses were separately conducted among boys and girls. The total prevalence of weight misperception was 44.50%. Boys, especially those in higher grade and living in wealthier district, were more likely to misperceive body weight. Girls were more likely to overestimate their weight (26.10%) while boys tended to underestimate the weight (28.32%). Three latent dietary and activity patterns including obesogenic pattern, malnourished pattern and healthy pattern were derived. The participants who had weight misperception were more likely to choose unhealthy dietary and exercise activities. The high prevalence of weight misperception was closely related to the unhealthy weight pattern and unhealthy dietary or exercise patterns. Our research found that most children and adolescents failed to perceive their weight correctly and boys tended to underestimate their weight while girls were subjected to overestimation. So, comprehensive intervention programs should focus on improving self-weight awareness, and appropriate guidance should be made to lead the adolescents to more healthy weight pattern.

The association between BMI and body weight perception among children and adolescents in Jilin City, China

Objectives

We evaluated the association between BMI and body weight perception in a sample of children and adolescents.

Methods

A cross-sectional school-based study was conducted among 7–18 year-olds (N = 9727) from 4 districts in Jilin City, China. We calculated BMI from measured weight and height and assessed body weight perception using a single questionnaire item. We analyzed these data using SPSS version 20.0.

Results

Approximately 19.8% of these youth perceived themselves as underweight, 57.8% as normal weight, and 22.4% as overweight. In reality, 4.9% were underweight, 64.3% were normal weight, and 30.8% were overweight. Furthermore, approximately 66.4% of these Chinese youth correctly perceived their body image, 28.2% underestimated their true body image, and 5.4% overestimated their weight status. Girls were more likely than boys to overestimate their weight (χ² = 135.4, p < 0.05). Adolescents 13–18 years old were more likely than children 7–12 years old to overestimate their weight (χ² = 248.4, p < 0.05). Senior high school students were the most likely to overestimate their weight (χ² = 297.6, p < 0.05). Kappa tests revealed significant differences in consistency analysis of BMI and body weight perception (Kappa = 0.352, p < 0.05). Kappa < 0.4, the consistency of BMI and body weight perception was poor.

Conclusions

A mismatch existed between BMI and body weight perception among these children and adolescents. Thus, schools and parents should take steps to help them improve weight management and overall health awareness.

The Association between Adolescent's Weight Perception and Health Behaviors: Analysis of National Health and Nutrition Examination Survey Data, 2011-2014

The association between adolescents' weight perception and their physical activity (PA) and sedentary behaviors remains unclear. Therefore, these associations were explored using data from 2438 adolescents aged 12-19 years who participated in the National Health and Nutrition Examination 2011-2014 Survey. Respondents reported weight perception, and their weight perception accuracy was determined by examining whether the measured weight and perceived weight were concordant. Respondents also reported sedentary time (sitting time and screen time), PA, and intention to lose weight. Linear and logistic regression models were conducted to determine whether adolescents' PA, sedentary behaviors, and weight loss intention differed by weight perception and weight perception accuracy adjusted for demographic variables accounting for complex sampling. About one-quarter (21.4%) of the respondents had obesity. For respondents who perceived themselves as being overweight/fat, despite greater weight loss intention, males reported more sitting time (512.7 ± 16.3 versus 474.1 ± 10.2 minutes/day, p < 0.05) and females reported less PA (48.7 ± 5.0 versus 64.6 ± 3.3 minutes/day, p < 0.05) than respondents who perceived themselves as being normal weight. Similar patterns were observed for weight perception accuracy among individuals with obesity. Study results show that perceiving oneself as being overweight/fat regardless of accuracy was associated with more sedentary time for males or less PA for females despite higher weight loss intention.

Agreement Between Actual and Perceived Body Weight in Adolescents and Their Weight Control Behaviors

Background

To investigate the agreements between actual and perceived body weight status among adolescents and to identify the associations of disagreements with their weight control behaviors.

Methods

This study used the secondary data of a sample survey (n=13,871) of the Seoul Student Health Examination among middle and high schools in 2010. Agreements between actual (underweight, normal, overweight, and obese, according to 2007 Korean National Growth Charts) and perceived body weight status (underweight, normal, overweight, and obese) were examined using Chi-square and Cohen’s kappa agreement, and then multinomial logistic regression including gender, grade, and attempt of weight control or method of weight control was done.

Results

Agreements between actual and perceived body weight status were only 45.2%, and disagreements were up to 54.8%, including mild over- (20.4%), severe over- (1.8%), mild under- (29.5%), and severe under-estimation (3.1%). The kappa coefficient of agreement was only 0.19. The odds ratios on severe over-estimated perception were 1.59 (95% CI, 1.22–2.07) in female subjects, 1.78 (95% CI, 1.36–2.34) in diet control behaviors, and 1.53 (95% CI, 1.18–2.00) in exercise. The odds ratios on severe under-estimated perception were only 0.40 (95% CI, 0.32–0.50) in female subjects but 5.77 (95% CI, 3.68–9.06) in taking medication.

Conclusion

There were associations of body weight control behaviors with disagreements of actual and perceived weight status. Therefore, further study is needed to identify the weight disagreement-related factors and to promote the desired weight control behaviors for adolescents.

Iron and Folate Status in Urban and Rural Costa Rican Teenagers

This study evaluated the iron and folate status of Costa Rican adolescents and their dietary intake of these micronutrients. Hematological data, serum ferritin, serum folate and iron and folate intakes were evaluated in 307 adolescents aged 13 to 17 years. The prevalence of anemia was 4%. Iron deficiency was found in 3% of adolescents and iron-deficiency anemia in 2% or less. The prevalence of deficient serum folate levels was less than 1%. Over 50% of females and around 20% of males did not consume 66.7% of the recommended daily allowance (RDA) for iron. Iron bioavailability in the diet of urban adolescents was intermediate, whereas it was low in the diet of rural adolescents. Approximately 53% of adolescents did not consume two-thirds of the RDA for folate. It is necessary to modify adolescents’ food habits in order to ensure an adequate iron and folate intake.

