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Teenage weight misperception can adversely affect diet, physical activity

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February 17, 2019

Weight misperception in adolescence can lead to increasingly unhealthy dietary behaviors and physical activity levels, according to findings published in The Journal of School Nursing.

Jagdish Khubchandani, MBBS, PhD

“When we look at adults who are overweight and misperceive their weight, a lot of it starts in adolescence and childhood,” Jagdish Khubchandani, MBBS, PhD, an associate professor of health science in the College of Health at Ball State University in Muncie, Indiana, told Endocrine Today. “Because such a large section of the population misperceives their weight, either they do not try to lose weight or maintain healthy weight (when they are truly overweight) or many are trying desperate and unhealthy means to lose weight when they should not (they are normal weight). Such behaviors are frequently associated with abnormal diet and psychological problems.”

Khubchandani and colleagues analyzed data from the 2015 Youth Risk Behavior Survey from the CDC. The survey was implemented in 180 public and private high schools in the U.S. and was made up of more than 100 questions that recorded information about adolescent health. Among these, height and weight were self-reported while other questions pertained to dietary behaviors, weight perception and physical activity levels.

Among the 12,016 participants (52% girls) included in the analysis by Khubchandani and colleagues, 31.8% were overweight, with the rate higher in boys than in girls (34.4% vs. 29.1%; P < .05). In addition, 22.9% of adolescents misperceived their weight, with 11.6% overestimating their weight and 11.3% underestimating it. A higher proportion of girls misperceived themselves as overweight compared with boys (17% vs. 5.8%; P < .05), according to the study. Conversely, more boys misperceived themselves as not overweight compared with girls (16% vs. 6.9%; P < .05).

Girls who falsely identified themselves as overweight were more likely to try losing weight (adjusted OR = 12.6; 95% CI, 10.08-14.4) than girls who accurately perceived that they were overweight (aOR = 9.9; 95% CI, 7.02-12.6), girls who incorrectly perceived themselves as not overweight (aOR = 1.88; 95% CI, 1.34-2.63) and girls who correctly perceived that they were not overweight, with the latter group used as reference. Among these four groups, the lowest odds for physical activity engagement was found in girls who accurately perceived that they were overweight (aOR = 0.59; 95% CI, 0.48-0.72), the researchers reported.

For boys, accurately perceiving overweight status was linked to higher odds of trying to lose weight (aOR = 10.71; 95% CI, 8.27-13.34) compared with boys who inaccurately perceived themselves as overweight (aOR = 8.69; 95% CI, 6.49-11.5), boys who inaccurately perceived themselves as not overweight (aOR = 3.51; 95% CI, 2.63-4.69) and boys who accurately perceived themselves as not overweight, with the latter group used as reference. Boys who overestimated their weight were least likely to engage in physical activity (aOR = 0.32; 95% CI, 0.22-0.48).

“Clinicians, especially pediatricians, need to understand the complex interplay between actual body weight, perceived body weight and body image, diet and physical activity habits, and psychological problems or mindset of teenagers,” Khubchandani said. “Frequently, many problems occur together in adolescents and children that warrant comprehensive screening and assessment. For example, feeling overweight may be associated with eating disorders, other mental health issues and suicidal ideation. Also, some teenagers will try laxatives, pills and vomiting to lose weight, even if they are not overweight, and this can lead to long-term psychological problems.” – by Phil Neuffer

Disclosure: Khubchandani reports no relevant financial disclosures.

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