Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates

Patient Related Outcome Measures, Dec 2014

Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates Amy E Bodde,1 Timothy J Beebe,1 Laura P Chen,2 Sarah Jenkins,3 Kelly Perez-Vergara,4 Lila J Finney Rutten,5 Jeanette Y Ziegenfuss6 1Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, USA; 2Seattle Children’s Hospital, Seattle, WA, USA; 3Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA; 4Children’s Hospital, Boston, MA, USA; 5Division of Epidemiology, Mayo Clinic, Rochester, MN USA; 6HealthPartners Institute for Education and Research, Minneapolis, MN, USA Objective: Accurate perceptions of weight status are important motivational triggers for weight loss among overweight or obese individuals, yet weight misperception is prevalent. To identify and characterize individuals holding misperceptions around their weight status, it may be informative for clinicians to assess self-reported body mass index (BMI) classification (ie, underweight, normal, overweight, obese) in addition to clinical weight measurement. Methods: Self-reported weight classification data from the 2007 Current Visit Information – Child and Adolescent Survey collected at Mayo Clinic in Rochester, MN, were compared with measured clinical height and weight for 2,993 adolescents. Results: While, overall, 74.2% of adolescents accurately reported their weight status, females, younger adolescents, and proxy (vs self) reporters were more accurate. Controlling for demographic and behavioral characteristics, the higher an individual's BMI percentile, the less likely there was agreement between self-report and measured BMI percentile. Those with high BMI who misperceive their weight status were less likely than accurate perceivers to attempt weight loss. Conclusion: Adolescents’ and proxies’ misperception of weight status increases with BMI percentile. Obtaining an adolescent's self-perceived weight status in addition to measured height and weight offers clinicians valuable baseline information to discuss motivation for weight loss. Keywords: BMI, obesity, weight perception, adolescents, primary care

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Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates

Patient Related Outcome Measures Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates Amy E Bodde 2 Timothy J Beebe 2 Laura P Chen 1 Sarah Jenkins 0 Kelly Perez-Vergara 5 Lila J Finney Rutten 4 Jeanette Y Ziegenfuss 3 0 Division of Biomedical Statistics and Informatics, Mayo Clinic , Rochester, MN , USA 1 Seattle Children's Hospital , Seattle, WA , USA 2 Division of Health Care Policy and Research, Mayo Clinic , Rochester, MN , USA 3 HealthPartners Institute for Education and Research , Minneapolis, MN , USA 4 Division of Epidemiology, Mayo Clinic , Rochester, MN USA 5 Children's Hospital , Boston, MA , USA 8 1 0 2 - l u J - 2 1 n o 7 0 2 . 6 4 . 9 5 . 7 3 y b / m o c . s s e r p e .vdo l.y PowerdbyTCPDF(ww.tcpdf.org) Objective: Accurate perceptions of weight status are important motivational triggers for weight loss among overweight or obese individuals, yet weight misperception is prevalent. To identify and characterize individuals holding misperceptions around their weight status, it may be informative for clinicians to assess self-reported body mass index (BMI) classification (ie, underweight, normal, overweight, obese) in addition to clinical weight measurement. Methods: Self-reported weight classification data from the 2007 Current Visit Information - Child and Adolescent Survey collected at Mayo Clinic in Rochester, MN, were compared with measured clinical height and weight for 2,993 adolescents. Results: While, overall, 74.2% of adolescents accurately reported their weight status, females, younger adolescents, and proxy (vs self) reporters were more accurate. Controlling for demographic and behavioral characteristics, the higher an individual's BMI percentile, the less likely there was agreement between self-report and measured BMI percentile. Those with high BMI who misperceive their weight status were less likely than accurate perceivers to attempt weight loss. Conclusion: Adolescents' and proxies' misperception of weight status increases with BMI percentile. Obtaining an adolescent's self-perceived weight status in addition to measured height and weight offers clinicians valuable baseline information to discuss motivation for weight loss. BMI; obesity; weight perception; adolescents; primary care - open access to scientific and medical research Introduction Rates of childhood and adolescent obesity have increased over the past 3 decades.1 An estimated 34.1% of adolescents in the United States are overweight or obese.2 Obese adolescents are more likely than their normal weight counterparts to suffer from health issues including obstructive sleep apnea, metabolic syndrome, diabetes mellitus type 2, hyperlipidemia, orthopedic issues, asthma, and hypertension.3,4 Obese adolescents also have higher rates of emotional and social problems.5–7 The negative effects of obesity accumulate over the life course; thus, intervening to address behavioral patterns that contribute to obesity in young populations is critical.8,9 Understanding the concordance between an adolescent’s perceived and actual weight classification provides insight into the risk for a number of health behaviors and psychosocial outcomes. Previous studies have shown perceptions of being overweight during adolescence to be associated with mental health problems,10,11 suicidal thoughts,12,13 problematic behaviors, and disordered eating.14 Even more concerning is that adolescents with altered body weight perception may experience more problem behavior than overweight adolescents with an accurate body weight perception.15 These correlates of weight misperception have been commonly studied in adolescents who are normal or underweight but misperceive themselves as overweight or obese; however, few studies have explored the correlates of overweight and obese adolescents who misperceive themselves as normal or underweight. Overweight adolescents who misperceive their weight status have been shown to be less likely to exercise or restrict calories for weight control compared to overweight adolescents who accurately perceive themselves as overweight.16 Just as an underweight or normal weight adolescent who misperceives his or her weight status may be identified for behavioral or mental health counseling, an overweight or obese adolescent who misperceives may be a candidate for weight loss counseling. Emerging evidence suggests that there is often a discrepancy between actual weight and perceptions of weight;17,18 this discrepancy is more pronounced among overweight or obese individuals.16,17,19,20 Accurate perceptions about being Methods We analyzed data from the Current Visit Information (CVI) – Child and Adolescent Survey administered in 2007 to all patients or a proxy prior to clinical visit in the Mayo Clinic Community Pediatrics and Adolescent Medicine or Family Medicine departments in Rochester, MN, to assess patients’ perceived health status and lifestyle. Our analysis focuses on adolescents (...truncated)


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Amy E Bodde, Timothy J Beebe, Laura P Chen, Sarah Jenkins, Kelly Perez-Vergara, Lila J Finney Rutten, Jeanette Y Ziegenfuss. Misperceptions of weight status among adolescents: sociodemographic and behavioral correlates, Patient Related Outcome Measures, 2014, pp. 163-171, DOI: 10.2147/PROM.S72621