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  • Original Article
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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=1267; age 13, n=1186; age 16, n=1212) from 178 schools. Mean body mass index (BMI) was 17.5, 20.6 and 22.2 kg/m2, 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 (P<0.001). 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.

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Acknowledgements

We thank the principals, teachers, students and administrative personnel at the data collection sites. The survey was funded by the Quebec Ministry of Health and Social Services and by Health Canada. While conducting this research, KM was supported by a Doctoral Fellowship award from the Canadian Institutes of Health Research. JOL holds a Canada Research Chair in Early Determinants of Adult Chronic Disease. TB is a recipient of a Postdoctoral Fellowship award from the Canadian Institutes of Health Research. An earlier version of this paper was presented at the American Public Health Association (APHA) 134th Annual Meeting and Exposition, Boston, MA, November 4–8, 2006.

Contributions KM designed the analysis, analyzed the data and drafted and revised the manuscript. JMG assisted in conceptualizing the design, the study variables and the analysis, and participated in writing the manuscript. TB assisted with statistical analyses, interpretation of the findings, and manuscript development. JOL, GP and ML designed the original study from which the data were drawn, obtained funding for the original study, supervised collection and reviewed drafts of the manuscript.

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Maximova, K., McGrath, J., Barnett, T. et al. Do you see what I see? Weight status misperception and exposure to obesity among children and adolescents. Int J Obes 32, 1008–1015 (2008). https://doi.org/10.1038/ijo.2008.15

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