Weight Status Misperception And The Health Behaviors Of Obese Adolescents

摘要

Background: Weight underestimation among U.S. adolescents is common, but the ramifications of this misperception are not yet well known. Purpose: To determine the relationship between weight self-perception and participation in health behaviors among obese adolescents. Methods: The sample consisted of 1,210 obese male and female 7th and 11th graders. Participants completed the Personal Wellness Profile – Teen Edition, a general self-report measure of adolescent health functioning, and had their BMI’s measured. Data were analyzed using Χ2 tests and logistic regression models. Results: Underestimated weight status was associated with higher reported rates of participation in health behaviors (physical activity, healthy diet, weight management, overall healthy lifestyle) as well as greater self-efficacy in one’s ability to engage in these behaviors. Self-efficacy either partially or fully mediated the relationship between weight underestimation and the health behaviors. Discussion: Both weight perception and self-efficacy should be considered when attempting to understand and predict which adolescents with obesity are likely to engage in health behaviors. For some adolescents it is possible that intervention efforts that emphasize fostering self-efficacy in regard to weight loss behaviors may be more effective than focusing on increasing self-awareness of obese status and the associated risks. Introduction The rate of pediatric obesity has risen significantly in the United States1 to the point at which 17% of children ages 2-19 were obese and an additional 15% were overweight in 2007-20082. This epidemic has become a major public health concern, as childhood obesity has been linked to many adverse health consequences, including juvenile hypertension, elevated cholesterol levels, orthopedic abnormalities, type II diabetes mellitus, gallstones, asthma, and sleep disorders, to name a few3. Prevention programs for children and adolescents have so far had limited success4,5. Thus, research is necessary to examine individual difference characteristics that contribute to the development of pediatric obesity and barriers to its treatment. This study intends to determine whether weight misperception may be an important factor in understanding the high prevalence of adolescent obesity. Weight underestimation among a multiethnic sample of overweight U.S. adolescents (BMI at or above the 85 th percentile) was found to be common, with 61% of males and 40% of females underestimating their actual weight status6. This finding is indicative of an ongoing trend among many Americans with overweight who have inaccurate self-perceptions of their weights7-10. Furthermore, many parents have been found to underestimate the weight status of both their child and adolescent offspring11-13, which thereby suggests a potential mechanism for transmitting an inaccurate gauge for healthy weight status to their children. In adults, the tendency to misperceive one’s weight varies substantially across demographic factors, with men, those with lower socioeconomic status, Hispanics, and African-Americans more likely to underestimate their overweight status10,14,15. Similar to adults, there is some evidence that gender, race, and family factors play an important role in adolescent weight perception16,17. However, Yan et al6 found only gender differences and no race or socioeconomic status associations with weight status misperception in their multiethnic sample of adolescents. This study seeks to add to the current literature by determining associations between weight misperception and specific adolescent health behaviors, such as physical activity and nutrition, among individuals with obesity. Across healthy and unhealthy adolescent populations, weight loss efforts are strongly related to adolescents’ perceptions of themselves as overweight15,18. Therefore, underestimation of overweight status might reduce the likelihood that adolescents with overweight would partici