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

Effect of weight satisfaction on adolescent facial and dental satisfaction

PURPOSE

To investigate if facial and dental satisfaction is related to body fat percentage and body weight satisfaction.

METHODS

A self-administered questionnaire was applied to adolescents from a Private School in Southern Brazil containing sociodemographic (sex and age) and self-perception variables. Adolescents were asked about their perceptions concerning dental problems. Body fat percentage was collected using bioelectrical impedance analysis.

RESULTS

A total of 372 adolescents were examined. Most adolescents were satisfied with their dental (81.7%) and facial appearance (87.6%), while 39% of adolescents were satisfied with their body weight. Poisson regression model showed that adolescents who expressed satisfaction with their body weight (PR = 1.12, 95%CI 1.06-1.19) and were satisfied with their dental appearance (PR = 1.24, 95% CI 1.08-1.41) exhibited a positive association with facial satisfaction. Adolescents dissatisfied with dental color (PR = 0.88, 95%CI 0.80-0.97), those reporting dental pain (PR = 0.88, 95%CI 0.80-0.97), and individuals with obesity (PR = 0.91, 95%CI 0.83-0.99) demonstrated a decrease in facial satisfaction. Adolescents aged 16 to 19 years (PR = 1.08, 95% CI 1.01-1.15) and those satisfied with their facial appearance (PR = 1.20, 95%CI 1.01-1.43) exhibited a higher prevalence of dental satisfaction. Conversely, adolescents dissatisfied with dental color (PR = 0.74, 95% CI 0.66-0.82) and those with misaligned teeth (PR = 0.63, 95%CI 0.55-0.73) reported lower levels of dental satisfaction. Parametric g-formula analysis found that the association between body fat and facial satisfaction was mediated by body weight satisfaction (p = 0.001).

CONCLUSIONS

While dental satisfaction was not influenced by corporeal characteristics, facial satisfaction was influenced by dental and body weight satisfaction. Obese adolescents had low facial satisfaction.

Weight misperception and weight-related behaviors in non-Hispanic Black youth

Current literature is conflicting regarding whether accurate weight perception encourages healthy weight-related behaviors. This study examined the prevalence of weight misperception and explored associations between weight misperception and weight-related behaviors among 353 Black adolescents in Broward County, Florida. Overall, 44.8% of participants misperceived their weight, with boys more often misperceiving their weight than girls (52.2% vs 40.2%). Students who misperceived their weight were more likely to try to lose weight but less likely to be adequately physically active. Adolescents who underestimated their weight were less likely to be physically active and excessively play video or computer games or use a computer. There was no association between weight misperception and daily physical education attendance or excessive television watching. Weight misperception appears to be a risk factor for obesity in adolescents, as weight misperception was associated with lower engagement in physical activity.

Weight self-misperception and obesity-related knowledge, attitudes, lifestyle behaviours and cardio-metabolic markers among Chinese school-aged children and adolescents

OBJECTIVE

The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population.

DESIGN

Cross-sectional study.

SETTING

Data sourced from a national survey in Chinese seven provinces in 2013.

PARTICIPANTS

Children and adolescents aged 5-19 years.

RESULTS

Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58).

CONCLUSIONS

Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked.

Weight and disordered eating among adolescents from low-income backgrounds

Disordered eating affects youth from varying socioeconomic backgrounds; however, representation of youth from low-income backgrounds within disordered eating research has been limited. The aim of the current study was to examine the association between adolescent weight and disordered eating among a sample of youth from a low-income background and to examine specific socioenvironmental factors that might moderate this association. Adolescents ages 12-17 (N = 73) from a low-income background and their parents/guardians completed self-report questionnaires. Adolescent height and weight were objectively measured to calculate BMI z-score. Adolescent weight was significantly positively associated with global disordered eating (95 % CI [0.26, 0.54]), after controlling for sex. Parental weight concern moderated the association between weight and global disordered eating, F(4, 68) = 18.44, p < .01, such that the relation between adolescent zBMI and disordered eating was no longer significant at low levels of parental weight concern. Structured family meals moderated the association between weight and global disordered eating, F(4, 68) = 11.99, p < .01, such that more frequent meals weakened the association between adolescent zBMI and disordered eating. Findings suggest that higher weight is associated with greater levels of disordered eating among adolescents from a low-income background. In addition, lower levels of parental weight concern and more frequent family meals significantly buffered the association between weight and disordered eating in this at-risk, yet understudied population. Both parental weight concern and family meals present as factors within the family environment that may serve as targets for intervention.

Association between lifestyle-related, psychosocial factors and obesity among female adolescents in Taiwan

PURPOSE

To examine a wide range of potential contributors to the risk of obesity in female adolescents.

DESIGN AND METHODS

Data for this study were collected using a cross-sectional design. A group of 175 female adolescents were recruited, and information on their demographic characteristics, lifestyle-related behaviors, and psychosocial factors was collected using a self-administered questionnaire during September 2018 to January 2019. Data were analyzed using SPSS 24.0.