Weight perception in overweight adolescents: Associations with body change intentions, diet and physical activity

This study examined the association of weight perception and weight satisfaction with body change intentions and weight-related behaviours in 928 overweight adolescents (aged 11-18 years, 44% female). Accurate perception of weight was associated with trying to lose weight and inaccurate perception was associated with trying to gain muscle. Weight dissatisfaction was associated with trying to lose weight and gain muscle. Accurate weight perception and weight dissatisfaction were not associated with healthy weight-related behaviours. Awareness of overweight and body dissatisfaction may be detrimental to the adoption of healthy weight-control behaviours. Interventions with overweight adolescents should encourage body satisfaction, rather than promoting awareness of overweight.

A School-Level Proxy Measure for Individual-Level Poverty Using School-Level Eligibility for Free and Reduced-Price Meals

BACKGROUND

Socioeconomic status (SES) impacts health outcomes. The Youth Risk Behavior Survey (YRBS), like many school-based data sources, lacks individual-level poverty information. We propose using school-level percentages of student eligibility for free/reduced-price meals (%FRPM) as a proxy for individual-level poverty.

METHODS

Using the New York City (NYC) 2009 YRBS, we created school-level poverty quartiles to append to individual YRBS records by ranking schools by %FRPM. We compared this with 2 other school-level poverty measures using students' home and school neighborhood-level poverty and measured the association of these 3 school-level proxies with individual's household income. Last, we evaluated health outcomes by race/ethnicity and poverty to demonstrate the importance of accounting for poverty.

RESULTS

The school-level measure that used %FRPM had the strongest association with household income. When the school-level individual poverty proxy was included in illustrative analyses using YRBS data, patterns by poverty within race/ethnicity emerged that were not seen when looking at race/ethnicity alone.

CONCLUSIONS

Using a poverty measure to analyze school-based data will provide a better understanding of the impact of SES on health outcomes. Based on our evaluation, when individual-level information is not available, we propose using school-level %FRPM, which are publicly available throughout the United States.

Associations between self-perception of weight, food choice intentions, and consumer response to calorie information: a retrospective investigation of public health center clients in Los Angeles County before the implementation of menu-labeling regulation

BACKGROUND

Although obesity continues to rise and remains a great public health concern in the U.S., a number of important levers such as self-perception of weight and calorie postings at point-of-purchase in restaurants are still not well-characterized in the literature, especially for low-income and minority groups in Los Angeles County (LAC). To study this gap, we examined the associations of self-perception of weight (as measured by body weight discrepancy) with food choice intentions and consumer response to calorie information among low-income adults residing in LAC during the pre-menu labeling regulation era.

METHODS

Descriptive and multivariable logistic regression analyses were performed to examine the aforementioned associations utilizing data from the 2007-2008 Calorie and Nutrition Information Survey (CNIS). The CNIS was a local health department study of 639 low-income adults recruited from five large, multi-purpose public health centers in LAC.

RESULTS

Survey participants who reported that their desired weight was less than their current weight (versus desired weight the same as current weight) had (i) higher odds of intending to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase (aOR = 2.0; 95 % CI: 1.0-3.9); and (ii) had higher odds of reporting that it is "very important" to have these calorie postings on food items in grocery stores (aOR = 3.1; 95 % CI: 0.90-10.7) and in fast-food restaurants (aOR = 3.4; 95 % CI: 1.0-11.4).

CONCLUSIONS

Self-perception of weight was found to be associated with the intention to select lower-calorie foods under the scenario that calorie information was available at point-of-purchase. Future public health efforts to support menu labeling implementation should consider these and other findings to inform consumer education and communications strategies that can be tailored to assist restaurant patrons with this forthcoming federal law.

Weight perception and its association with socio-demographic and health-related factors among Korean adolescents

BACKGROUND

Adolescence is a time of rapid growth with dramatic changes in physical appearance. The body image established at this time could affect their physical and mental health throughout their entire life. However, adolescents sometimes perceive themselves as underweight or overweight irrespective of actual weight status. The purpose of the present study was to examine the extent of weight misperception for Korean adolescents, to explore socio-demographic factors associated with weight misperception, and to examine gender-specific differences in the relationships between weight misperception and health-related factors.

METHODS

We selected data on 3321 adolescents aged 12-18 years from the five-year Korea Health and Nutrition Examination Survey (KNHANES) datasets (2007-2011). Self-perceived weight status was compared with measured weight status by cross-tabulation. The generalized logit model was used to explore the socio-demographic factors associated with weight misperception, and separate logistic regression models were fitted to examine gender-specific differences in the relationships between weight misperception and health-related factors.

RESULTS

Overall, 25.8 % of boys (overestimation 17.1 %; underestimation 8.6 %) and 29.3 % of girls (overestimation 24.0 %; underestimation 5.3 %) misclassified their weight status according to the objective standards. Weight overestimation was particularly prominent among underweight girls. Weight misperception was associated with socio-demographic factors such as gender, age, BMI, place of residence, and maternal education level. Weight overestimation and underestimation in boys and weight overestimation in girls were significantly related to inappropriate weight control practice. However, weight underestimation in girls seems to be negatively linked to inappropriate weight control practice.

CONCLUSIONS

Based on the results of the present study, comprehensive intervention programs for adolescents and their parents could be devised to raise self-awareness of their weight status, to overcome weight misperception, and to prevent obesity and its related health risks.

Body Attitudes and Eating Behaviours of Female Malay Students Studying in Australia

The extent to which 113 adolescent Malay women studying in Australia expressed the desire to lose weight was examined, as was the degree to which this desire reflected a genuine need to lose weight. Comparisons between participants who expressed the desire to either lose weight, stay at their current weight, or gain weight were made using both attitudinal and behavioural components of body image. An in-depth analysis of those who wished to lose weight was also undertaken. There was evidence that negative body attitudes were in excess of what actual body weight might dictate. However, these negative attitudes were not found to be consistently predictive of dysfunctional eating behaviours. Results were interpreted with reference to the potential influence of Westernisation in countries in the South Pacific region, and in particular how attitudes and behaviours are influenced by this process.

How adolescent boys perceive their bodies, body parts, and weight: letting adolescent boys' voices be heard

The purpose of this study was to conduct elicitation, semistructured interviews with adolescent boys to document their attitudes, perceived norms, personal agency, intentions, and actions about their weight. The boys indicated that they liked and disliked certain body parts and were in charge of their weight. Almost half of the boys did not want to change their weight. Most of the parents were inaccurate when asked to self-report their sons' heights and weights. A screening procedure that adds adolescents' perceptions of their bodies to BMI classification can aid in the referral and treatment of weight management.

