Association Between Weight Misperception and Some Mental Health-Related Characteristics in Korean Adolescents

Individualized Implementation of Youth Quality of Life Instrument-Research Version (YQOL-R) Among Chinese Adolescents with Different Weight Status

Purpose

This study implemented the individualized Youth Quality of Life Instrument-Research Version (YQOL-R) to estimate the quality of life (QoL) among Chinese adolescents with three different Body Mass Index (BMI) levels. The study aims to explore and provide a reference for developing individualized QoL (IQoL) measurements in China.

Methods

The sample consisted of 822 aged 11-18 from nine schools. The data collection included all participants' primary characters (age, sex, annual household income, parental education, and recruitment community) and their self-report QoL. Precisely, based on the generic measurement of YQOL-R, we developed IQoL measurements by asking adolescents' perceived five most important things to them (IQOLimportance) and the aspects they most want to change (IQOLchange) from 19 facets, respectively. The one-way analysis of variance (ANOVA) was applied to compare total and subscale scores of IQOLimportance, IQOLchange, and YQOL-R among adolescents with three different weight status. Also, the data analysis used multivariable linear regression modeling to test the effects on scores of IQOLimportance and IQOLchange.

Results

Overall, the obese adolescents identified "Having good physical health" as the most important (54.03%) and most like-to-change (42.65%); in contrast, the normal-weight group ranked "Being myself" as the top facet of IQOLimportance (52.42%) and "Having good friends" as the top facet of IQOLchange (43.12%). The obese adolescents' reported IQOLimportance scores are significantly lower than those of the normal-weight group (P=0.039). However, there is no significant difference in IQOLchange score among the three weight-status groups. The multivariable linear regression models indicated that adolescents who are girls (P=0.035), have higher educated fathers (P=0.049), and are overweight/obese (P=0.041) self-reported worse IQOLimportance score; yet, the girls (P=0.023) and older adolescents (P=0.004) answered lower IQOLchange scores. In addition, adolescents who had higher educated mothers (P=0.047; 0.023) and responded with higher total YQOL-R scores (P<0.001; <0.001) reported higher IQOLimportance and IQOLchange scores.

Conclusion

In the current study, although the self-reported YQOL-R scores from different weight status did not present a significant difference, the obese group reported a statistical trend towards lower IQOLimportance scores than the normal-weight and overweight adolescents. These findings emphasize that IQOLimportance and IQOLchange could capture adolescents' perspectives with different weight statuses about their lives, which are unique as complementary health outcomes accompanying YQOL-R in health surveys and interventions among Chinese adolescents.

Sociodemographic factors associated with weight perception of adolescents: A systematic review and meta-analysis

PURPOSE

To systematically assess the main sociodemographic factors associated with weight perception of adolescents.

METHODOLOGY

All studies related to adolescents' weight perception were retrieved from seven databases from January 2001 to July 2022. A total of 13 Medical Subject Headings (MeSH) and keywords were used to identify qualified studies, and reference lists included in the retrieved studies were manually searched to identify potentially relevant publications. Two evaluators independently assessed the eligibility and extracted data of each study. Agency for Healthcare Research and Quality (AHRQ) risk of bias evaluation tool was used to evaluate the quality and bias risk of included studies. RevMan (version: 5.3) software was used to conduct heterogeneity test and meta-analysis.

RESULTS

A total of 12 studies, published between 2003 and 2020, were selected and included in the systematic review and meta-analysis, consisting of 325,367 adolescents from five countries. The risk of bias evaluation indicated that risk of bias was low in five studies and moderate in seven studies. The results of meta-analysis showed that there were no differences in the weight perception accuracy among adolescents under different gender (odds ratio [OR] = 1.00, 95% confidence interval [CI]: 0.88-1.15, p = 0.940), place of residence (OR = 0.98, 95% CI: 0.83-1.16, p = 0.800), grade (OR = 1.73, 95% CI: 0.68-4.42, p = 0.250), and family economic level (OR = 0.94, 95% CI: 0.86-1.02, p = 0.140). Egger's linear regression showed that there was no significant publication bias in the primary analysis.