RESULTS

An overestimation of body weight was negatively correlated with overweight in the female adolescents. Age at menarche was negatively correlated with the arisk of overweight. Adolescents who slept for >7 h on weekend nights were less likely to be overweight. Eating more cheese, fish, seafood, and organ meats was negatively correlated with obesity risk. The female adolescents were more likely to become overweight if they ate dinners prepared by family and experienced more disturbances from parents and other family members.

CONCLUSIONS

Female adolescents are a unique population affected by obesity. Although incorporating both lifestyle-related behavioral and psychosocial factors in future investigations and developing multicomponent interventions for obesity prevention are crucial, female adolescents should receive the utmost attention from researchers to alleviate the health burden of obesity.

PRACTICE IMPLICATIONS

The intertwined nature of obesity-related factors warrants future investigations to elaborate their roles interplaying with the risk of obesity. Multicomponent interventions should be developed, and nurses and health-care providers should target their efforts on obesity prevention for this specific population.

Assessment of Actual Weight, Perceived Weight and Desired Weight of Romanian School Children-Opinions and Practices of Children and Their Parents

Objective: Children and parental awareness regarding weight is linked to the development and management of overweight and obesity. The aim of this study is to assess the actual weight, perceived weight, and desired weight of Romanian school children. Methods: A cross-sectional study was conducted in 2019 in seven schools from two counties of Romania and included 880 pupils aged between 10 and 15 years old and 665 parents. We administrated confidential questionnaires to the participants, and we measured children’s weight and height during school activities. Results: A total of 61.0% of pupils had normal weight, 7.4% were underweight, and 31.6% were overweight or obese. A total of 66.7% of normal weight children, 56.5% of overweight children, and 40% of underweight children perceived their weight accurately. Regarding parents, a majority correctly appreciated the weight of their normal weight children and only a third appreciated correctly the body weight of their underweight and overweight children. Factors such as body mass index, gender, weight related behaviors, parents’ estimation about their children’s weight, discussions of weight topics inside family, and bullying, cyberbullying and exclusion from groups were associated with misperceptions. Conclusion: The study provides useful information for health education activities targeting both children and their parents regarding appropriate body weight management of children.

Associations among psychological satisfaction in physical education, sports practice, and health indicators with physical activity: Direct and indirect ways in a structural equation model proposal

BACKGROUND AND OBJECTIVES

Physical education (PE) classes are among the main intervention strategies for increasing levels of physical activity (PA) to adolescent's health improvements. However, low levels of psychological satisfaction in physical education classes (PE satisfaction) and multiple associations with some factors as sex, age, sedentarism, sports practice, sleep, quality of life can act as moderators of levels of physical activity. Considering these aspects, this study aims to propose a theoretical model of multivariate relationships to verify the association between PE satisfaction with PA levels, considering the contribution of sports practice, health indicators, age, and sex on these relations.

METHODS

A cross-sectional study with 470 adolescents (230 boys) aged 11-17 years from the south of Brazil. Several questionnaires were applied to measure the study variables. The theoretical/statistical support of the structural equation model was evaluated according to fit parameters and strength of relations.

RESULTS

Sports practice, health indicators, age, and sex were mediators of the relationship between PE satisfaction and PA levels.

CONCLUSION

There is a positive, however indirect, relationship between PE satisfaction with the levels of physical activity in adolescents, with greater strength of association in boys and at younger ages. It was identified that the practice of sport contributes to the main mediator factor for all relationships beneficial to the health of adolescents in the multivariate model. This means that adolescents who practiced sports showed greater PE satisfaction, more appropriate health indicators, associated with higher levels of physical activity as compared to nonpractitioners of sport.

Dietary Patterns, Weight Perception and Obesity Status, among 10-12-Year-Old Children; an Epidemiological Study in Greece

Adherence to certain dietary patterns influences obesity status in both children and adults. Weight perception influences dietary habits. The aim of this study was to examine children’s dietary habits and obesity status, in relation to weight perception. One thousand seven hundred Greek students enrolled in this study during 2014–2016. Children’s characteristics were assessed through validated questionnaires, and weight status was classified according to the criteria of the International Obesity Task Force. Dietary patterns were assessed through exploratory factor analysis. Overall, 52.2% of children characterized themselves as normal weight, 34.5% as low weight, and 13.3% as overweight/obese; 52.5% of children were in accordance with their actual weight status, with girls being more likely to overestimate their weight. Children followed three dietary patterns, i.e., starchy and protein foods, unhealthy/high-fat foods, and healthy foods. Children who followed the healthy dietary pattern and had accurate weight perception (in accordance with their actual weight), had lower odds of being overweight/obese (p < 0.001). Accurate weight perception in conjunction with healthy dietary habits may play a determinant role in the prevention of obesity. From a public health perspective, early identification of children’s weight misperception along with healthy dietary habit promotion shape a crucial role in childhood obesity confrontation.