Cross-sectional survey of daily junk food consumption, irregular eating, mental and physical health and parenting style of British secondary school children

BACKGROUND

Previous research has established that poor diets and eating patterns are associated with numerous adverse health outcomes. This study explored the relationships between two specific eating behaviours (daily junk food consumption and irregular eating) and self-reported physical and mental health of secondary school children, and their association with perceived parenting and child health.

METHODS

10 645 participants aged between 12 and 16 completed measures of junk food consumption, irregular eating, parental style, and mental and physical health through the use of an online survey implemented within 30 schools in a large British city.

RESULTS

2.9% of the sample reported never eating regularly and while 17.2% reported daily consumption of junk food. Young people who reported eating irregularly and consuming junk food daily were at a significantly greater risk of poorer mental (OR 5.41, 95% confidence interval 4.03-7.25 and 2.75, 95% confidence interval 1.99-3.78) and physical health (OR 4.56, 95% confidence interval 3.56-5.85 and 2.00, 95% confidence interval 1.63-2.47). Authoritative parenting was associated with healthier eating behaviours, and better mental and physical health in comparison to other parenting styles.

DISCUSSION

A worrying proportion of secondary school children report unhealthy eating behaviours, particularly daily consumption of junk food, which may be associated with poorer mental and physical health. Parenting style may influence dietary habits. Interventions to improve diet may be more beneficial if also they address parenting strategies and issues related to mental and physical health.

Discrepant body mass index: behaviors associated with height and weight misreporting among US adolescents from the National Youth Physical Activity and Nutrition Study

BACKGROUND

The accuracy and reliability of self-reported height and weight among adolescents in the process of calculating BMI is usually subject to bias. The aim of this study was to determine whether over- and under-reporting of self-reported height and weight existed among US high school students by weight category; if so, to examine anthropometric, behavioral, and demographic factors associated with over- and under-reporting.

METHODS

Data were retrieved from the National Youth Physical Activity and Nutrition Study, 2010, a nationally representative sample (7160 students, grades 9-12). Analysis of variance was performed to determine any significant difference between weight categories in misreporting. Discriminant function analysis and sequential logistic regression were executed to detect behavioral and demographic predictors of reporting accuracy, respectively.

RESULTS

The mean over-reporting of height and under-reporting of weight were 1.1 cm and 1.020 kg, respectively, which underestimated BMI and BMI percentile by 0.671 and 2.734, respectively. Use of self-reported height and weight for BMI calculation overestimated prevalence of healthy weight by 3.8% and underestimated prevalence of obesity by 4.1%. Underweight students under-reported height and over-reported weight, whereas overweight and obese students over-reported height and under-reported weight. Reporting accuracy of females was significantly higher. Weight loss behaviors, both healthy and unhealthy, were associated with BMI underestimation, whereas fast foods and screen time were associated with overestimation.

CONCLUSION

Whenever possible, measuring height and weight is essential. However, because many studies must rely on self-reported values alone, additional research should examine the relationships between misreport of anthropometric data and lifestyle features in diverse adolescent samples to better interpret self-reported anthropometric data.

Associations between different forms of body dissatisfaction and the use of weight-related behaviors among a representative population-based sample of adolescents

Weight management strategies have two components: weight goals and behaviors to reach weight goals. In the literature, weight goals and weight-related behaviors have both been linked with body dissatisfaction separately, but have rarely been examined simultaneously. This paper examines the associations between different forms of body dissatisfaction and various weight-related behaviors and investigates the moderating role of weight goals in these associations. Measures included weight goals (matching or mismatching current weight status), self-reported frequencies of use of weight-related behaviors, and a body dissatisfaction measure (strength of aspiring for weight gain or weight loss) from a representative population-based sample of adolescents (n = 2,346, 51 % female). Sex-specific multilevel logistic and ordinal regression analyses indicated that aspiring for a thinner body among girls was associated with more frequent use of healthy and unhealthy behaviors, whereas body dissatisfaction of any type among boys was linked to more frequent use of unhealthy behaviors. Girls aspiring for substantial weight loss and boys aspiring for substantial weight gain were more likely to use disordered health behaviors. Aiming for a goal that is mismatched with current weight status increases the use of unhealthy behaviors among body dissatisfied adolescents. We conclude that in order to elaborate interventions aimed at promoting health, research should focus on processes leading to specific forms of body dissatisfaction which in turn produce varying frequencies of use of weight-related behaviors.

Accuracy of child and adolescent weight perceptions and their relationships to dieting and exercise behaviors: a NHANES study

OBJECTIVE

Recent public health and media attention on child obesity may have altered accuracy of self-perception of obesity and associated weight control behaviors in children and adolescents. Thus, we examined whether accuracy of weight perceptions were associated with weight loss behaviors.

METHODS

We examined children 8 to 15 years old in the National Health and Nutrition Examination Survey (2005-2010) who reported themselves as "overweight/too fat," "about right," or "underweight/too thin." Children reported on efforts to lose weight and engagement in specific weight control behaviors, including how frequently he or she had been on a diet, starved, cut back on eating, skipped meals, or exercised to lose weight. We categorized obesity on the basis of measured body mass index, and we determined the accuracy of weight perceptions. We used chi-square tests to examine age- and sex-based differences in accuracy of perceptions and relationship to weight loss behaviors.

RESULTS

Girls and older children more accurately perceived weight status. Both girls and boys of all ages who perceived themselves as overweight were more likely to engage in weight loss behaviors. Children who were overweight engaged in more weight loss behaviors than healthy weight children perceiving themselves as overweight. Among children who reported themselves as "about right," overweight children engaged in more weight loss behaviors than healthy weight children but less so than those who accurately perceived themselves as being overweight.

CONCLUSIONS

The perception of being overweight and actual overweight status are both strongly associated with weight loss behaviors. These findings have important implications for counseling patients who may have inaccurate weight perceptions.

Body weight perception among high school students and its influence on weight management behaviors in normal weight students: a cross-sectional study

AIM

This study investigates body weight perception and its influence on weight management behaviors in normal weight adolescents in Timis County, Romania. We hypothesized that misperception of overweight in normal weight adolescents would be positively associated with unhealthy weight control behaviors.

METHODS

From 2908 respondents participating in the survey we selected a total of 2093 normal weight high school students for the analysis. Outcome measures included self-reported height and weight measurements, overweight misperceptions and weight control behaviors. Weighted prevalence estimates and odds ratios were computed.

