Do you see what I see? Weight status misperception and exposure to obesity among children and adolescents

Abstract

Objective: Obesity prevention in childhood is important. However, changing children's lifestyle behaviors to reduce overweight is a substantial challenge. Accurately perceiving oneself as overweight/obese has been linked to greater motivation to change lifestyle behaviors. Children and adolescents may be less likely to perceive themselves as overweight/obese if they are exposed to overweight/obese people in their immediate environments. This study examined whether youth who are exposed to overweight parents and schoolmates were more likely to misperceive their own weight status. Design: The Quebec Child and Adolescent Health and Social Survey was a provincially representative, school-based survey of children and adolescents conducted between January and May 1999. Subjects: 3665 children and adolescents (age 9, n ¼ 1267; age 13, n ¼ 1186; age 16, n ¼ 1212) from 178 schools. Mean body mass index (BMI) was 17.5, 20.6 and 22.2 kg/m 2 , respectively. Measurements: The misperception score was calculated as the standardized difference between self-perception of weight status (Stunkard Body Rating Scale) and actual BMI (from measured height and weight). Exposure to obesity was based on parent and schoolmate BMI. Results: Overweight and obese youth were significantly more likely to misperceive their weight compared with non-overweight youth (Po0.001). Multilevel modeling indicated that greater parent and schoolmate BMI were significantly associated with greater misperception (underestimation) of weight status among children and adolescents. Conclusion: Children and adolescents who live in environments in which people they see on a daily basis, such as parents and schoolmates, are overweight/obese may develop inaccurate perceptions of what constitutes appropriate weight status. Targeting misperception may facilitate the adoption of healthy lifestyle behaviors and improve the effectiveness of obesity prevention interventions.

Large proportions of overweight and obese children, as well as their parents, underestimate children’s weight status across Europe. The ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project

“…more than half of the respondents underestimating their weight status) observed in Spain and Greece. These proportions are much higher than the percentage presented by similar previous studies, reporting 30 % misconception that also included some overestimation of weight status in underweight children (8,9,23) . These studies were conducted in children Table 2 Odds ratios and 95 % confidence intervals resulting from multilevel binary multiple logistic regression analyses assessing the relationship between underestimation of children's weight status by 10-to 12-year-old children and their parents and sociodemographic variables and parental weight status, for normal-weight and overweight children; the ENERGY project, 2010 and adolescents from the USA, Canada and Australia, while our findings are from a sample of European countries, which implies the possible effect of cultural or other factors on the correct perception of actual weight status among children and adolescents.…”

“…A deviation between actual and perceived weight status in children and adolescents has been reported repeatedly and in different countries (7)(8)(9) , and this is more common among overweight and obese individuals (10) .…”

Size Misperception Among Overweight and Obese Families

“…11,18 Participants chose silhouettes ranging from overweight (silhouettes # 1-2), normal weight (# 3-5), and underweight (# 6-7), identified as current, ideal, and healthy. 11 Current size was the silhouette selected in response to "Which figure do you look like?"…”

“…8 Children from households with overweight/obese parents are likely to become overweight/obese adults, 7,9 with the prospective risk of development of obesity-related cardiovascular risk factors and subsequent cardiovascular disease (CVD). 10,11 The significance of excessive weight during childhood is a challenge for the biomedical community at large, particularly pediatricians, primary care physicians, nutritionists, cardiologists, and public health advocates. Understanding weight perception is critical in addressing the national increase in obesity and consequent cardiovascular disease morbidity and mortality attributed to it.…”

“…Understanding weight perception is critical in addressing the national increase in obesity and consequent cardiovascular disease morbidity and mortality attributed to it. 11 To investigate intergenerational views concerning weight status and size, we examined 1) mother and child's awareness of self-weight, 2) mother's perception of child's weight, and 3) mother's and child's attitudes concerning ideal size and size dissatisfaction. Moreover, a key goal was to explore child's perception of mother's weight, an approach that has not been reported previously.…”