Perception of Body Weight Status Is Associated With the Health and Food Intake Behaviors of Adolescents in the United States

The purpose of this study was to determine the associations among body weight status perception, health status, diet quality, and consumption of fruits and vegetables within the adolescent population in the United States. A cross-sectional study was conducted with 1737 adolescents (12-17 years) participating in the Family Life, Activity, Sun, Health, and Eating study, an internet-based survey study sponsored by the National Cancer Institute. Adolescents reported their perception of their weight status, diet quality, health status, and the frequency with which they consumed common fruits and vegetables in a week. Results showed that 62% of the adolescents reported perceiving their weight as "just right," and 10.9%, 22.4%, and 4.7% perceived their weight to be "underweight," "a little overweight," and "very overweight," respectively. Those who perceived their weight status as "just right" also reported their health to be "very good" or "excellent" and that their diet was good. Similarly, adolescents who perceived their weight to be just right consumed significantly more fruits and vegetables than those who perceived their weight as "underweight" or "overweight." Results of this study have important implications for future research on weight and health status, diet quality, and healthy eating behaviors among adolescents.

The association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity in adolescents: A systematic review

A systematic review examined the association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity in adolescents, since it represents an alert to adolescent's health and well-being. Six electronic databases and gray literature were systematically searched from January 1980 to December 2018. A total of 11 articles met the inclusion criteria. Included studies assessed body weight dissatisfaction using different dimensions/components: satisfaction component of the attitudinal dimension was assessed in five studies, behavior component of the attitudinal dimension was assessed in two studies, perceptual dimension was assessed in two studies, and two studies were unclear about dimension. Behaviors: two assessed only unhealthy eating behaviors, six assessed lack of physical activity, and three assessed both behaviors. Only three studies found an association between body weight dissatisfaction with unhealthy eating behaviors, three with lack of physical activity, and one did not perform a statistical test for an association between body weight dissatisfaction with unhealthy eating behaviors and lack of physical activity. Few studies have reported an association between body weight dissatisfaction with one of these unhealthy behaviors. There was substantial heterogeneity related to unit of measures, both for body weight dissatisfaction and for behaviors studied.

Mediating effect of fitness and fatness on the association between lifestyle and body dissatisfaction in Spanish youth

BACKGROUND

Previous studies have identified sedentary behaviour, physical activity and eating habits as variables that define a healthy lifestyle. The aims of this investigation were to determine the association between lifestyle and body dissatisfaction, as well as to test the mediating effect of fatness and fitness in this relationship in adolescents.

METHODS

The sample comprised 2216 adolescents aged 13.1 ± 0.90 years, of whom 980 were girls (age 13.1 ± 0.86) and 1236 were boys (age 13.1 ± 0.92). Body composition was measured by body mass index, neck circumference, waist to height ratio and body fat percentage, whereas physical activity, sedentary time, body dissatisfaction and eating habits were self-reported. Physical fitness was evaluated through the ALPHA-Fitness Battery.

RESULTS

The results showed that lifestyle was negatively related with body dissatisfaction. Moreover, physical fitness (β = -0.062; SE = 0.022; 95% IC [-0.106, -0.017]) and fatness (β = -0.052; SE = 0.011; 95% IC [-0.075, -0.032]) showed a significant mediation effect on the relationship between lifestyle and body dissatisfaction. The bootstrapped confidence intervals for the indirect effect were statistically significant, suggesting the mediation effect of fatness (percentage of the total effect of 51.0%) and fitness (percentage of the total effect of 21.3%) on the relationship between healthy lifestyle and body dissatisfaction.

CONCLUSION

The study suggests that adolescents with a healthy lifestyle may have less body dissatisfaction. Fatness and physical fitness can positively affect this relationship, decreasing young people's body dissatisfaction. Therefore, this study highlights the importance of a healthy lifestyle on physical and psychological health in adolescence.

Associations Between Weight Perception, Unhealthy Weight Control Behavior, and Suicidal Ideation and Planning Among Korean Adolescents: A National Cross-Sectional Secondary Analysis

PURPOSE

This study aimed to investigate the associations between weight perception, unhealthy weight control behavior, and suicidal ideation and planning and identify the role of unhealthy weight control behavior as a mediator in these associations among Korean adolescents.

DESIGN AND METHODS

This national cross-sectional secondary study used data from the 2015-2017 Korea Youth Risk Behavior Web-Based Surveys, with a final sample of 96,285 adolescents who tried to manage their weight in the 30 days prior to the surveys. A multivariate logistic regression was conducted.