RESULTS

There were 22.64% of normal weight students who perceived themselves as overweight. Females (36.48%) were more likely to perceive themselves as overweight than males (8.15%) (P < 0.0001). After adjusting for age and gender, students who perceived themselves as overweight were more likely to exercise (OR = 2.85; 95% CI: 2.25-3.61), eat less food, fewer calories or low fat foods (OR = 3.54; 95% CI: 2.78-4.51), fast for 24 hours or more (OR = 1.79; 95% CI: 1.28-2.49), take diet pills, powders or tea (OR = 3.93; 95% CI: 2.62-5.89), vomit or take laxatives (OR = 1.96; 95% CI: 1.15-3.34) to lose weight or to keep from gaining weight, compared to students who did not perceive themselves as overweight.

CONCLUSION

A significant proportion of normal weight high school students misperceive themselves as overweight and are engaging in unhealthy weight management behaviors. These results should be considered when establishing prevention programs and educational components that address weight misperceptions and the harmful effects of unhealthy weight control methods should be performed even among normal weight adolescents.

Insatisfação com o peso corporal e fatores associados em adolescentes

OBJETIVO: Estimar a ocorrência de insatisfação com peso corporal e os fatores associados em adolescentes. MÉTODOS: Estudo transversal, representativo dos escolares de 15 a 19 anos de escolas públicas de Santa Catarina, no ano de 2002. O desfecho do estudo foi a satisfação com o peso corporal, avaliada pela pergunta: "Você está satisfeito(a) com seu peso corporal?". As variáveis avaliadas foram: sexo, idade, renda familiar, local de residência, estado nutricional, tempo semanal assistindo televisão, tabagismo e autopercepção de saúde. Investigaram-se também os seguintes comportamentos alimentares: tomar remédios para emagrecer, provocar vômitos após as refeições e realizar, no mínimo, três refeições/dia. Empregou-se regressão multinomial nas análises bruta e ajustada. RESULTADOS: Dentre os adolescentes avaliados (n=5.028), 16,7% (IC95%: 15,7-17,7) estavam insatisfeitos com seu peso e gostariam de aumentá-lo, e 36,2% (IC95%: 34,9-37,5) gostariam de diminui-lo. Tomar remédios para emagrecer, provocar vômitos após as refeições e não realizar, no mínimo, três refeições/dia foram mais frequentes entre aqueles que gostariam de reduzir o peso. Após análise ajustada, os fatores associados ao desejo de aumentar o peso foram: sexo masculino, idade >17 anos, residir na zona urbana, não ter excesso de peso e autopercepção de saúde negativa. Já os fatores associados ao desejo de diminuir o peso foram: sexo feminino, residir na zona urbana, ter excesso de peso e uma percepção negativa de saúde. CONCLUSÕES: Encontrou-se alta prevalência de insatisfação com o peso, sendo as variáveis sexo, estado nutricional e autopercepção de saúde os fatores mais fortemente associados a tal comportamento.

Assessing weight perception accuracy to promote weight loss among U.S. female adolescents: a secondary analysis

BACKGROUND

Overweight and obesity have become a global epidemic. The prevalence of overweight and obesity among U.S. adolescents has almost tripled in the last 30 years. Results from recent systematic reviews demonstrate that no single, particular intervention or strategy successfully assists overweight or obese adolescents in losing weight. An understanding of factors that influence healthy weight-loss behaviors among overweight and obese female adolescents promotes effective, multi-component weight-loss interventions. There is limited evidence demonstrating associations between demographic variables, body-mass index, and weight perception among female adolescents trying to lose weight. There is also a lack of previous studies examining the association of the accuracy of female adolescents' weight perception with their efforts to lose weight. This study, therefore, examined the associations of body-mass index, weight perception, and weight-perception accuracy with trying to lose weight and engaging in exercise as a weight-loss method among a representative sample of U.S. female adolescents.

METHODS

A nonexperimental, descriptive, comparative secondary analysis design was conducted using data from Wave II (1996) of the National Longitudinal Study of Adolescent Health (Add Health). Data representative of U.S. female adolescents (N = 2216) were analyzed using STATA statistical software. Descriptive statistics and survey weight logistic regression were performed to determine if demographic and independent (body-mass index, weight perception, and weight perception accuracy) variables were associated with trying to lose weight and engaging in exercise as a weight-loss method.

RESULTS

Age, Black or African American race, body-mass index, weight perception, and weight perceptions accuracy were consistently associated with the likeliness of trying to lose weight among U.S. female adolescents. Age, body-mass index, weight perception, and weight-perception accuracy were positively associated (p < 0.05) with trying to lose weight. Black/African American subjects were significantly less likely than their White counterparts to be trying to lose weight. There was no association between demographic or independent variables and engaging in exercise as a weight-loss method.

CONCLUSIONS

Findings suggest that factors influencing weight-loss efforts, including age, race, body-mass index, weight perception, and weight-perception accuracy, should be incorporated into existing or new multi-component weight-loss interventions for U.S. adolescent females in order to help reduce the national epidemic of overweight and obesity among U.S. female adolescents.

Equal weights but different weight perceptions among US adolescents

We investigate sex and race/ethnic differences in adolescents' perceptions of the same objectively measured weight in a nationally representative US sample. At the same BMI z-score, girls perceive themselves as heavier than boys. Regardless of sex and relative to Whites, African-Americans perceive the same BMI z-score as leaner and Native Americans are more likely to perceive objectively heavier weights as 'about the right weight'. Asian boys consider a narrower weight range to be 'about the right weight' relative to White boys, and Asian girls are less likely than White girls to perceive objectively lower weights as 'about the right weight'.

Overweight, body image, and depression in Asian and Hispanic adolescents

OBJECTIVES

To prospectively investigate associations between overweight and depressive symptoms in Asian and Hispanic adolescents.

METHODS

Data included 780 Hispanic and 375 Asian students. Structural equation model was used to prospectively explore moderation effects of gender, ethnicity, and acculturation on associations of overweight, body image dissatisfaction, and depressive symptoms.

RESULTS

Significant mediation effect was found only in Asian girls (mediation effect = 0.16, P < 0.05) and girls with high acculturation (mediation effect = 0.17, P < 0.05). Overweight significantly predicted higher body image dissatisfaction, which in turn was significantly related to depressive symptoms.

