Perception makes the difference: the association of actual and perceived weight status with self-reported and parent-reported personal resources and well-being in adolescents

Weight Status and Mental Well-Being Among Adolescents: The Mediating Role of Self-Perceived Body Weight. A Cross-National Survey

PURPOSE

Overweight and obesity are associated with poor mental health in adolescents. However, little is known about whether the influence of overweight and obesity on mental well-being is mediated by self-perceived body weight. Exploring the mechanisms underlying the relationships between obesity and mental well-being is of interest to policy makers and others working in the field of adolescent health.

METHODS

This study was based on nationally representative data from adolescents (age 15 years) who participated in the 2017/2018 Health Behaviour in School-aged Children study (47 countries, N = 76,998). Mixed regression models that included gender and socioeconomic status as covariates were used to identify associations between weight status and mental well-being (life satisfaction and subjective health complaints) and to explore whether self-perceived body weight (feeling too thin or too fat) has a mediating effect. Associations between weight status, self-perceived weight, and mental well-being were further assessed country by country.

RESULTS

Self-perceived body weight mediated the observed associations between overweight or obesity and mental well-being. Perceiving one's body weight as "too thin" or "too fat" was associated with poorer mental well-being, regardless of weight status. Self-perceived body weight varied by gender, socioeconomic status, and country.

DISCUSSION

Self-perceived body weight may explain, to a greater extent than body mass index, variation in mental well-being among adolescents. These results are important to policy makers, clinicians, and others targeting adolescent health.

Weight underestimation and weight nonregulation behavior may be related to weak grip strength

The hypothesis of this study is that weight-related behaviors such as weight perception and weight control efforts may be related to health indicators such as grip strength as an indicator of muscle strength. This cross-sectional study aimed to prove this hypothesis by assessment of the associations of perceived weight status, weight misperceptions, and weight control efforts with grip strength. A questionnaire and measurements were used to assess the perceived weight status, weight control efforts, weight control methods, weight misperceptions, grip strength (sarcopenic vs normal), and confounding factors (measured body mass index, sociodemographic characteristics, concurrent chronic diseases, high sensitivity C-reactive protein, depressive mood, health-related quality of life, health behaviors, and protein intake) among 12,727 adults (men, 43.1%; 51.0 ± 16.6 years old) using the 2015 to 2017 Korea National Health and Nutrition Examination Survey. In fully adjusted models, the odds of sarcopenic grip strength tended to increase with thinner weight perceptions (P for trend <.001). Sarcopenic grip strength was inversely associated with accurate estimation or overestimation of weight (adjusted odds ratio [aOR] 0.64-0.68) and weight loss/maintenance efforts (aOR 0.68-0.73) compared with underestimation of weight and nonweight control efforts. These findings were consistent across sex and weight status, and were found among participants aged 60 years or older but not less than 60 years. In conclusion, this study supports the research hypothesis that the perception of one's own weight, the accuracy of the perceived weight, and the weight control efforts may be related to weak handgrip strength.

Body Weight Misperception and Psychological Distress Among Children and Adolescents: The CASPIAN-V Study

Objectives

Misperception of weight status is a risk factor that affects psychological health. The aim of this study was to evaluate the association between weight misperception patterns and psychological distress among Iranian children and adolescents.

Methods

This was a cross-sectional nationwide study where data was collected from 14,440 students, aged 7–18 years who participated in the national school-based surveillance program (CASPIAN-V). The students’ weight perception and psychological distress were assessed by validated questionnaires. Weight misperception was classified as misperception of being either underweight or overweight with respect to actual weight.

Results

The rate of weight misperception in all study participants was 59.1%. In groups with a perception of being underweight or overweight, the risks of worthlessness, being worried, experiencing aggression, insomnia, or depression, were significantly higher than groups with an accurate weight perception (p < 0.05). The risk of anxiety in girls of normal weight who perceived themselves as underweight, decreased by 57% compared to girls with an accurate weight perception (OR: 0.43; 95% CI, 0.28–0.66).

Conclusion

Weight misperception is highly prevalent among Iranian children and adolescents and is associated with their psychological health status. Appropriate education intervention needs to be developed to improve the children and adolescents’ perception of their body weight status.

