Body mass index as a moderator of the association between weight status misperception and disordered eating behaviors

Association between body shape misperception and unhealthy eating behaviors among Korean adolescents

BACKGROUND/OBJECTIVES

Body shape misperception (BSM) is the disagreement between the subjectively perceived body size and body mass index. This study investigated the association between BSM and unhealthy eating behaviors (UEB) among Korean adolescents.

SUBJECTS/METHODS

This cross-sectional study used data from the 2019 Korea Youth Risk Behavior Web-based Survey with 55,748 participants. UEB were measured according to the weekly consumption frequency of caffeinated energy drinks, fast food, carbonated beverages, and sugar-sweetened beverages. The covariates included demographic and socioeconomic characteristics and health-related factors. Multiple logistic regression analysis determined the association between BSM and UEB.

RESULTS

Among the participants, 37,607 (67.5%) reported UEB. The gap between UEB among those with BSM was the largest between the underestimated and accurately estimated groups. Participants who underestimated their body shape were likelier to engage in UEB (adjusted odds ratio [AOR], 1.18; 95% confidence interval [CI], 1.11-1.25). Both sexes with underestimation of body size showed an association with UEB compared to those with accurate estimations (girls: AOR, 1.19; 95% CI, 1.09-1.30; boys: AOR, 1.16; 95% CI, 1.08-1.26).

CONCLUSIONS

Underestimating body shape can provoke UEB among Korean adolescents. The need for appropriate school health interventional programs to prevent underestimating body shape is emphasized to avoid UEB.

Does your past define you? How weight histories are associated with child eating-disorder psychopathology

PURPOSE

To examine how parents' and adolescents' weight histories were associated with parents' approach to eating/weight-related parenting and children's eating-disorder behaviors.

METHODS

Participants were 502 parents (69.3% mothers, 30.7% fathers) of children 12-16 years old who completed an online survey. Parents reported their own and their child's weight status during childhood and adolescence. Parents' and children's weight histories were categorized as "weight loss," "weight stability," or "weight gain" and were examined in relation to feeding practices and eating-disorder psychopathology.

RESULTS

Parents with a history of weight gain had greater personal eating-disorder psychopathology and more concerns about their child's weight than parents with weight stability or loss. They also reported greater parental overvaluation (judgment of themselves as parents according to their child's weight/shape). Children with a history of weight loss or gain were more likely to have eating-disorder behaviors than those with stable weight. Analyses revealed that results largely persisted after adjusting for child BMI-z.

CONCLUSIONS

Both parent and child weight gain between childhood and adolescence were associated with eating-disorder psychopathology, eating/weight-related parenting, and feeding practices. Pediatricians and clinicians should assess weight history when considering risk for eating disorders and obesity.

LEVEL OF EVIDENCE

Level III, Evidence obtained from well-designed cohort or case-controlled analytic studies.

Differences in overweight/obesity prevalence by demographic characteristics and self-weight misperception status

BACKGROUND & AIMS

Increasing the prevalence of overweight and obesity is one of the main concerns of health systems of the world. This research was conducted to estimate the prevalence of overweight/obesity and its related factors in the Eastern part of Iran.

METHODS

An analytical, cross-sectional study was conducted among 1048 inhabitants aged between 15 and 64 years who lived in Gonabad and Bajestan, two districts locating in the East of Iran, in 2016. A probability proportional to size stratified sampling was used to select the participants. We applied a checklist to collect the required data. Analyzing the data, we used t-test, χ2, and ANOVA. A significant level of 0.05 was considered in this study.

RESULTS

Total prevalence of overweight/obesity was 43.8%. There were significant associations between overweight/obesity and age (P < 0.001), sex (P = 0.008 in Gonabad, P = 0.004 in Bajestan), marital status (P < 0.001, in Gonabad, P = 0.001 in Bajestan), and job (P < 0.001). There was also a discrepancy between the participants' self-perception of weight and their real weight status.

CONCLUSION

The findings of the present study showed a high prevalence of overweight/obesity among women, government employees, and married individuals. Therefore, focusing on these groups in implementing weight control interventions is recommended. According to the high prevalence of obesity in housewives as well as the role of women to control the normal weight of their family members via providing healthy food, it seems that one of the most effective groups in the programs would be housewives. Besides, strengthening health literacy is recommended to eliminate self-weight misperception.

The role of drive for thinness in the association between weight status misperception and disordered eating

Weight status misperception is related to disordered eating outcomes, but little research has explored the differential impacts of misperception directionality, nor factors that explain these relationships. Self-Discrepancy Theory applied to body image gives a framework to how weight status over-perception may prompt a drive for thinness, which in turn may be important in the development of disordered eating cognitions and behaviors.

AIMS

To that end, the current study tested whether drive for thinness may account for the association between direction of weight status misperception and disordered eating behaviors.

METHODS

Young adults (N = 522) completed measures identifying weight status perception (accurate, under-, and over-perception), drive for thinness, and disordered eating attitudes and behaviors (appearance satisfaction, restrained, uncontrolled, and emotional eating). Indirect effect models with drive for thinness entered as the intervening variable were estimated for each outcome.

RESULTS

Drive for thinness accounted for the associations between weight status misperception and all outcomes. In general, compared to either accurate or under-perception, over-perception of weight status was associated with more disordered eating attitudes and behaviors via higher drive for thinness.

CONCLUSIONS

Consistent with Self-Discrepancy Theory, drive for thinness emerged as a possible mechanism of the association between weight status misperception and disordered eating outcomes. Findings suggest potential utility in targeting drive for thinness, as opposed to accuracy of weight status perception, for prevention of disordered eating attitudes and behaviors, including those that may contribute to weight gain.

Frequency of Trying to Lose Weight and Its Association with Children's Weight Perception and Dietary Intake (NHANES 2011-2012)

Weight loss practices and frequency among children and adolescents can impact overall diet quality. We used cross-sectional U.S. National Health and Nutrition Examination Survey data (NHANES) 2011-2012 from 1303 children and adolescents (8-15 years) to examine associations between frequency of trying to lose weight (never vs. sometimes/a lot) and sociodemographic characteristics, self-perception of weight, and dietary intake. A greater frequency of trying to lose weight was reported by participants with overweight/obesity, those from households with lower annual income and those who perceived they were overweight or obese compared to their counterparts. A high proportion of participants with overweight and obesity considered themselves to be "about the right weight" (76.7 and 42.8%, respectively). Intake data based on one 24-h dietary recall were examined using multivariable regression models adjusted for child and parent/family characteristics. In adjusted analyses, energy and total fat intakes were lower among those trying to lose weight compared to those never trying to lose weight. Intakes of cholesterol, sodium, and refined grains were not different by frequency of trying to lose weight (all p = 0.059-0.074). Weight loss efforts may be related to better nutritional profiles for some children and adolescents.