CONCLUSIONS

Our findings help understanding the association of overweight and experience of depressive symptoms.

Gender and race/ethnic differences in inaccurate weight perceptions among U.S. adolescents

PURPOSE

Inaccurate weight perceptions may lead to unhealthy weight control practices among normal weight adolescents and to a greater risk of adult obesity and related morbidities for overweight adolescents. To examine which U.S. adolescents are at risk of these outcomes, we examine gender and racial/ethnic differences in weight perception inaccuracy. This is the first study of weight perception inaccuracy to include Latino/a and Asian American adolescents.

METHODS

Among the 12,789 Wave II participants of the National Longitudinal Study of Adolescent Health, we estimate multivariate models that reveal how gender, race/ethnicity, and clinical weight categories predict weight perception inaccuracy.

RESULTS

Relative to boys, girls have lower odds of underestimating their weight and greater odds of overestimating their weight. In particular, among overweight and obese adolescents, girls are more accurate than boys, but among normal weight adolescents, boys are more accurate. Compared with Whites, African Americans are more likely to underestimate their weight, particularly among overweight girls and obese boys. Overall and particularly among girls and normal weight adolescents, African Americans are less likely to overestimate their weight than their White counterparts. Finally, Asian American girls are more likely to underestimate their weight than White girls.

CONCLUSION

These findings have important implications for identifying and intervening with adolescents at the greatest risk of long-term weight problems, weight-related morbidity, and unhealthy weight control practices.

Casting weight goal as a function of weight status among a representative population-based sample of adolescents

This paper pursues two objectives: (1) to estimate proportions of adolescents with a weight goal that matched and mismatched weight status, and (2) to identify correlates of a mismatched weight goal. Data were from a representative population-based sample of adolescents (n=2346, 51% female; 91.5% complete data). Results showed that 69% of adolescents had a weight goal that matched weight status whereas 31% had a weight goal that mismatched weight status. Body dissatisfaction was a significant predictor of having a mismatched weight goal for both sexes while elevated psychological distress was a predictor among girls. Being body dissatisfied mediated the association between psychological distress and having a mismatched weight goal among girls. Casting weight goal as a function of weight status may allow for a better understanding of overall weight management strategies.

Adolescents' experience of comments about their weight - prevalence, accuracy and effects on weight misperception

Background

Weight comments are commonly received by adolescents, but the accuracy of the comments and their effects on weight misperception are unclear. We assessed the prevalence and accuracy of weight comments received by Chinese adolescents from different sources and their relation to weight misperception.

Methods

In the Hong Kong Student Obesity Surveillance (HKSOS) project 2006–07, 22612 students aged 11–18 (41.5% boys) completed a questionnaire on obesity. Students responded if family members, peers and professionals had seriously commented over the past 30 days that they were "too fat" or "too thin" in two separate questions. The accuracy of the comments was judged against the actual weight status derived from self-reported height and weight. Self-perceived weight status was also reported and any discordance with the actual weight status denoted weight misperception. Logistic regression yielded adjusted odd ratios for weight misperception by the type of weight comments received.

Results

One in three students received weight comments, and the mother was the most common source of weight comments. Health professional was the most accurate source of weight comments, yet less than half the comments were correct. Adolescents receiving incorrect comments had increased risk of having weight misperception in all weight status groups. Receiving conflicting comments was positively associated with weight misperception among normal weight adolescents. In contrast, underweight and overweight/obese adolescents receiving correct weight comments were less likely to have weight misperception.

Conclusion

Weight comments, mostly incorrect, were commonly received by Chinese adolescents in Hong Kong, and such incorrect comments were associated with weight misperception.

Which measures of obesity are related to depressive symptoms and in whom?

The authors asked which obesity measurements were associated with depressive symptoms, whether this relationship differed by gender, and whether controlling for fatigue and response bias affected the relationship. A sample of 129 subjects (66 men, 63 women), with a mean age of 36.9 years and a mean Body Mass Index (BMI) of 26.4 participated in the study. Depressive symptoms, levels of fatigue, response bias, and anthropometrics were assessed. In women, but not men, BMI and percent of ideal body weight were related to depression. However, percent of body fat did not show a relationship with depression after controlling for fatigue and response bias. These findings suggest that women's depressive symptoms are more influenced by body size than body fat composition, whereas men's depressive symptoms seem to be unrelated to obesity.

Increasing rate of weight loss among schoolchildren, especially girls, in Sweden

PURPOSE

This study compared the rates of relative weight loss (body mass index, BMI) among boys and girls, from age 7 to 18 years, in two birth cohorts to determine changing patterns over time.

METHODS

Samples from two Swedish national birth cohorts, 1973 and 1981 (all children born on the 15th day of every month), with few missing cases (4.5% and 1.6%, respectively), were studied. Data (height and weight) were collected from school health records and analyzed longitudinally. Episodes of more than 5% reduction in BMI for 3530 boys and girls born in 1973 and 3041 boys and girls born in 1981 were analyzed and compared.

RESULTS

An increased rate in 1981 compared with 1973 of relative weight reduction episodes was found for both boys and girls. The increase for girls was most pronounced, started from a higher rate, and was seen in nearly all body weight categories and in all ages. For boys, the reductions increased for all body weight categories in the age interval 7-9 years; otherwise, the pattern was much more heterogeneous. Body weight and reduction of BMI were highly correlated in both cohorts, as more of the overweight than the thinner children reduced their BMI. For girls, the increase in rate reduction between 1981 and 1973 was highest among the thinnest individuals.

CONCLUSIONS

Both boys and, especially, girls had an increased rate of weight loss in two longitudinal cohorts. Whether healthy or unhealthy behavior is causing the increase needs to be investigated further.

Socio-demographic and cultural comparison of overweight and obesity risk and prevalence in adolescents in Southern California and Wuhan, China

PURPOSE

This study performed parallel analyses on two large samples of seventh graders living in Los Angeles, California and in Wuhan, China to make direct comparisons of overweight and obesity risks in Western and Eastern cultural environments.

