BackgroundRapid physical and emotional growth occurs during youth. Adolescence is one of the most important periods for adapting to body change and establishing an ideal body image. Body change is an important and sensitive concern for adolescents, and the values and self-conception established at this time affect various aspects of the entire life. This study aimed to investigate the prevalence and trends of weight misperception among adolescents in Korea.MethodsWe analyzed raw data from the 2011 Korea Youth Risk Behaviour Web-based Survey-VII (KYRBWS-VII), in which 73,474 adolescents from the middle-school first grade to the high-school third grade (aged 12–18) participated. For the multivariate logistic regression model, the dependent variable was existence of misperception (yes/no) and independent variables were sociodemographic factors.ResultsWe found that the prevalence of weight misperception was 49.3% (overestimation, 23.7%; underestimation, 25.6%). Among male students, 65.0% underestimated their weight, whereas 62.2% of female students overestimated their weight. Multivariate logistic regression analysis revealed that gender (OR = 1.254; 95% CI = 1.214–1.294; p < 0.001) and socioeconomic status (OR = 1.173; 95% CI = 1.121–1.228; p < 0.001) were significantly associated with weight misperception. Compared with overweight/obese adolescents, adolescents whose BMI-based body weight was underweight or normal showed 2.386-times higher (OR = 2.386; 95% CI = 2.045–2.783, p < 0.001) and 32.804-times higher (OR = 32.804; 95% CI = 29.829–36.077, p < 0.001) body shape misperception, respectively.ConclusionsAn effective obesity intervention program for adolescents must reflect and monitor body shape perception as well as BMI, and should include subjects who overestimate as well as underestimate their weight.