Predictors of Persistent Body Weight Misclassification from Adolescence Period to Adulthood: A Longitudinal Study

Different Categories of Social Media Use and Their Association With Body Image Among Adolescents in 42 Countries

Objectives

Social media has become integrated into adolescents' lives and influences body image perceptions. Our study examined four patterns of social media use (SMU): non-active, active, intensive, and problematic. We hypothesised that intensive SMU and problematic SMU would be associated with negative body image (negative subjective body weight) and over/underestimated body weight congruence, compared to non-active and active SMU. In addition, we expect these associations to be stronger for girls.

Methods

Data from 190,892 respondents aged 11, 13, and 15 from 42 countries involved in the Health Behaviour in School-aged Children study were analysed.

Results

Findings revealed higher rates of intensive or problematic SMU among adolescents who perceived themselves as too fat or too thin. Two-level regression analyses showed intensive and problematic SMU as more likely to perceive themselves as too fat or too thin than active users. The association was significant among intensive and problematic girl social media users, whereas, among boys, the relationship was only significant for problematic users.

Conclusion

Our findings highlight the importance of assessing SMU patterns to evaluate associations with body image.

Psychosocial Predictors of Body Weight Congruence in Adolescents Aged 15 and 17 Years in Poland: Findings from the Health Behaviour in School-Aged Children (HBSC) Study

Background: Body weight congruence (BWC) has implications for adolescent health. The main goal of this study was to examine the distribution of BWC and its relationship with six psychosocial factors. Methods: A representative sample of N = 3508 adolescents aged 15 and 17 years (52.4% girls) derived from the Health Behaviour in School-aged Children study, conducted in 2017/2018 in Poland, was used. BWC groups were defined based on self-reported BMI and subjective assessment of weight: (1) correct perception; (2) overestimation, and (3). underestimation. Principal component analysis (PCA) extracted the following two factors: a socio-relational factor (SR) related to perceived social support and social self-efficacy, and a body attitudes and social media exposure factor (BAME). Using the total sample, multinomial logistic regression was applied to estimate their impact on the BWC, and gender-specific models were compared. Results: Half (48.6%) of the adolescents correctly estimated their body weight, 31.0% overestimated it (girls 43.9%, boys 17.1%), and 20.0% underestimated it (boys 37.2%, girls 9.0%). Overestimation of body weight concerns 48.0% of normal weight girls, 50.0% of underweight girls, and 21.3% and 32.1% of normal weight and underweight boys, respectively. The percentage of normal weight (34.4%), and overweight and obese (30.8%) boys who underestimated their body weight was three times higher than the respective percentages of girls that underestimated their weight (9.0% and 11.9%). The SR factor protected adolescents from both underestimation (only in girls) and overestimation in the total sample (OR 0.74, 95%CI 0.68–0.81) and both genders. BAME increased this risk of overestimation in both genders (OR = 1.83, 95%CI 1.67–2.0), and the risk of underestimation among boys. Conclusions: Prevention programmes should include a wide range of psychosocial factors to improve BWC among adolescents.

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.

Overestimation of body weight and its association with parental, teacher and peer support: evidence from the Israeli Health Behaviours in Schools survey

OBJECTIVE

To investigate the association between family, teachers and peer support patterns on gaps in adolescent's weight perceptions.

DESIGN

A cross-sectional, school-based survey collected information on weight and height, weight perception, socio-economic and family characteristics and social support. Principal component analysis (PCA) was performed to capture social support patterns (SSP). Multivariable logistic regression was used to model adolescent weight perception, including SSP adjusted for demographic variables.

SETTING

The 2014 Israeli Health Behaviours in School-Aged Children (HBSC) survey.

PARTICIPANTS

Adolescents aged 11-18 years (n 7563).

RESULTS

In total, 16·1 % of the boys and 10·7 % of the girls were overweight or obese. Most participants perceived their size accurately. Body size was underestimated by 25·6 % of the boys and 15·1 % of the girls, while 15·2 % of the boys and 27·7 % of the girls overestimated their body size. PCA generated three SSP accounting for 81·9 % of the variance in social support. Female sex and higher SES increased odds of overestimating body size. Students in the top quartile (Q4 v. Q1-Q3) of family support and teacher support were less likely to overestimate their body size. Good parental communication reduced the odds of body size overestimation in middle school students. Male sex and higher family support increased odds of underestimation.

CONCLUSIONS

Significant support from parents and teachers was associated with accurate weight perceptions; thus, support skills may be amenable to intervention. Efforts should be made to educate adolescents on healthy weight.

Predictors of One-Year Change in How Youth Perceive Their Weight

Overall, perceptions of being at "about the right weight" appear advantageous for youth physical and mental health, regardless of BMI classification, whereas perceptions at either extreme (overweight or underweight) may negatively impact health behaviours and mental health. Instead of considering weight misperceptions as problematic, some researchers have proposed that underestimations of weight status may offer resiliency among individuals with overweight or obesity. Promoting "about right" WPs and preventing change to overweight or underweight perceptions may offer an effective public health strategy for supporting youth health over time. However, limited prospective evidence exists on factors that shape perceptions of weight status over time. The current study examined modifiable predictors of one-year change in weight perception among youths. We used 2-year linked data of 18,112 grade 9-12 students from Year 3 (Y₃:2014-2015) and Year 4 (Y₄:2015-2016) of the COMPASS study. Generalized Estimating Equation models tested screen use, physical activity, and bullying victimization as predictors of change from perceptions of "about the right weight" to "overweight" or "underweight" perceptions, adjusting for Y₃ covariates (body mass index, ethnicity, and grade) and school cluster. Results support the value of team sports among females and resistance exercise among males as protective against changes to overweight or underweight perceptions over one year. Also, various forms of bullying victimization predicted overweight perceptions in males and females. Watching TV/movies or messaging/texting for over 2 hours/day was associated with overweight and underweight perceptions, respectively, in females only. Playing video/computer games for over 2 hours/day was associated with overweight perceptions in males and underweight perceptions in females. Findings support the potential of bullying prevention, limiting certain screen use, and supporting engagement in team sports for females and resistance exercise for males as strategies to maintain perceptions of being at "about the right weight."