METHODS

Two representative samples of 1772 and 1896 seventh grade students were randomly selected from the public or parochial middle schools in the greater Los Angeles area of Southern California in the United States, and public schools in Wuhan city of China. Two body mass index (BMI) references recently established by the U.S. National Center for Health Statistics (NCHS) and the International Obesity Task Force (IOTF), respectively, were used to define overweight (85th < or = BMI < 95th percentile) and obesity (BMI > or = 95th percentile). Logistic regressions were conducted to examine relationships between socioeconomic status (SES) and obesity risk.

RESULTS

The prevalence rates of combined overweight and obesity in Los Angeles and in Wuhan were 43.1% and 12.1%, respectively, by the US-NCHS reference, and 45.8% and 11.9%, respectively, by the IOTF reference. Chinese-American adolescents had higher prevalence rates for overweight and obesity than those from China. SES was positively related to the risk of overweight and obesity in the Chinese sample, whereas a negative association was found in Southern California adolescents. Urbanicity was significantly positively related to higher overweight and obesity prevalence.

CONCLUSION

Different overweight and obesity prevalence estimates and SES effects were observed for American and Chinese adolescent samples. Research on the underlying mechanisms is needed to help us to set up a tailored program for obesity prevention in Eastern and Western cultural environments.

Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents

BACKGROUND

Rapid economic development accompanied by imported Western media, advertising, fashion, and lifestyle in mainland China has resulted in shifts in cultural beliefs and beauty ideals in adolescents. The present study focused on understanding relationships among weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents.

METHODS

Data collected in 2002 from 6863 middle and high school students and their parents from four large cities in mainland China were used. Weight status was determined by measured weight and height. Weight perception, media exposure, attitudes, and health behaviors were assessed by a structured questionnaire survey.

RESULTS

Boys were more likely to describe themselves as either too thin or relatively thin than girls (37.32% vs. 18.79%), while girls more often considered themselves either relatively heavy or too heavy than boys (50.83% vs. 26.54%). Girls who were actually normal or underweight were more likely than boys to describe themselves as either relatively heavy or very heavy (41.6% vs. 11.6%), while boys who were actually normal or overweight were more likely than girls to believe themselves as underweight (30.9% vs. 15.7%). Girls who were frequently exposed to media from Japan, Korea, Hong Kong, and Taiwan, and placed high value on their physical appearance, were more likely to be dissatisfied with their body weight, which in turn were more likely to restrict consumption of certain foods, smoke cigarettes, and drink alcohol. Similar results were not observed in boys.

CONCLUSIONS

Weight dissatisfaction was prevalent in Chinese adolescents and was significantly related to media exposure, attitudes towards physical appearance, and adoption of certain health-risk behaviors in girls. Our findings underscore the importance of sociocultural influences in shaping realistic body image and have implications for prevention and early intervention for establishing health behavioral practices during adolescence.

Adolescent depression: challenges and opportunities: a review and current recommendations for clinical practice

Many aspects of the treatment for adolescent depression are still uncertain. However, our body of knowledge continues to accumulate, and our approaches continue to be refined. When we remember that 40 years ago the field was still arguing about the existence of depression in youth, it is clear that significant progress has been made. Recent controversies have provided another opportunity to step back and re-evaluate. Given the chronicity, morbidity, and mortality associated with adolescent depression, the risks of doing nothing are too great. Evidence-based research has provided us with some direction during this unsettling time. After careful reviews, the major professional organizations representing pediatric medicine and psychiatry all support the continued use of SSRI antidepressant medications but emphasize close monitoring. The debates also have heightened interest in effective psychotherapy approaches, particularly CBT and IPT. Given the risk for suicidality in depressed adolescents, assessment and management of safety concerns remain critical, regardless of medication usage. Above all, it is most important that we remain hopeful about our ability to guide adolescents and families through the struggles with depression toward recovery.

Effects of perceived peer isolation and social support availability on the relationship between body mass index and depressive symptoms

OBJECTIVE

To examine relationships between body mass index (BMI) and psychological correlates in Chinese school adolescents during the period of economic transition.

DESIGN

Baseline data of 1655 Chinese adolescents aged 11-15 y were retrieved from a longitudinal smoking cessation and health promotion program in Wuhan, China. Assessments of body weight and height, depressive symptoms, perceived peer isolation (PPI) and perceived availability of social support (PASS) were collected.

RESULTS

Based on the International Obesity Task Force (IOTF) age-and sex-specific BMI cutoffs, 12.5% of boys and 9.2% of girls were overweight. In girls, high BMI was significantly related to higher self-reported depressive symptoms, and was dominantly mediated by PPI. On the contrary, high BMI boys reported significantly lower levels of PPI although high PPI level aggravated depressive symptoms. For both girls and boys, the observed effect of PPI on the relationship between BMI and depressive symptoms was sustained only in low PASS boys and girls.

CONCLUSIONS

The present study revealed different effects of PPI on the association of BMI and depressive symptoms between boys and girls, which were buffered by levels of PASS. The findings of this study may contribute to our understanding of the influences of psychological correlates in pediatric overweight in the Eastern cultural environment.

The relationship between dieting and body image, body ideal, self-perception, and body mass index in Turkish adolescents

OBJECTIVE

The current study examined the roles of body image, ideal body weight, self-perception, and body mass index (BMI) on the dieting behavior of Turkish adolescents.

METHOD

The 531 subjects who participated in the study ranged from 15 to 17 years old and were recruited from five selected high schools in Ankara. They completed the Self-Perception Profile for Adolescents (SPPA), the Body Image Satisfaction Questionnaire (BISQ), and the Dieting Status Measure (DiSM). Height and weight were measured.

RESULTS

Dieting adolescents received significantly lower scores than nondieters for most of the BISQ items and for the physical appearance and global self-worth subscales of the SPPA. A thinner body ideal, the physical appearance domain of self-concept, and low global self-worth were the predicting factors of frequent dieting. However, BMI and body image dissatisfaction were not predicting factors.

DISCUSSION

The results indicate that a thinner body ideal, low self-worth, and low physical self-concept have more significant effects on body dissatisfaction and dieting than being actually overweight does. Furthermore, high physical self-concept scores and body satisfaction may not necessarily preclude having a thinner body ideal and, hence, dieting in girls.

High prevalence of abnormal eating and weight control practices among U.S. high-school students

OBJECTIVE

This study sought to determine the prevalence and to identify correlates of abnormal eating and weight control practices in U.S. high-school students.

METHOD

A three-stage cluster design technique was used to select 15,349 students from 144 different high schools. Each completed the 1999 Youth Risk Behavior Survey (YRBS) Questionnaire.