Reconsidering the experience machine: Self-reported versus objective measures of physical activity to increase positive affect

This article tests the utility of self-report and objective assessment of physical activity to predict increased positive affect. Participants wore Fitbit activity trackers and responded to single-item assessments of momentary affect and self-reported physical activity following an experience sampling method protocol. A test of the within-person mediation indicated that, on average, 63 percent of the relationship between objective physical activity and affect was accounted for by self-reported physical activity. This research adds to the body of literature demonstrating the benefits of physical activity and discusses the utility of perceived over actual assessments of physical activity in naturalistic settings.

Fear of Being Laughed at in Children and Adolescents: Exploring the Importance of Overweight, Underweight, and Teasing

Weight bias toward obese youths is often accompanied by the experience of psychological stress in those affected. Therefore, the fear of being laughed at (i.e., gelotophobia) in overweight children and adolescents can be rather serious. In four explorative studies, the importance of relative weight, self-awareness of weight (incl. satisfaction with weight), experiences of teasing and ridicule, as well as the role of social-evaluative situations in school were analyzed with regard to gelotophobia. In two online interviews of adults with pronounced gelotophobia (Study I: 102 English-speaking participants, Study II: 22 German-speaking participants) relating to reasons they assumed for their development of gelotophobia, there was evidence of injurious appearance-related experiences during childhood and adolescence. In Study III (75 Swiss adolescents) associations between the experience of weight-related teasing and mockery with overweight, self-perceptions of weight, and gelotophobia were analyzed. Especially in girls, overweight was associated with the experience of weight-related teasing and ridicule, which in turn was accompanied by gelotophobia. Study IV included 178 German adolescents who were asked to report their body image (“Do you think you are… too thin, just the right weight, or too fat?”). In addition, gelotophobia, teasing, BMI based on self-reports, and joy at school were measured. In particular, girls who felt too fat and boys who felt too thin reported teasing. Teasing was related to diminished joy at school and to gelotophobia. Among boys, underweight mediated by weight-related teasing contributed to gelotophobia. The results suggest that more research should be devoted to gelotophobia and the experience of weight-related teasing and mocking to better understand factors contributing to the well-being of children and adolescents with weight problems.

Weight Status and Weight Perception in Relation to Mental Distress and Psychosocial Protective Factors Among Adolescents

OBJECTIVE

To measure how weight status and weight perception relate to mental distress and psychosocial protective factors in adolescents.

METHODS

Adolescents in 8th, 9th, and 11th grade participating in the 2013 Minnesota Student Survey (N = 122,180) were classified on the basis of weight perception (overweight or not overweight) and weight status (not overweight, overweight, obese). Bivariate tests were used to assess the relationship of weight status and weight perception with internal mental distress, and generalized linear models were used to measure the association between weight status and weight perception with psychosocial protective factors including parent, school, and friend connectedness, social competency, and positive identity. Logistic regressions measured the relationship between psychosocial protective factors and internal mental distress.

RESULTS

Prevalence of internal mental distress ranged from 14.5% for overweight boys who perceived themselves as not overweight to 55.0% for girls who were not overweight but self-perceived as overweight. Across all weight-status categories, adolescents who perceived themselves as overweight, compared to those who did not, had higher internal mental distress and lower mean levels of psychosocial protective factors. All psychosocial protective factors were related to lower odds of internal mental distress, with significant small differences by weight status and weight perception.

CONCLUSIONS

Weight status and weight perception affected both mental distress and psychosocial protective factors. Those who perceived themselves as overweight, regardless of weight status, had the highest prevalence of mental distress and the lowest levels of psychosocial protective factors. Health care providers should consider screening for weight perception to provide a tailored approach to adolescent care.

Obese children are thin in parents' eyes: A psychologically, socially, or culturally driven bias?

Although obesity presents a serious health problem in children, parents often underestimate their children's overweight and obesity status. Therefore, scientific literature was systematically screened through PubMed and PsycINFO to demonstrate the psychological, social, and cultural processes that underlie this evaluation bias. A total of 37 papers that focused on research conducted in different geopolitical contexts were taken into account. Furthermore, a lexicometric analysis of the papers' conclusions was performed. The findings showed that education plays a key role in promoting parents' awareness and their realistic recognition of their children's weight. Accordingly, adequate educational support for parents should be implemented in all healthcare policies addressing childhood obesity.