Research Article| Volume 49, ISSUE 5, P670-677, November 2015

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More Overweight Adolescents Think They Are Just Fine

Generational Shift in Body Weight Perceptions Among Adolescents in the U.S.


      As obesity prevalence has increased, adolescents’ self-perceived body weight might have shifted accordingly. This study aims to investigate the generational shift in adolescents’ perception of their body weight.


      We used data from adolescents aged 12–16 years who participated in the National Health and Nutrition Examination Survey in 1988–1994 (early, n=1,720) or 2007–2012 (recent, n=2,518). Self-perceived weight status was assessed by face-to-face interviews, and BMI z-scores were calculated using directly measured weight and height with the 2000 CDC Growth Charts as the reference. The analysis was conducted in 2013.


      The median BMI z-score of self-perceived overweight adolescents increased from 1.32 (95% CI=1.18, 1.46) among adolescents interviewed early to 1.82 (1.74, 1.90) among adolescents interviewed recently. After adjusting for age, race/ethnicity, sex, and family income, the probability of self-perceiving as “overweight” declined by 29% for overweight/obese adolescents interviewed recently (probability ratio [PR]=0.71 [0.62, 0.82]) compared with adolescents with the same z-scores but interviewed early. The declining tendency of accurately self-perceiving as overweight was most pronounced among whites (PR=0.64 [0.48, 0.85]), and least among blacks (PR=0.76 [0.58, 0.99]). Both boys and girls interviewed recently were significantly less likely to accurately self-perceive as overweight (PR=0.70 [0.56, 0.89] and 0.73 [0.61, 0.87], respectively) compared with their counterparts who were interviewed early.


      Fewer overweight/obese adolescents self-perceived as such in the 2007–2012 survey compared with the 1988–1994 survey. The declining tendency among overweight or obese adolescents may be indicative of a generational shift in body weight perceptions.
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