269686 Perception Matters:: Efforts to lose weight among U.S. High School students who are overweight or obese: Findings from the 2009 YRBS data

Tuesday, October 30, 2012 : 3:15 PM - 3:30 PM

Dr. Joy P. Nanda, DSc, MS, MHS, MBA , Johns Hopkins Medical Institutions, Johns Hopkins University, Baltimore, MD
Michelle Demeule, MS, RD, LDN , Center for Pediatric Weight Management and Healthy Living, Mount Washington Pediatric Hospital, Baltimore, MD
Eileen Sousa, MPH Candidate , School of Allied Health and Life Sciences, University of West Florida, Pensacola, FL
Elizabeth Getzoff, PhD , Center of Pediatric Weight Management and Healthy Living, Mount Washington Pediatric Hospital, Baltimore, MD
Ann O. Scheimann, MD, MBA , Division of Pediatric Gasteroenterology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD
Background: Discordance between actual and perceived obesity may influence children's efforts to lose weight. After a health risk severity has been perceived, motivation to improve health can occur, per health behavior models. Purpose: To investigate the concordance between perceived weight and computed BMI percentile, we analyzed the latest available (2009) Youth Risk Behavior Surveillance (YRBS) data. Additionally, we measured whether these concordant-discordant pairs based on perception vs. BMI differed in their efforts to lose weight (ELW). Methodology: The YRBS surveyed 16,410 representative high school students on perceived weight, ELW (“what are you trying to do about weight?”), demographic, eating and lifestyle behaviors (DEL), and anthropometric measures to compute BMI percentile. Survey design effect was adjusted during all exploratory analyses and multiple logistic regression analyses provided the odds of ELW among groups after controlling for DEL covariates. Finding/Results: 26% were overweight/obese per BMI percentile whereas 27% perceived themselves as overweight/obese. Among those with normal BMI, 13% perceived as overweight/obese (“Normal:Obese”), while among overweight/obese children, 34.2% perceived themselves as normal (“Obese:Normal”) (p<0.001). Among “Normal:Obese” and “Obese:Obese” groups, each reported 86% ELW. Among “Obese:Normal” and “Normal:Normal” groups, 45% and 26.3% reported ELW, respectively (P<0.001). Following covariate adjustments, ELW was 15 times (O.R. 15.3, 95%CI:12.8-18.1, p<0.001) greater among "Normal:Obese" group, 24 times (O.R. 24.2, 95%CI:21.1-27.6, p<0.001) greater among "Obese:Obese" group, but only 4 times (O.R. 4.0, 95%CI 3.6-4.5, p<0.001) greater among "Obese:Normal" than "Normal:Normal" group. Conclusion: Self-perception of weight has significant impact on efforts to lose weight. Education must emphasize improved self-perception of weight.

Learning Areas:
Administer health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the concordance between perceived and actual weights among high school students in the U.S. Evaluate efforts to lose weight among these concordant/discordant groups, based on perceived and actual weights.

Keywords: Adolescent Health, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have presented similar research in various forums, including APHA in the past.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.