Obesity, weight perception and weight intention among sixth grade students in a segregated suburban community

BACKGROUND: Adolescent obesity is a national public health concern and disparities exist based on race-ethnicity, geographic region, and socioeconomic status. Physical environment is a significant factor for obesity, with residential segregation contributing to racial inequities across class lines. This study examines students’ weight perception, intention and behaviors in a racially/ethnically segregated suburban county in New York State.

METHODS: BMI and BMI-%ile calculated from measured height and weight and questions from the Youth Risk Behavior Survey of 365 sixth-grade students in 2012 and 2013. Descriptive statistics, chi square analysis and logistic regression assessed associations between students’ weight status, perceptions and reported behaviors.

RESULTS: Almost half (49%) of students identified as black and 38% Hispanic, and 14% white or other. Almost one-third (30%) of the students were obese, 22% overweight and a majority (69%) had a concordant perception of their weight. 25% indicated that they had fasted, and overweight/obese students were more likely to fast than those with a healthy weight (72.8% versus 27.2%, P < 0.001).  Students who reported not eating breakfast were more likely to be trying to lose weight than those not trying (62.3% versus 37.7%, P < 0.012).

CONCLUSION:  Obesity prevalence is higher in this residentially segregated suburban middle school than the rest of the county.  Most obese students accurately perceive their weight status, intend to lose weight and are more likely to adopt unhealthy weight loss strategies, i.e. skipping breakfast and fasting. Interventions need to provide students with knowledge and resources for effective and safe weight loss.