RESULTS

Both adolescent groups who perceived themselves to be underweight or overweight were significantly linked to a greater likelihood of suicidal ideation and planning (COR, 95% CI = 1.249, 1.141-1.367; COR, 95% CI = 1.339, 1.282-1.399) respectively. While adolescents with perceptions of being underweight are associated with suicidal ideation and planning through the suppression effect of unhealthy weight control behavior (Pathway A: OR, 95% CI = 0.628, 0.587-0.671), adolescents with perceptions of being overweight are linked with the same through the mediation effect (Pathway A: OR, 95% CI = 1.195, 1.141-1.251).

CONCLUSIONS

Adolescents with perceptions of being overweight are highly likely to have unhealthy weight control behavior that can be linked to the possibility of suicidal ideation and planning, while adolescents with perceptions of being underweight are comparatively less likely to engage in such behavior.

PRACTICE IMPLICATIONS

It is necessary to identify the status of weight perception among adolescents and closely monitor the unhealthy weight control behavior to prevent suicidal ideation and planning.

Energy intake and expenditure in children and adolescents, contributions of biological maturity

OBJECTIVE

The aim of this study was to examine the relationship between the ratio of energy intake (EI) and energy expenditure (EE) and body composition, physical activity and macronutrients intake, considering maturity as a moderator.

METHODS

The study involved 459 adolescents aged 10 to 17. Energy and macronutrients intake were estimated using a valid Food Frequency Questionnaire; basal metabolic rate (BMR) was predicted from Schofield equations and EE was estimated using BMR and physical activity level obtained through a Portuguese validated biosocial questionnaire. Body mass index, body composition, and bone age were objectively measured. Statistical analyses included independent samples t-tests, ANCOVA and Pearson correlations. All analyses were adjusted for chronological age, sex, and EI.

RESULTS

Body mass index, fat and fat-free mass, physical activity and protein intake were negatively correlated with EI/EE (P < .001). The study showed significant interactions between maturity and body mass index, fat-free mass and physical activity level. Maturity attenuated the negative relationships between EI/EE and body mass index, fat-free mass and physical activity, especially among early maturers. All categories of maturity showed implications in body mass index for values lower than 23.8 kg/m² . A significant EI/EE reduction was observed among late maturers with a fat-free mass above 39.8 kg.

CONCLUSIONS

Our findings suggest that maturity moderates the relationship between EI/EE and body mass index, fat-free mass and physical activity, especially evident among late maturers.

Obesity epidemic in urban Tanzania: a public health calamity in an already overwhelmed and fragmented health system

BACKGROUND

Worldwide, the epidemiological and demographic transitions have resulted in nutrition shift characterized by an increased consumption of high energy fast food products. In just over 3 decades, overweight and obesity rates have nearly tripled to currently affecting over a third of the global population. Notwithstanding the ever present under-nutrition burden, sub Saharan Africa (SSA) is witnessing a drastic escalation of overweight and obesity. We aimed to explore the prevalence and associated factors for obesity among residents of Dar es Salaam city in Tanzania.

METHODS

Participants from this study were recruited in a community screening conducted during the Dar es Salaam International Trade Fair. Sociodemographic and clinical data were gathered using a structured questionnaire during enrollment. Dietary habits and anthropometric measurements were assessed using standard methods. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student's T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with BMI ≥ 25. All tests were 2-sided and p < 0.05 was used to denote a statistical significance.

RESULTS

A total of 6691 participants were enrolled. The mean age was 43.1 years and males constituted 54.2% of all participants. Over two-thirds of participants were alcohol consumers and 6.9% had a positive smoking history. 88.3% of participants were physically inactive, 4.7% had a history of diabetes mellitus and 18.1% were known to have elevated blood pressure. Overweight and obesity were observed in 34.8 and 32.4% of participants respectively. Among overweight and obese participants, 32.8% had a misperception of having a healthy weight. Age ≥ 40, female gender, a current working status, habitual breakfast skipping, poor water intake, high soft drink consumption, regular fast food intake, low vegetable and fruit consumption, alcohol consumption and hypertension were found to be independent associated factors for obesity.

CONCLUSION

Amidst the ever present undernutrition in SSA, a significant proportion of participants had excess body weight. Concomitantly, the rates of physical inactivity and unhealthy eating are disproportionately high in Dar es Salaam. In view of this, community-based and multilevel public health strategies to promote and maintain healthy eating and physical activity require an urgent step-up in urban Tanzania.

Mediating role of body-related shame and guilt in the relationship between weight perceptions and lifestyle behaviours

INTRODUCTION

A substantial proportion of individuals with overweight or obesity perceive themselves as 'too heavy' relative to 'about right'. Perceiving one's weight as 'too heavy' is associated with lower levels of physical activity and higher levels of sedentary behaviour. However, the mechanisms underpinning the associations between weight perception and lifestyle behaviours have not been identified. Based on theoretical tenets and empirical evidence, the self-conscious emotions of shame and guilt may mediate these associations.

METHODS

Participants were young adults (n = 618, Mage = 24.0 ± .6 years) who provided data on weight, weight perception, body-related shame and guilt, physical activity and screen time.

