Healthy Habits: Teen Body Perception

Nearly a fourth of American teenagers misjudge their weight and they often avoid a healthy diet, suffer from eating disorders, and have reduced physical activity based on weight misperceptions, says a study from Ball State University.

“Adolescent Body Weight Perception: Association with Diet and Physical Activity Behaviors” is an analysis of about 12,000 teens (ages 15-17) who participated in the Youth Risk Behavior Survey. The study, which was posted by the Journal of School Nursing, found that nearly a fourth (22.9 percent) misperceived their weight; 11.6 percent believe they are overweight but aren’t, and 11.3 percent weigh more than they should but think it’s healthy and continually underestimate their weight.

“American adolescents who misperceive their weight are significantly more likely to engage in unhealthy dietary and food habits, have eating disorders, and are more likely to have sedentary lifestyles,” said Jagdish Khubchandani, corresponding author and a health science professor at Ball State. “On the contrary, teenagers who have accurate perceptions of their weight are less likely to have eating disorders, practice healthier behaviors, and avoid risky diets and weight loss methods.”

This is a significant finding, as the U.S. is currently witnessing high rates of unhealthy diet and eating disorders in youth, Khubchandani said.

“Recent evidence also suggests that adolescent weight misperception is associated with obesity in adulthood,” he said. “Early childhood interventions to promote appropriate weight-related perception and healthy diet could have a lasting impact on chronic disease burden, in addition to preventing eating disorders and physical inactivity in youth.”

The study also found:

• Almost a third (31.8 percent) of adolescents were overweight and obese.
• Boys and girls who believed they were overweight but were not truly overweight were less likely to drink fruit juice or milk, eat fruits, or consume breakfast regularly.
• Physical activity behaviors also varied with weight perception. For example, both boys and girls who were truly overweight or only believed they were, had the lowest odds of engaging in physical activity for at least 60 minutes per day five days a week.
• Females were more likely to have misperceptions about their weight than males.

“Interestingly, weight misperception has also been linked with eating disorders that are a major cause of morbidity in young Americans,” Khubchandani said. “School nurses and health teachers are uniquely poised to educate students and prevent weight misperception, eating disorders, and engage students in healthy behaviors.

I had a chance to interview Khubchandani to learn more.

Why was this study conducted?

To understand what factors influence diet and physical activity in adolescents, a lot of studies external to teenagers have been conducted (e.g. family and social influences).

What is not well known is how teenagers think about their body weight and what is the influence of internal perceptions of body weight on behaviors related to diet and physical activity.

Also, we wanted to create a national profile of teenagers as it relates to their real body weight, perceived body weight, and the influence of weight misperception.

What factors contribute to misperceptions about body weight?

A lot of factors influence these misperceptions. A few notable examples are personality type of child, peer networks, social and mass media, race and gender of teenager, and parental beliefs about body weight.

How can parents help their children have an accurate perspective on their weight?

Parents have the highest and most prominent influence on a child’s life especially as it relates to providing healthy food (appropriate quality and quantity. Unfortunately, a sizeable proportion of parents have a disconnect when it comes to actual child weight and what parents perceive of the child’s weight. This results in unhealthy feeding practices because of a lack of awareness of the child’s actual weight status. In this regard, healthcare providers at school and in the community (e.g. pediatricians and family medicine practitioners) need to work aggressively in educating parents. Terms such as body weight, BMI for age and gender, recommended level of fruits and vegetables, and exercise should be reinforced in parents. Periodic assessments and sharing of results with parents about child health are key in keeping them on track.