Perspective from Marlene Schwartz, PhD
July 24, 2014
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NHANES: Most overweight children perceive their weight as healthy

Perspective from Marlene Schwartz, PhD
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About one-third of adolescent children in the United States misperceive their weight status, and weight status misperception is more common among boys than girls.

An analysis of National Health and Nutrition Examination Survey data released by the CDC also showed that 81% of overweight boys and 71% of overweight girls aged 8 to 15 years perceive themselves as having a healthy weight.

Study data also demonstrated that nearly 48% of obese boys and 36% of obese girls perceived themselves to be an appropriate weight for their age.

Neda Sarafrazi, PhD, and colleagues from the CDC’s National Center for Health Statistics, recently published the data brief summarizing perceptions of body weight in adolescents aged 8 to 15 years. NHANES data were collected from 2005 to 2012 at sites across the country, and figures correspond to an estimated 9.1 million children living in the United States.

“Accurate weight status self-perception has been linked to appropriate weight control behaviors in youth,” the researchers wrote. “Weight status misperception occurs when the child’s perception of their weight status differs from their actual weight status based on measured height and weight.”

The Obesity Society released a statement from Steven Smith, MD, stating:

“The concern with these findings is twofold. Without an accurate understanding of their weight, particularly the health concerns associated with excess weight, parents and children may be less likely to take steps to achieve a healthier weight. This lack of understanding has the potential to put their health at risk.”

“However, shaming all individuals as a result of a weight-related problem can have even worse health consequences. These potential negative effects are likely worse among children given the various physical, physiological (including hormonal) changes they are experiencing. Weight is something we wear on the outside and is a very personal topic,” Smith said.

“For children, the focus for improving weight and health should be on encouraging healthy habits and norms that will follow children into adulthood, not just weight status,” he added. “Encouraging healthy habits for kids, without causing harm, often requires a delicate balance — most suited for an experienced health care professional.” 

Demographic analysis

Graphs in the brief provide a visual perspective on demographic trends in age, sex, race and income/poverty status:

  • 34% of Mexican-American and 34.4% of non-Hispanic black children and adolescents misperceive their weight vs. 27.7% of non-Hispanic white children.
  • 81% of overweight boys and 71% of overweight girls perceive themselves as having a healthy weight.
  • About 48% of obese boys and 36% of obese girls perceived themselves to be an appropriate weight for their age.
  • Children from families within the study’s lowest income bracket misperceived their weight at the highest rate (32.5%), with children from the middle income bracket (30.7%) and children from the highest income bracket (26.3%) misperceiving their weight less.
  • Overall, about 30% of children misperceive their weight status, with boys at 32.3% and girls at 28%.

From 2011 to 2012, nearly 17% of children and adults living in the United States were obese, and the condition poses an immediate public health concern, according to the study researchers.

“Understanding the prevalence of weight status misperception among U.S. children and adolescents may help inform public health interventions,” they said.

For more information:

Sarafrazi N. Perception of weight status in U.S. children and adolescents aged 8-15 years, 2005-2012. NCHS data brief, no 158. Hyattsville, MD: National Center for Health Statistics. 2014.

Disclosure: The researchers are employed by the CDC’s National Center for Health Statistics.