RESULTS

Mediation analyses using the PROCESS macro indicated that shame and guilt significantly mediated the relationships between weight perception and physical activity and shame significantly mediated the relationship between weight perception and screen time.

CONCLUSIONS

These findings provide preliminary evidence that self-conscious emotions may be mechanisms by which weight perception influences physical activity and sedentary behaviour in young adults. However, longitudinal investigations of this mechanism are needed.

Perceived weight and barriers to physical activity in parent-adolescent dyads

OBJECTIVE

Family-based physical activity interventions have the potential to reduce obesity, but more information is needed regarding physical activity in the family context. This study used an actor-partner interdependence model to estimate the dyadic association between perceived weight status and barriers to physical activity in dyads of adults and their adolescent children. It was hypothesized that greater perceived weight would be associated with greater barriers perceived by both one's self and one's partner.

METHOD

Data from 1,568 dyads in the Family Life, Activity, Sun, Health, and Eating study were used to examine the dyadic association between perceived weight status (i.e., greater perceived weight category) and barriers to physical activity. Models were stratified by actual weight (an overweight or obese dyad member vs. two normal weight dyad members) and adjusted for parent education, parent and adolescent age, gender, and race.

RESULTS

Among dyads with at least 1 overweight/obese member, greater perceived weight status was positively associated with one's own perceived barriers (significant actor effects, βs = 1.17 and 1.03, ps < 0.01) and one's partner's perceived barriers (significant partner effects, βs = 0.38 and 0.62, ps < 0.01). No statistically significant relationships were found for dyads with only normal weight members.

CONCLUSIONS

Among dyads with at least 1 overweight or obese member, significant partner effects for parents and adolescents demonstrate that the weight perception of 1 dyad member correlates with the barriers of the other member. These dyadic associations highlight the potential importance of family-based interventions for physical activity. (PsycINFO Database Record

Incidence of childhood overweight and obesity and its association with weight-related attitudes and behaviors in China: a national longitudinal study

BACKGROUND

Childhood obesity is a major public health challenge. We aimed to investigate the incidence of overweight/obesity among Chinese children; and prospectively examine the associations of weight-change intention with risk of overweight/obesity and behavioral changes in initially normal-weight children.

METHODS

A national sample of 21,796 children aged 6-17 years were investigated in September 2013 and followed up nine months later, of which 19,887 (91%) were normal weight and 1909 (9%) were underweight at baseline. Weight and height were objectively measured. Weight perception, weight-change intention, weight control practices, weight-related behaviors, and demographic information were obtained by questionnaires.

RESULTS

Among children with underweight or normal-weight, the cumulative incidence of overweight/obesity was 2.77% (95% CI 2.55-2.99). Among normal-weight children, those who overestimated their weight had higher baseline BMI z-scores and an increased relative risk (RR) of overweight/obesity (RR 1.51, 95% CI 1.15-1.99). Children who misperceived themselves as underweight or overweight had stronger weight-change intention than their counterparts. However, children with weight-change intention did not develop greater changes in dietary intakes, physical activities, or sedentary behaviors than those without intention. There was no significant association between weight-change intention and incidence after adjusting for BMI z-scores at baseline. Self-reported improving diet, increasing physical activity, and dieting were associated with certain actual behavioral improvements and smaller increase in BMI z-score, but not associated with decreased risk of overweight/obesity.

CONCLUSION

The 9-months cumulative incidence of overweight/obesity was 2.77% among Chinese children. Weight-change intention was not associated with incidence of overweight/obesity in normal-weight children, regardless of their weight perception. More importantly, children's weight-change intention was insufficient in achieving desirable behavioral changes. Future overweight and obesity prevention programs should directly target on promoting children's actual behavioral changes.

The Association between US Adolescents' Weight Status, Weight Perception, Weight Satisfaction, and Their Physical Activity and Dietary Behaviors

Background: It remain unclear that the association between weight status, weight perception, weight satisfaction and the clustering of physical activity (PA) and dietary behaviors in adolescents. Method: A cross-sectional analysis of National Health and Nutrition Examination Survey and the US Department of Agriculture's Food Patterns Equivalents 2007⁻2014 data from adolescents aged 12⁻17 years (n = 2965) was conducted. Multivariable logistic regression models adjusted for demographic characteristics examined the association between weight status, weight perception, weight satisfaction, and the four created lifestyle groups (healthier behaviors, healthier diet only, physically active only, unhealthier behaviors). Results: Males with obesity were more likely to be in the healthier diet only group than males with a normal weight (OR = 1.90, 95% CI: 1.02, 3.52). Similar patterns were found in males who perceived themselves as being overweight or having obesity (OR = 2.09, 95% CI: 1.09, 3.99) and males with obesity who perceived their weight status accurately (OR = 2.33, 95% CI: 1.12, 4.88). Female respondents who were satisfied with their weight were 59% less likely to be in the healthier diet only group than healthier behaviors group compared with females who were weight dissatisfied (OR = 0.41, 95% CI: 0.23, 0.75). This pattern was not observed in males. Conclusions: Clustering PA and dietary behaviors were associated with weight status and weight perception for males but not females. Weight satisfaction was associated with clustered PA and dietary behaviors for females. These findings are important for obesity prevention policies and programs to better address adolescents' obesity and reduce health disparities in this population.