CONCLUSIONS

The current analysis indicates that gender, place of residence, grade, and family economic level were not identified as influencing factors for adolescents' weight perception accuracy. Due to the limitations of the review and included studies, more robust trials are warranted in different social and economic environments to confirm our findings.

The association of weight control attempts with suicidality: The role of objective weight status and weight perception among adolescents of United States

BACKGROUND

The evidence for the association of weight control attempts with suicidality by objective weight status, subjective weight perception, and distorted weight perception among adolescents was limited.

METHODS

Data were extracted from a national representative sample of Youth Risk Behavior Surveys in the United States from 2011 to 2019. Binary logistic regression models with complex sampling designs were used to explore the association of weight control attempts, objective weight status, and weight perception with suicidality.

FINDINGS

The adolescents attempting to lose weight had higher weighted prevalence of suicidal ideation, suicide plan, suicide attempt, and suicide attempt with medical treatment compared with other attempts of weight control. Totally, attempting to lose weight was significantly associated with increased risk of suicidal ideation (OR: 1.17, 95%CI: 1.05-1.30) and suicide attempt (OR: 1.26, 95%CI: 1.10-1.46) when adjusting objective weight status, weight perception and all other covariates. In the subgroup analyses, attempting to lose weight was significantly associated with increased risk of suicidality in the adolescents of normal weight, underweight, perceived normal weight, perceived underweight, right estimation of objective weight status.

LIMITATIONS

Uncertain causal relationship existed because of cross-sectional design.

CONCLUSIONS

The risk of suicidality associated with weight control attempts varied among different subgroups. The findings in this study suggest that not only objective weight status but also weight perception should be with consideration when performing weight control attempts.

Parental Stress on Children's Appearance, Body Dissatisfaction, and Eating Behaviours in Chinese Children: A Pathway Analysis

Purpose

This study aimed to analyze the association pathways of parental stress on children's appearance, body dissatisfaction, and eating behaviours in Chinese children and adolescents.

Patients and Methods

The children aged 8-15 years were selected from 2 nine-year schools using stratified cluster random sampling. The appearance-related social stress questionnaire and the body dissatisfaction subscale of EDI-1 were used to investigate parental stress on children's appearance and body dissatisfaction, respectively. The self-administered eating frequency questionnaire was used to investigate children's eating behaviours.

Results

Body dissatisfaction in girls mediated associations between BMI, parental teasing, parental injustice and ignorance, parental encouragement and healthy eating behaviour: BMI → body dissatisfaction → healthy eating behaviour, parental teasing → body dissatisfaction → healthy eating behaviour, parental injustice and ignorance → body dissatisfaction → healthy eating behaviour, parental encouragement → body dissatisfaction → healthy eating behaviour. Parental injustice and ignorance directly and negatively predicted healthy eating behaviour in girls. In boys and girls, parental teasing was a direct predictor factor of unhealthy eating behaviour.

Conclusion

Parental teasing, parental injustice and ignorance, parental encouragement, and BMI through body dissatisfaction positively predicted healthy eating behaviour in girls, parental injustice and ignorance directly negatively predicted healthy eating behaviour in girls, and parental teasing directly positively predicted unhealthy eating behaviour in girls and boys. Therefore, parental pressure on children's appearance may pay important role in children's eating behaviours.

Relationships between Weight Perceptions and Suicidal Behaviors in Chinese Adolescents: Results from an Ongoing School-Based Survey in Zhejiang Province

BACKGROUND

Weight perception has been implicated in suicidal behaviors among children and adolescents, yet little is known about the relationships in China. We examined the associations of self-perceived weight status and weight misperception with suicidal behaviors among Chinese adolescents.

