Original Article

Weight Perception and Weight Control Practice in a Multiethnic Sample of US Adolescents

Authors: Alice F. Yan MD, Guangyu Zhang PhD, Min Qi Wang PhD, Carolyn A. Stoesen MA, B Michelle Harris PhD, MPH, RD, LD

Abstract

Objectives:Obesity is disproportionately prevalent among many racial/ethnic minority groups. The main objectives of this study are (1) to examine the extent of body weight misperception for a representative sample of US adolescents; (2) to explore the gender and racial/ethnic differences associated with an adolescents’ weight goals and weight loss attempts and; (3) to examine the influence of an array of sociodemographic factors (eg socioeconomic status) on body weight misperception in adolescents.Methods:A sample of 2,195 adolescents (aged 10 to 18 years) enrolled in the National Health and Nutrition Examination Survey (2005–2006) was examined. Adolescents’ weight and height were measured by lab exams. Perception of weight status, weight goals, and weight loss attempts were obtained by questionnaire. Participants’ self-perceptions of their current weight status were compared to classification of their body mass index (BMI) in order to determine concordance. We used multinomial logistic regression models to assess the predictive effects of various sociodemographic factors on weight misperception.Results:Twenty-five percent of girls and 33.2% of boys misperceived their weight status by medical standards. Significant sex and racial/ethnic differences existed in weight perception, attempts to lose weight, and weight goals. Multivariate analysis revealed that age, gender, marital status of parent/guardian were independently associated with the misperception of weight status, controlling for body mass index.Conclusions:Differences in weight perception, weight goals, and weight loss attempts among ethnic and racial groups call for targeted obesity control efforts.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