Relationship between body weight perception and weight-related behaviours

Objectives

This study aimed to examine the prevalence of weight misperception and to explore the association of weight perception with physical activity and dietary intake.

Methods

A population-based, nationally representative cross-sectional survey was conducted of 920 Thai adolescents aged 13 to 24 years. Respondents were selected using stratified multistage sampling. Respondents who agreed to participate were asked to complete the Youth Risk Behavior Questionnaire.

Results

Females were more likely than males to misperceive themselves as overweight (21.8% vs. 11.7%), whereas males were more likely than females to misperceive themselves as underweight (12.3% vs. 3.4%). Males were more likely than females to report a high intake of vegetables (45.7% vs. 38.0%), milk (39.1% vs. 38.0%), 100% fruit juice (20.9% vs. 17.7%) and soda or pop (38.5% vs. 20.6%). Males were also more likely than females to report vigorous physical activity of more than 60 minutes per day (38.1% vs. 21.3%) and vigorous exercise to strengthen or tone muscles (37.3% vs. 13.2%).

Conclusions

Gender differences in dietary intake and physical activity were identified. However, there were no significant differences in dietary intake and physical activity between adolescents who correctly perceived themselves as overweight and those who misperceived themselves as overweight.

Cross-sectional associations between weight-related health behaviors and weight misperception among U.S. adolescents with overweight/obesity

Background

Weight misperception occurs when there is a discrepancy between one’s actual and perceived weight status. Among adolescents with overweight/obesity, many believe that correcting weight misperception is imperative to inspire weight-related behavior change. However, past research has shown that adolescents with overweight/obesity who misperceive their weight status gain less weight over time compared to accurate perceivers. Therefore, our objective was to examine possible mechanisms underlying this relationship. Specifically, we examined the association between weight misperception and engagement in weight-related health behaviors among adolescents with overweight/obesity.

Methods

Self-reported data from the 2015 National Youth Risk Behavior Survey was used in analyses restricted to participants with overweight/obesity (n = 4383). Using multivariate logistic models correcting for sex, race/ethnicity, and grade in school, we examined the cross-sectional associations between weight misperception and engagement in weight-related health behaviors, specifically related to dietary intake, physical activity, and sleep.

Results

Adolescents with overweight/obesity who misperceived their weight status were more likely to drink 100% fruit juice two or more times per day (OR = 1.53, 95% CI: 1.20, 1.94), eat vegetables two or more times per day (OR = 1.29, 95% CI: 1.07, 1.57), be physically active for 1 hour or more per day for at least 5 days in the week prior (OR = 1.40, 95% CI: 1.15, 1.72), be on a sports team in the last year (OR = 1.55, 95% CI: 1.21, 1.97), sleep an average of at least 8 hours per school night (OR = 1.40, 95% CI: 1.15, 1.72), and less likely to be trying to lose weight (OR = 0.17, 95% CI: 0.15, 0.20). Misperceivers were more likely to consume breakfast every morning in the week prior and to drink a sports drink at least once per day, though these results were not statistically significant. We observed no difference in fruit intake, soda intake, or TV viewing between weight misperceivers and accurate perceivers.

Conclusions

Overall, weight misperception among adolescents with overweight/obesity was associated with a number of beneficial weight-related health behaviors. Engagement in these healthy weight-related behaviors may explain some of the protective effect of weight misperception on weight gain over time.

Trial registration

Not applicable.

Trends and correlates of unhealthy dieting behaviours among adolescents in the United States, 1999-2013

Background

The increase in adiposity problems among United States adolescents has been accompanied by persistently high prevalence of unhealthy dieting behaviours (UDBs) such as fasting, taking diet pills/powders/liquids, and vomiting/taking laxatives. This study aimed to examine the associations of self-perceptions of weight status, weight change intentions (WCIs) and UDBs with sex, age and race, as well as trends of UDBs in American adolescents across the weight spectrum.

Methods

Data come from the biennial cross-sectional, school-based surveys, the Youth Risk Behaviour Surveillance System (1999–2013, n = 113,542). The outcome measures were the self-reported UDBs: fasting for 24 h or more; taking diet pills/powders/liquids; and vomiting/taking laxatives. Sex-stratified logistic regressions assessed relationships between weight status misperceptions across all weight statuses, race and WCIs with UDBs. Differential trends between races were assessed using race*year interaction terms.