METHODS

Data used in this analysis were from the 2017 Zhejiang Youth Risk Behavior Survey, which included 17,359 middle and high school students aged 9 to 18 years. Information on perceived weight status, as well as the actual height, weight and other related traits, was extracted by a self-reported questionnaire. Multivariate logistic regression models were used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for suicidal behaviors associated with perceived weight status and weight misperception.

RESULTS

Overall, the mean (SD) age was 15.7 (1.6) years among the study participants. Students who perceived themselves as overweight were more likely to have increased suicidal ideation and attempts reports, with ORs of 1.22 (95% CI: 1.09-1.37) and 1.32 (1.06-1.34), compared to those who perceive themselves as having about the right weight. Overestimated weight was significantly associated with greater odds of suicidal ideation (OR: 1.15, 95% CI: 1.03-1.27) and attempts (1.35, 1.10-1.65) relative to accurate weight perception.

CONCLUSIONS

Controlling for potential confounders, we found that both self-perception of overweight and overestimated perception were significantly associated with suicidal ideation and attempts among Chinese adolescents.

Body Weight, Weight Self-Perception, Weight Teasing and Their Association with Health Behaviors among Chinese Adolescents-The Shanghai Youth Health Behavior Survey

Weight-related status has been associated with the physical and psychological health of adolescents. This cross-sectional study evaluated three different kinds of weight-related statuses (Body Mass Index (BMI), weight self-perception and weight teasing from others) among Chinese adolescents and identified their associations with health risk behaviors (lack of healthy dietary behavior, unhealthy dietary behavior, binge eating behavior, lack of physical activity (PA), sedentary behaviors (SB) and sleep disturbance). A stratified random cluster sampling method was used to select 10,070 students aged 11−18 years old from schools in Shanghai. Self-reported questionnaires were collected, weight-related statuses were divided into three categories and six specific health risk behaviors were classified into two groups: positive or negative. Overall, 27.82% of the adolescents were classified as being overweight and obese (35.61% of boys and 18.21% of girls), 43.45% perceived themselves as too heavy and 30.46% experienced weight teasing in the past. Among overweight or obese participants, 50.55% have been teased about their weight, and 77.48% perceived themselves as too heavy. Weight perception and weight teasing were significantly associated with health risk behaviors rather than the actual body weight status based on BMI, especially regarding binge eating behavior (body weight status (BMI): p > 0.05, underweight perception: OR = 1.18, 95%CI 1.03−1.34; weight teasing for more than once a year: OR = 2.00, 95%CI 1.76−2.27). In addition, weight perception and weight teasing were significantly associated with health risk behaviors, mainly in normal and overweight/obese groups but not in underweight groups. Weight teasing and weight self-perception play an independent and stronger role than actual body weight in the health behaviors of adolescents. This calls for more attention and intervention to reduce peer bullying and stigmas on weight among adolescents.

Novel anthropometric predictors of subjective weight among women

The main aim of the current study was to examine novel anthropometric predictors of subjective weight among women. In this cross-sectional study, 229 women were selected through simple random sampling method. The participants completed the Multidimensional Body Self-Relation Questionnaire. Pearson correlation coefficient and linear regression were used to analyze the data. The mean subjective weight score was 4.05 ± 1.01. There was a significant relationship between anthropometric indices and subjective weight (Pearson r correlation range: 0.62-0.81, p < .01). Beta coefficients for predictor variables indicated that weight (ß = -2.774, t (229) = -2.868, p = .005), hip circumference (ß = 3.454, t (229) = 5.999, p < .001), waist to hip ratio (ß = 4.218, t (229) = 4.953, p < .001), waist to height ratio (ß = -3.284, t (229) = -2.067, p = .04), and conicity index (ß = -0.708, t (229) = -2.518, p = .013) significantly predicted the subjective weight. The waist to hip ratio was the most important predictor of the subjective weight. This study suggests using the waist to hip ratio as an anthropometric index in subjective weight studies in women. Considering the negative impact of subjective weight on women's health, these results indicate the need for interventions designed to control body weight and unsuitable anthropometric indices in women.