RESULTS

Abnormal eating and weight control practices during the past month were reported by over 26% of female students and 10% of male students. Rates of abnormal eating and weight control practices varied by ethnicity and geographic location. Other correlates of abnormal eating and weight control practices included having an underweight body mass index (BMI): (OR=1.39, 95% CI=1.01-1.91), exercising to control weight in past 30 days (OR=1.51, 95% CI=1.30-1.76), dieting to control weight in past 30 days (OR=3.89, 95% CI=2.65-5.73), and interactions between gender and both weight perception and weight satisfaction.

DISCUSSION

The high proportion of U.S. high-school students who have participated in abnormal eating and weight control practices in the past month demands immediate attention. The identified correlates may help target prevention and control programs.

Weight perception and psychological factors in Chinese adolescents

PURPOSE

To investigate the pattern of weight perception and its relationship with psychological distress among Chinese adolescents.

METHODS

A sub-cohort of 2179 healthy Chinese adolescents randomly selected from schools in Wuhan, China, including 1156 boys and 1023 girls 11 to 15 years of age was included in the current study. Weight, height, self-perceptions of weight status, depressive psychological symptoms including anxiety, depression, perceived peer isolation, and other constructs were measured by a structured questionnaire. A General Linear Model was used to compare psychological differences between actual and perceived weight groups.

RESULTS

Perceived underweight was more likely to occur in boys, whereas perceived overweight was more likely to occur in girls. Compared with objective body weight status defined by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) age- and gender-specific body mass index (BMI) cutoffs, girls were more likely to misperceive themselves as overweight, whereas relatively more boys misclassified their weight status as underweight. After adjusting for age, parents' educational attainment, and urban residence, perceived overweight boys and girls were more likely to experience anxiety and depression than perceived normal and underweight subjects (p <.05). Perceived overweight girls and perceived underweight boys experienced higher peer isolation than other groups (p <.05). Significant differences were not found in social support, school connectedness, trouble with teachers, and family disharmony among different weight-perception groups.

CONCLUSIONS

Our results suggested distortion of weight perception was prevalent, and may have detrimental psychological influences in Chinese adolescents.

Self-perception of weight appropriateness in the United States

BACKGROUND; The self-perception of weight appropriateness is an important component of eating and weight-loss behaviors. Self-perceived weight status, however, is not fully explained by objective weight status.

OBJECTIVE

To examine the influence of sociodemographic factors on Americans' perceptions of their weight appropriateness, controlling for objective weight status.

DESIGN

In the Third National Health and Nutrition Examination Survey, respondents were asked, "Do you consider yourself now to be overweight, underweight, or about the right weight?" Responses to this question were compared with how respondents (n=15,593) would be classified by medical standards given their body mass index (BMI). A proportional odds logistic regression model was used to assess the predictive effects of various sociodemographic factors on weight self-perception.

RESULTS

Overall, 27.5% of women and 29.8% of men misclassified their own weight status by medical standards. Of particular note, 38.3% of normal weight women thought they were "overweight," while 32.8% of overweight men thought they were "about the right weight" or "underweight." Multivariate regression analysis revealed that, controlling for BMI, numerous factors-including gender, age, marital status, race, income, and education-were independently associated with the self-evaluation of weight status.

CONCLUSIONS

The self-perceived appropriateness of weight status varies in highly predictable ways among population-level subgroups, likely reflecting differences in the normative evaluation of bodily weight standards. Such evaluations may assist in the explanation of discrepancies between clinical recommendations based on weight status and actual weight control behaviors, discrepancies that are socially patterned along some of the same subgroupings.

The relationship between eating disorder attitudes and the risk of cardiovascular disease

The purpose of this study was to examine the relationship between eating disorder (ED) attitudes and the risk of cardiovascular disease (CVD). Forty women (M age = 18.85) agreed to participate in this study. A regression analysis was used to statistically examine this relationship. The criterion variable was the risk of CVD. The predictor variables were the Eating Disorder Inventory-2 subscales. Drive for thinness and body dissatisfaction accounted for 45% (adjusted R(2) =.449) of the variance in the participant's CVD risk score. The knowledge gained from this study of this relationship would be beneficial to health care professionals responsible for primary and secondary prevention.

Explanatory variance in bulimia nervosa

In order to prevent disease, one must understand the factors that contribute to the variance of the illness. In an effort to better understand factors that contribute to bulimia nervosa (BN), a study was designed to investigate explanatory factors in BN. Of particular interest to the researchers in the study was the effect of the Hispanic subculture on the variance of BN. Female participants (n = 372) and male participants (n = 109) from the ages of 17-49 agreed to serve in the study. A self-report scale designed to assess the symptoms of BN was the criterion variable in the study. Predictor variables included in the regression model were drive for thinness, body mass index (BMI), age, and ethnicity (Hispanic or Anglo). Separate analyses were run for males and females. Based on the results of the analysis it seems that the desire to be thinner and an individual's BMI contribute to the variance in BN for females, but not for males. There was no difference in the attitudes associated with BN between Hispanic (n = 27) and Anglo (n = 321) females.

Children and adolescents with eating disorders: the state of the art

BACKGROUND

Eating disorders in children and adolescents remain a serious cause of morbidity and mortality in children, adolescents, and young adults. The working knowledge of pathophysiology, recognition, and management of eating disorders continues to evolve as research in this field continues.

OBJECTIVES

This article builds on previous background and position papers outlining issues relevant to the care of the adolescent patient with an eating disorder.

METHODS

The eating disorder special interest group from the Society for Adolescent Medicine recognized the need to update the state of the art published guidelines for the care of the adolescent patient with an eating disorder. This article was a multidisciplinary, group effort to summarize the current knowledge of best practice in the field.

RESULTS

This article summarizes newer findings on pathogenesis and etiology, prevention and screening, risk factors, nutritional issues, care from the primary care clinician's perspective, appropriate use of a multidisciplinary team, and issues of managed care and reimbursement.

CONCLUSIONS

Primary prevention combined with early recognition and treatment helps decrease morbidity and mortality in adolescents with eating disorders.

Association of self-perceived body weight status with dietary reporting by U.S. teens

OBJECTIVE

Children's self perception of body weight and the medical definition of obesity show poor correlation. This study examined the independent associations of body mass index (BMI) and self-perceived weight status (considered self over-, under-, or right weight) with food reporting, nutrient intake estimates, and biomarkers of dietary exposure.