Results

In males, all non-White races had higher odds of fasting and vomiting/taking laxatives than Whites (except fasting in Hispanic/Latinos), with Adjusted Odds Ratios (AORs) between 1.44 and 2.07. In females, Black/African Americans and Hispanic/Latinos had lower odds of taking diet pills/powders/liquids compared to Whites (AORs 0.50 and 0.78 respectively). Racial disparities persisted throughout the study period. Prevalence of fasting and vomiting/taking laxatives did not change between 1999 and 2013 for all races, while taking diet pills/powders/liquids decreased. Compared to individuals of normal weight who were accurate weight status perceivers, individuals of almost all other combinations of weight status and weight status perception had significantly higher odds of displaying any UDB outcome. Overestimation of weight status was found to be the strongest determinant of UDBs. Compared to individuals endorsing "not wanting to do anything" about their weight, individuals endorsing all other WCIs (including wanting to gain weight) also showed significantly higher odds for every UDB outcome, with wanting to lose weight having AORs of the greatest magnitudes.

Conclusions

Prevalence of UDBs is persistently high, and highest among females across all racial groups. UDBs may elevate undesired weight gain and weight loss in individuals who are obese/overweight and underweight respectively. Further research into weight status perceptions among adolescents may inform efforts to reduce UDBs.

A systematic review of the relationship between weight status perceptions and weight loss attempts, strategies, behaviours and outcomes

It is commonly assumed that a person identifying that they are 'overweight' is an important prerequisite to successful weight management. However, there has been no systematic evaluation of evidence supporting this proposition. The aim of the present research was to systematically review evidence on the relationship between perceived overweight and (i) weight loss attempts, (ii) weight control strategies (healthy and unhealthy), (iii) weight-related behaviours (physical activity and eating habits), (iv) disordered eating and (v) weight change. We synthesized evidence from 78 eligible studies and evaluated evidence linking perceived overweight with outcome variables separately according to the gender, age and objective weight status of study participants. Results indicated that perceived overweight was associated with an increased likelihood of attempting weight loss and with healthy and unhealthy weight control strategies in some participant groups. However, perceived overweight was not reliably associated with physical activity or healthy eating and was associated with greater disordered eating in some groups. Rather than being associated with improved weight management, there was consistent evidence that perceived overweight was predictive of increased weight gain over time. Individuals who perceive their weight status as overweight are more likely to report attempting weight loss but over time gain more weight.

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.

Longitudinal impact of weight misperception and intent to change weight on body mass index of adolescents and young adults with overweight or obesity

OBJECTIVE

Accurate perception of one's weight status is believed to be necessary to motivate weight loss intention and subsequent weight loss among those with overweight/obesity. This proposed pathway, however, is understudied in longitudinal research. This study examined the indirect effect of weight change intention on the relationship between weight status perception and BMI change among adolescents with overweight/obesity.

METHODS

Participants included 2664 adolescents with overweight/obesity (52% female) from the National Longitudinal Study of Adolescent Health. Longitudinal associations between Wave II weight status perception (accurate versus misperception) and intent to change weight (i.e., gain, lose, stay the same) on BMI change (Wave II-Wave IV) were examined using multiple linear regression. Indirect effects of weight change intention were investigated using the Monte Carlo method. Analyses were stratified by gender.

RESULTS

Accurate perceivers (81.0% female; 60.1% male) were more likely than misperceivers (i.e., perception of "about the right weight") to report weight loss intention (p<0.001). Among females, weight status misperception and weight loss intention individually were associated with smaller (β=-1.37, 95% CI [-2.64, -0.10]) and greater (β=1.18, 95% CI [0.11, 2.25]) BMI gains, respectively. Among males, fully adjusted models suggested that weight status misperception was associated with significantly smaller gains in BMI over time (β=-1.51, 95% CI [-2.38, -0.63]). Weight change intention did not emerge as an indirect effect for either gender.

CONCLUSIONS

Although weight status misperception was protective against weight gain, weight change intention did not provide an explanation for this relationship.

Motivation and obstacles for weight management among young women - a qualitative study with a public health focus - the Tromsø study: Fit Futures

Background

Due to a worldwide increase in overweight and obesity, weight-management through lifestyle changes has become an important public health issue. Adolescents and young adults comprise a vulnerable group. The transition into adulthood represents a stage in life when establishing good lifestyle habits for the future is important. The aim of this study was to explore motivation and obstacles for weight reduction, weight maintenance and healthy lifestyle choices in young women.

Methods

We conducted semi-structured in depth interviews with 12 young women, both overweight and normal weight, recruited from a school-based population survey. By the use of thematic analysis we searched the interview text for relevant meaning units that emerged as topics that illuminated our research questions.

