What is ‘normal'? discrepancies between BMI classification vs. perceived weight status in social context

The study identifies significant discrepancies between the clinical weight status and perceived body size of children and adolescents and the cultural, generational, and gender differences associated with these discrepancies. The analysis is based on data from two state-wide, multi-year population surveys conducted in Delaware: • The Delaware Survey of Children's Health collects data about children's behaviors and family and neighborhood environments from over 3000 parents. A child's height and weight are obtained from the parents and primary care providers to compute child's BMI; parents are also asked about their perception of the child's weight status. • The Youth Risk Behavior Surveillance System collects data from a representative sample of middle and high school students. The students report their height and weight as well as their perception of their weight status and intentions of changing it. The stratified sampling design and systemic multiple administrations of both surveys allow for exploring the changes in body weight and body weight perceptions over time and across generations and demographics. The study reveals consistent cultural and gender discrepancies in body size perceptions and contributes to the general knowledge on this topic with its scope, multi-year data collection, and the number of demographic variables it utilizes. The findings expand the theoretical framework by providing cross-sectional, generational and longitudinal perspectives to inform the design and implementation of public health initiatives. They highlight the need to develop targeted and comprehensive public health strategies taking into consideration not only cultural and gender differences but also generational perspectives and biases.