Abstract
Background/Objective:
The purpose of this study was to examine the longitudinal effects of body size over- and underestimation and other psychosocial factors on the risk for onset of overweight (OW) or obesity (OB) 1 year later among US adolescents.
Subjects/Methods:
Participants with non-missing height and weight were drawn from the first two waves of the National Longitudinal Study of Adolescent to Adult Health (n=13 568). Multinomial logistic regressions were conducted to assess longitudinal risk factors for OW and OB onset, controlling for baseline weight status, age, race/ethnicity, parent education and family structure. Analyses were stratified by sex.
Results:
Compared with accurate body size perception, body size overestimation increased the relative risk (RR) of OW onset among women and men (RR=3.34, confidence interval (CI)=2.39–4.68; RR=6.01, CI=4.09–8.83, respectively, P<0.001) in fully adjusted models including body mass index z-scores. Body size underestimation decreased the RR of OW onset among women and men (RR= 0.08, CI=0.03–0.20; RR=0.13, CI=0.06–0.27, respectively) and OB onset (RR=0.05, CI=0.02–0.14; RR=0.19, CI=0.08–0.47, respectively, P<0.001 for all) in fully adjusted models. Dieting, extreme weight loss behaviors and skipping breakfast at Wave 1 increased the risk of OB onset by Wave 2.
Conclusions:
Contrary to a common assumption, body size underestimation did not increase, but in fact decreased, the RR for the onset of OW and of OB among adolescents using a prospective longitudinal design. However, body size overestimation predicted onset of OW 1 year later. Body size self-concept and other psychosocial factors have an important role in risk for OW and for OB among both males and females during adolescence.
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Acknowledgements
This study was supported in part by the Office of the Vice Chancellor for Research Campus Research Board Programs at the University of Illinois. This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J Richard Udry, Peter S Bearman and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill, and funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations. Special acknowledgement is due Ronald R Rindfuss and Barbara Entwisle for assistance in the original design. Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth). No direct support was received from grant P01-HD31921 for this analysis.
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Liechty, J., Lee, MJ. Body size estimation and other psychosocial risk factors for obesity onset among US adolescents: findings from a longitudinal population level study. Int J Obes 39, 601–607 (2015). https://doi.org/10.1038/ijo.2014.191
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DOI: https://doi.org/10.1038/ijo.2014.191
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