Results

A strong motivation for obtaining or keeping normal weight was clearly present among the participants. Independent of weight-group, the participants described increased levels of physical activity, better eating habits and regularity in daily life as desirable changes. Parents were described as important influencers regarding lifestyle habits. Several participants expressed a need for more information about healthy nutrition and eating. Their motivation for physical activity depended on a positive social setting and elements of joy. The participants described the transition into adulthood including moving out of their parents’ home and other structural changes in everyday life, as challenging. It affected their food choices and eating habits and other lifestyle issues. High costs of healthy food and sports activities were frequently mentioned among the obstacles they encountered.

Conclusion

The results revealed an obvious motivation for lifestyle changes in individuals and environmental challenges for young women in the relevant stage of their life-course. There seems to be a need for health strategies that strengthens individuals’ capacity to overcome the environmental challenges in the transition to adulthood. This should include reliable and accessible health education/information regarding healthy nutrition, eating habits, food choices and preparation of meals. Structural initiatives such as easier access to affordable healthy food and less expensive opportunities for physical activity and sports should be considered.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4321-9) contains supplementary material, which is available to authorized users.

Parents' Perceptions of Their Children as Overweight and Children's Weight Concerns and Weight Gain

The global prevalence of childhood obesity is alarmingly high. Parents' identification of their children as overweight is thought to be an important prerequisite to tackling childhood obesity, but recent findings suggest that such parental identification is counterintuitively associated with increased weight gain during childhood. One possibility is that parental identification of their child as being overweight results in that child viewing his or her body size negatively and attempting to lose weight, which eventually results in weight gain. We used data from two longitudinal cohort studies to examine the relation between children's weight gain and their parents' identification of them as being overweight. Across both studies, children whose parents perceive them to be overweight are more likely to view their body size negatively and are more likely than their peers to be actively trying to lose weight. These child-reported outcomes explained part of the counterintuitive association between parents' perceptions of their children as being overweight and the children's subsequent weight. We propose that the stigma attached to being recognized and labeled as "overweight" may partly explain these findings.

An analysis of weight perception and physical activity and dietary behaviours among youth in the COMPASS study

PURPOSE

Weight misperceptions appear common among youth, potentially influencing their motivation to engage in health-related behaviours; however, the direction of impact remains unclear. The current study examined how weight perception influences physical activity (PA) and diet among youth.

METHODS

This study used 2-year linked data of 19,322 grade 9-12 students from Year 2 (Y2:2013-2014) and 3 (Y3:2014-2015) of the COMPASS study. Generalized Estimating Equation models tested the effect of Y3 weight perception on the various Y3 PA and dietary behaviour measures, adjusting for Y3 covariates (grade, race/ethnicity, weekly spending money), school cluster, school area median household income, and the Y2 outcome. Models were stratified by gender and body mass index (BMI) classification.

RESULTS

Regardless of BMI status, overweight perceptions among boys and girls were associated with lower likelihoods of playing school sports, physical education class enrollment, meeting resistance exercise recommendations, eating breakfast regularly, and less vigorous-intensity PA, and among boys only, lower odds of meeting PA guidelines, compared to their peers who perceived their weight as "about right". In boys with normal-weight BMIs, underweight perceptions predicted less vigorous-intensity PA, and lower odds of physical education class enrollment, and of meeting PA and resistance exercise recommendations, than "about right" perceptions. Among girls, underweight perceptions predicted lower likelihoods of engaging in adequate resistance exercise and playing intramurals, and greater odds of eating fast food on weekends, purchasing snacks, and drinking energy drinks and sugar-sweetened beverages. Girls with overweight/obese BMIs who perceived their weight as such were less likely to consume adequate fruits and vegetables relative to their counterparts with "about right" weight perceptions.

CONCLUSIONS

Overall, weight perceptions of "about right" appear more favourable for health behaviours among youth across the weight range. Results suggest obesity prevention strategies aiming to increase awareness of weight status may have unintended effects.

Assessment of adolescent weight status: Similarities and differences between CDC, IOTF, and WHO references

OBJECTIVE

The research sought to determine the reliability of assessing adolescents' weight status based on three standard criteria, Centers for Disease Control and Prevention (CDC) growth charts, International Obesity Task Force (IOTF) standards, and the World Health Organization (WHO) growth references.

METHODS

Data from the NEXT Generation Health Study US 10th grade cohort (n=2323, mean age=16.19years) starting in 2009 were used. Kappa statistics assessed agreement of assignment to weight categories. Associations of weight status with perceived body image, weight control intention, and general health were examined using linear regressions accounting for complex survey design.

RESULTS

Kappas across weight status criteria were≥.89 and agreement exceeded 90% in all analyses. For all three criteria, overweight and obese participants, compared to normal weight, were significantly more likely to indicate fatter body image, higher weight control intention, and poorer general health; small differences in the regression coefficients by classification method were observed.

CONCLUSION

The three criteria of weight status classifications substantially agreed. Associations of weight status with selected health correlates were similar regardless of the methods. Thus, the three classifications can be considered comparable for most research and practice purposes.