RESEARCH METHODS AND PROCEDURES

Dietary (one 24-hour recall), anthropometric, and biochemical data were from the third National Health and Nutrition Examination Survey (1269 boys and 1385 girls, ages 12 to 18 years). Sex-specific multiple regression analyses were used to determine the association of BMI and self-perceived body weight status with reported intakes of energy, macronutrients, low-nutrient-dense foods, micronutrients, and serum concentrations of selected vitamins and carotenoids.

RESULTS

Reported intakes of energy, macronutrients, number of eating occasions, percentage of energy from low-nutrient-dense foods, likelihood of meeting the standard of intake of micronutrients, and biomarkers were not different among boys and girls who perceived themselves as overweight relative to those who perceived themselves at the right weight (p > 0.05). In boys, BMI was a negative predictor of percentage of energy from low-nutrient-dense foods (p = 0.004) and intake of ascorbic acid (p = 0.04). BMI was inversely related to serum concentrations of most carotenoids (p < or = 0.002).

DISCUSSION

Perceiving oneself as overweight was not associated with reporting of low-nutrient-dense foods, macronutrients, micronutrients, and biomarker status; BMI, however, was a significant predictor of several outcomes.

Eating and body image disturbances in adolescent psychiatric inpatients: gender and ethnicity patterns

OBJECTIVE

To examine gender and ethnicity patterns in eating and body image disturbances in adolescents hospitalized in a psychiatric facility.

METHOD

Participants comprised 715 inpatients who completed the Millon Adolescent Clinical Inventory. Gender (317 males, 398 females), ethnicity (553 Caucasians, 77 Latinõ Americans, 85 African Americans), and Gender x Ethnicity interactions in the features of eating disorders and body image disturbance were explored in the study group.

RESULTS

Eating-related disturbances at diagnostic threshold were infrequent but participants' reported rates of specific features and symptoms were not. Overall, a significantly higher proportion of females than males reported features of eating and body image disturbances. The three ethnic groups differed significantly in their reports of body image disturbances but not in their endorsement of features of eating disorders. Post-hoc comparisons revealed that a significantly higher proportion of Caucasian participants reported body image concerns than did African American and Latinõ American participants who did not differ significantly from one another. Significant Gender x Ethnicity interactions were observed, with Caucasian females endorsing higher rates of features of eating disorders and body image disturbances than African American and Latinõ American females.

DISCUSSION

In adolescent psychiatric inpatients, although Caucasian females report the highest rates of the features of eating and body image disturbances, such concerns are not uncommon in males and in minorities.

The role of body dissatisfaction as a risk factor for depression in adolescent girls: are the differences Black and White?

Body dissatisfaction, disordered eating and depression differentially affect adolescent girls (compared to boys); however, these variables have not been examined in relation to ethnicity. A review of the literature finds that Black adolescent girls are more satisfied with their bodies than White adolescent girls and engage much less frequently in dieting or disordered eating than do White girls in the US. A central question raised by this review is whether body dissatisfaction and pubertal timing are as relevant to our understanding of the etiology of depression in Black girls as they appear to be in White girls. Based on the available data, it does not seem that a risk factor model supporting the role of early pubertal timing, weight increases and body dissatisfaction in the development of depression applies to Black adolescent girls. This review underscores the need for future research with a variety of ethnic minority groups to better understand the etiology of adolescent depression.

The relationship between body weight perceptions, weight control behaviours and smoking status among adolescents

OBJECTIVES

This paper examines the relation between body weight perceptions, weight control behaviours and smoking status among a representative sample of Ontario students.

METHODS

Bivariate and multivariate logistic regression analysis was used to evaluate the association between smoking status and perception of being overweight, and between smoking status and specific weight control behaviours.

RESULTS

Among females, the odds of being a smoker were significantly higher among those who perceived themselves to be overweight and who had employed weight control behaviours in the last 12 months. Among males, the adjusted odds of being a smoker was higher only among those who skipped meals in the past 12 months.

CONCLUSIONS

Body weight perceptions and the use of weight control behaviours were significantly associated with predictors of smoking among adolescent females. This suggests a need to incorporate discussion on body weight perception and body image in smoking prevention and cessation programs targeted toward adolescent females.

Behaviour, body composition and diet in adolescent girls

The purpose of the study was to examine the relationships between patterns of behaviour, body composition and diet in adolescent girls. A group of 328 14 to 16-year-old girls at school in Southampton, U. K. completed a questionnaire about their behaviour and lifestyle, and had their heights, weights and skinfold thicknesses measured. Of these girls, 286 also provided dietary information. Socially independent girls were more likely to smoke, and less likely to eat breakfast and meals with family. They consumed more snacks, chocolate and soft drinks. Girls who were dissatisfied with their weight dieted and exercised, watched less television and spent less of their money on food. Dissatisfaction with weight was strongly related to body mass index. The odds of being a dieter, an indication of dissatisfaction with weight, increased with every unit increase in body mass index, so that girls with a body mass index of 24 kg/m(2)and over were 19 times more likely to diet than those with a body mass index of 19 kg/m(2)or less. Girls who were less satisfied with their weight reported lower energy intakes but ate more green vegetables and brown bread than other girls. The eating habits of the girls were therefore influenced by the extent of their social lives and by their satisfaction with their weight.

Body image and body change methods in adolescent boys. Role of parents, friends and the media

OBJECTIVE

This study examines sociocultural influences affecting both body image and body change methods in adolescent boys.

METHODS

Twenty boys in grade 7 (aged 12-13) and twenty boys in grade 9 (aged 14-15) were individually interviewed. The influence of parents, siblings, friends and the media on both body image and body change methods was evaluated.

RESULTS

For approximately a third of the boys, parents, siblings, friends and the media were perceived to have at least some influence over boys' feelings about their bodies and body change methods. In particular, feedback from mothers and female friends were viewed as having a positive impact on boys' body image whereas feed-back from fathers and male friends was viewed as more important in influencing body change methods. The media was also viewed as contributing to boys' body satisfaction but it was seen to encourage greater exercise to alter body size and shape.

CONCLUSION

The differences and similarities between the sociocultural messages received by males and females are discussed. The implication of these findings in fostering better health among adolescent males are explored.