References1.USDHHS. Healthy People 2010: Conference Edition. Washington, DC, U.S. Government Printing Office, 2000.2.Hedley AA, Ogden CL, Johnson CL, et al. Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA 2004;291:2847–2850.HedleyAA]]OgdenCL]]JohnsonCL&etal;Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002.JAMA20042912847-28503.Ogden CL, Carroll MD, Curtin LR, et al. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006;295:1549–1555.OgdenCL]]CarrollMD]]CurtinLR&etal;Prevalence of overweight and obesity in the United States, 1999–2004.JAMA20062951549-15554.Wang Y, Beydoun MA. The obesity epidemic in the United States-gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a system review and meta-regression analysis. Epidemiol Rev 2007;29:6–28.WangY]]BeydounMAThe obesity epidemic in the United States-gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a system review and meta-regression analysis.Epidemiol Rev2007296-285.Daniels J. Weight and weight concerns: are they associated with reported depressive symptoms in adolescents? J Pediatr Health Care 2005;19:33–41.DanielsJWeight and weight concerns: are they associated with reported depressive symptoms in adolescents?J Pediatr Health Care20051933-416.Brener ND, Eaton DK, Lowry R, et al. The Association between weight perception and BMI among high school students. Obes Res 2004;12:1866–1874.BrenerND]]EatonDK]]LowryR&etal;The Association between weight perception and BMI among high school students.Obes Res2004121866-18747.Desmond SM, Price JH, Gray N, et al. The etiology of adolescents’ perceptions of their weight. J Youth Adolesc 1986;15:461–474.DesmondSM]]PriceJH]]GrayN&etal;The etiology of adolescents’ perceptions of their weight.J Youth Adolesc198615461-4748.Johnson-Sabine E, Wood K, Patton G, et al. Abnormal eating attitudes in London school girls- a prospective epidemiological study: factors associated with abnormal response on screening questionnaires. Psychol Med 1988;18:615–622.Johnson-SabineE]]WoodK]]PattonG&etal;Abnormal eating attitudes in London school girls- a prospective epidemiological study: factors associated with abnormal response on screening questionnaires.Psychol Med198818615-6229.Page RM, Ihász F, Uvacsek M, et al. Self-Perception of body weight, weight management practices and goals, and other weight-related factors in central and eastern European adolescents. Int Q Community Health Educ 2007;27:39–58.PageRM]]IhászF]]UvacsekM&etal;Self-Perception of body weight, weight management practices and goals, and other weight-related factors in central and eastern European adolescents.Int Q Community Health Educ20072739-5810.Olvera N, Suminski R, Power TG. Intergenerational perceptions of body image in hispanics: role of BMI, gender, and acculturation. Obes Res 2005;13:1970–1979.OlveraN]]SuminskiR]]PowerTGIntergenerational perceptions of body image in hispanics: role of BMI, gender, and acculturation.Obes Res2005131970-197911.Chang VW, Christakis NA. Self-perception of weight appropriateness in the United States. Am J Prev Med 2003;24:332–339.ChangVW]]ChristakisNASelf-perception of weight appropriateness in the United States.Am J Prev Med200324332-33912.Centers for Disease Control and Prevention (CDC). Update: prevalence of overweight among children, adolescents, and adults—United States, 1988–1994. MMWR Morb Mortal Wkly Rep 1997;46:198–202.Centers for Disease Control and Prevention (CDC)Update: prevalence of overweight among children, adolescents, and adults—United States, 1988–1994.MMWR Morb Mortal Wkly Rep199746198-20213.Strauss RS. Self-reported weight status and dieting in a cross-sectional sample of young adolescents: National Health and Nutrition Examination Survey III. Arch Pediatr Adolesc Med 1999;153:741–747.StraussRSSelf-reported weight status and dieting in a cross-sectional sample of young adolescents: National Health and Nutrition Examination Survey III.Arch Pediatr Adolesc Med1999153741-74714.Paeratakul S, White MA, Williamson DA, et al. Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight. Obes Res 2002;10:345–350.PaeratakulS]]WhiteMA]]WilliamsonDA&etal;Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight.Obes Res200210345-35015.CDC. Epi Info Version 3.5 Release date: June 17, 2008. Available at: http://www.cdc.gov/epiinfo/. Accessed July 6, 2008.16.Kuczmarski RJ, Ogden CL, Guo SS, et al. 2000 CDC growth charts for the United States: methods and development. National Center for Health Statistics. Vital Health Stat 2002;11:1–190.KuczmarskiRJ]]OgdenCL]]GuoSS&etal;2000 CDC growth charts for the United States: methods and development. National Center for Health Statistics.Vital Health Stat2002111-19017.Chang VW, Christakis NA. Extent and determinants of discrepancy between self-evaluations of weight status and clinical standards. J Gen Intern Med 2001;16:538–543.ChangVW]]ChristakisNAExtent and determinants of discrepancy between self-evaluations of weight status and clinical standards.J Gen Intern Med200116538-54318.Barlow SE, Dietz WH. Obesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services. Pediatrics 1998;102:E29.BarlowSE]]DietzWHObesity evaluation and treatment: Expert Committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration and the Department of Health and Human Services.Pediatrics1998102E2919.Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser 1995;854:1–452.&NA;Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee.World Health Organ Tech Rep Ser19958541-45220.Wang Y, Zhang Q. Are American children and adolescents of low socioeconomic status at increased risk of obesity? Changes in the association between overweight and family income between 1971 and 2002. Am J Clin Nutr 2006;84:707–716.WangY]]ZhangQAre American children and adolescents of low socioeconomic status at increased risk of obesity? Changes in the association between overweight and family income between 1971 and 2002.Am J Clin Nutr200684707-71621.Chang VW, Lauderdale DS. Income disparities in body mass index and obesity in the United States, 1971–2002. Arch Intern Med 2005;165:2122–2128.ChangVW]]LauderdaleDSIncome disparities in body mass index and obesity in the United States, 1971–2002.Arch Intern Med20051652122-212822.Gustafson-Larson AM, Terry RD. Weight-related behaviors and concerns of fourth-grade children. J Am Diet Assoc 1992;92:818–822.Gustafson-LarsonAM]]TerryRDWeight-related behaviors and concerns of fourth-grade children.J Am Diet Assoc199292818-82223.Flynn KJ, Fitzgibbon M. Body images and obesity risk among black females: a review of the literature. Ann Behav Med 1998;20:13–24.FlynnKJ]]FitzgibbonMBody images and obesity risk among black females: a review of the literature.Ann Behav Med19982013-2424.Stevens J, Kumanyika SK, Keil JE. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health 1994;84:1322–1325.StevensJ]]KumanyikaSK]]KeilJEAttitudes toward body size and dieting: differences between elderly black and white women.Am J Public Health1994841322-132525.Smith DE, Thompson JK, Raczynski JM, et al. Body image among men and women in a biracial cohort: the CARDIA Study. Int J Eat Disord 1999;25:71–82.SmithDE]]ThompsonJK]]RaczynskiJM&etal;Body image among men and women in a biracial cohort: the CARDIA Study.Int J Eat Disord19992571-8226.Paeratakul S, White MA, Williamson DA, et al. Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight. Obes Res 2002;10:345–350.PaeratakulS]]WhiteMA]]WilliamsonDA&etal;Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight.Obes Res200210345-35027.Rubin LR, Fitts ML, Becker AE. Whatever feels good in my soul: body ethics and aesthetics among African American and Latina women. Cult Med Psychiatry 2003;27:49–75.RubinLR]]FittsML]]BeckerAEWhatever feels good in my soul: body ethics and aesthetics among African American and Latina women.Cult Med Psychiatry20032749-7528.Bandini LG, Dietz WH. Myths about childhood obesity. Pediatr Ann 1992;21:647–652.BandiniLG]]DietzWHMyths about childhood obesity.Pediatr Ann199221647-65229.Sharpe TM, Killen JD, Bryson SW, et al. Attachment style and weight concerns in preadolescent and adolescent girls. Int J Eat Disord 1998;23:39–44.SharpeTM]]KillenJD]]BrysonSW&etal;Attachment style and weight concerns in preadolescent and adolescent girls.Int J Eat Disord19982339-4430.Lynch E, Liu K, Spring B, et al. Association of ethnicity and socioeconomic status with judgments of body size: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Am J Epidemiol 2007;165:1055–1062.LynchE]]LiuK]]SpringB&etal;Association of ethnicity and socioeconomic status with judgments of body size: the Coronary Artery Risk Development in Young Adults (CARDIA) Study.Am J Epidemiol20071651055-106231.Xie B, Liu C, Chou CP, et al. Weight perception and psychologtical factors in Chinese Adolescents. J Adolesc Health 2003;33:202–210.XieB]]LiuC]]ChouCP&etal;Weight perception and psychologtical factors in Chinese Adolescents.J Adolesc Health200333202-210