Advertisement

Accuracy of Weight Perceptions in a Nationally Representative Cohort of US 8th Grade Adolescents

  • Ashlesha Datar
    Correspondence
    Address correspondence to Ashlesha Datar, PhD, MA, Center for Economic and Social Research, University of Southern California, 635 Downey Way, Los Angeles, CA 90089-3332.
    Affiliations
    Center for Economic and Social Research, University of Southern California, Los Angeles, Calif

    RAND Health, The RAND Corporation, Santa Monica, Calif
    Search for articles by this author
  • Paul J. Chung
    Affiliations
    Departments of Pediatrics and Health Policy and Management, University of California, Los Angeles, Calif

    Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, Los Angeles, Calif

    RAND Health, The RAND Corporation, Santa Monica, Calif
    Search for articles by this author

      Abstract

      Objective

      To describe the accuracy of weight perceptions in a nationally representative sample of US 8th graders, its relationship with weight control intentions (WCI), and the relationship of weight misperceptions and WCI with diet and activity behaviors.

      Methods

      Data analyzed came from the 8th grade wave (2006–2007) of the Early Childhood Longitudinal Study–Kindergarten Class, a nationally representative sample. Body mass index was calculated from height and weight measurements for 7800 8th graders (mean age 14.3 years). Measured weight status was categorized into underweight, normal weight, overweight, and obese using the US Centers for Disease Control and Prevention's age- and sex-specific growth charts. Self-reported weight status was compared with measured weight status to classify adolescents into accurate perceivers, overestimators, and underestimators. Multivariate logistic and negative binomial regression models were estimated for binary and count data outcome variables, respectively.

      Results

      Overall, 42.1% of adolescents misperceived their weight status: 35.3% underestimated and 6.8% overestimated their weight status. Among overweight or obese adolescents, 68.4% misperceived their weight status; 35% of underweight adolescents overestimated their weight status. Among normal-weight adolescents, 8.5% overestimated and 18.5% underestimated their weight. Compared to accurate perception, both overestimation and underestimation of weight status were associated with greater likelihood of inappropriate WCI, but only underestimation was associated with unhealthy diet and activity behaviors.

      Conclusions

      Weight misperception was a common problem among US adolescents from all weight categories and was associated with inappropriate WCI. Future research should examine how adolescents' weight perceptions are formed and whether reducing misperceptions may improve behaviors.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ogden C.L.
        • Carroll M.D.
        • Curtin L.R.
        • et al.
        Prevalence of high body mass index in US children and adolescents, 2007–2008.
        JAMA. 2010; 303: 242-249
        • Whitaker R.C.
        • Wright J.A.
        • Pepe M.S.
        • et al.
        Predicting obesity in young adulthood from childhood and parental obesity.
        N Engl J Med. 1997; 337: 869-873
        • Guo S.S.
        • Wu W.
        • Chumlea W.C.
        • et al.
        Predicting overweight and obesity in adulthood from body mass index values in childhood and adolescence.
        Am J Clin Nutr. 2002; 76: 653-658
        • Singh A.S.
        • Mulder C.
        • Twisk J.W.R.
        • et al.
        Tracking of childhood overweight into adulthood: a systematic review of the literature.
        Obes Rev. 2008; 9: 474-488
        • Must A.
        • Strauss R.S.
        Risks and consequences of childhood and adolescent obesity.
        Int J Obes Relat Metab Disord. 1999; 23: S2-S11
        • Goran M.I.
        • Ball G.D.C.
        • Cruz M.L.
        Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents.
        J Clin Endocrinol Metab. 2003; 88: 1417-1427
        • Freedman D.S.
        • Khan L.K.
        • Dietz W.H.
        • et al.
        Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study.
        Pediatrics. 2001; 108: 712-718
        • Must A.
        • Jacques P.F.
        • Dallal G.E.
        • et al.
        Long-term morbidity and mortality of overweight adolescents.
        N Engl J Med. 1992; 327: 1350-1355
        • Baker J.L.
        • Olsen L.W.
        • Sorensen T.I.A.
        Childhood body-mass index and the risk of coronary heart disease in adulthood.
        N Engl J Med. 2007; 357: 2329-2337
        • Bush P.J.
        • Iannotti R.J.
        A children's health belief model.
        Med Care. 1990; 28: 69-86
        • Chen H.Y.
        • Lemon S.C.
        • Pagoto S.L.
        • et al.
        Personal and parental weight misperception and self-reported attempted weight loss in US children and adolescents, National Health and Nutrition Examination Survey, 2007–2008 and 2009–2010.
        Prev Chronic Dis. 2014; 11: E132
        • Edwards N.M.
        • Pettingell S.
        • Borowsky I.W.
        Where perception meets reality: self-perception of weight in overweight adolescents.
        Pediatrics. 2010; 125: e452-e458
        • Brener N.D.
        • Eaton D.K.
        • Lowry R.
        • et al.
        The association between weight perception and BMI among high school students.
        Obes Res. 2004; 12: 1866-1874
        • Goodman E.
        • Hinden B.R.
        • Khandelwal S.
        Accuracy of teen and parental reports of obesity and body mass index.
        Pediatrics. 2000; 106: 52-58
        • Neumark-Sztainer D.
        • Croll J.
        • Story M.
        • et al.
        Ethnic/racial differences in weight-related concerns and behaviors among adolescent girls and boys: findings from Project EAT.
        J Psychosomat Res. 2002; 53: 963-974
        • Pasch K.E.
        • Klein E.G.
        • Laska M.N.
        • et al.
        Weight misperception and health risk behaviors among early adolescents.
        Am J Health Behav. 2011; 35: 797-806
        • Sarafrazi N.
        • Hughes J.P.
        • Borrud L.
        • et al.
        Perception of weight status in US children and adolescents aged 8–15 years, 2005–2012.
        NCHS Data Brief. 2014; : 1-7
        • Tourangeau K.
        • Nord C.
        • Lê T.
        • et al.
        Early Childhood Longitudinal Study, Kindergarten Class of 1998–99 (ECLS-K): Combined User's Manual for the ECLS-K Eighth-Grade and K–8 Full Sample Data Files and Electronic Codebooks.
        National Center for Education Statistics; Institute of Education Sciences; US Dept of Education, Washington, DC2009 (Available at:) (Accessed June 6, 2015)
        • Kuczmarski R.J.
        • Ogden C.L.
        • Grummer-Strawn L.M.
        • et al.
        CDC growth charts: United States.
        Adv Data. 2000; : 1-27