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Body size perception and weight control in youth: 9-year international trends from 24 countries

International Journal of Obesity volume 38, pages 988–994 (2014)Cite this article

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Abstract

Objectives:

To examine 9-year trends and relationships regarding misperceptions of body size and dieting for weight loss among adolescents from 24 countries, and explore the influence of country-level overweight prevalence.

Methods:

Sociodemographic characteristics, body size perception and dieting for weight loss were assessed in the Health Behaviour in School-aged Children survey conducted in 24 countries cross-sectionally at three time points (2001/2002, 2005/2006 and 2009/2010). Logistic regression models examined change over time in overestimation of body size in non-overweight adolescents, underestimation of body size in overweight adolescents, dieting for weight loss in non-overweight and overweight adolescents and relationships between body size perception and dieting. Analyses were stratified by weight status and sex. Covariates included country-level overweight prevalence, family affluence and country level of development. Body mass index was only included in models examining dieting for weight loss.

Results:

Country-level overweight prevalence increased over time (11.6–14.7%). Compared with Time 1, overweight adolescents had greater odds of body size underestimation at Time 3 (odds ratio (OR)=1.68 for girls; OR=1.10 for boys), whereas non-overweight adolescents had lower odds of body size overestimation at Time 3 (OR=0.87 for girls; OR=0.89 for boys). Controlling for country-level overweight prevalence attenuated these relationships. Compared with Time 1, overweight and non-overweight boys were 10% more likely to diet at Time 3, whereas overweight and non-overweight girls were 19% and 16%, respectively, less likely to diet at Time 3. Controlling for country-level overweight prevalence did not impact trends in dieting for weight loss. Additionally, the association of self-perceived overweight with increased odds of dieting diminished over time.

Conclusions:

Body size perceptions among adolescents may have changed over time concurrent with shifts in country-level body weight. However, controlling for country-level overweight prevalence did not impact trends in dieting for weight loss, suggesting a potentially stronger impact of social comparison on weight-related perceptions than on behavior.

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Acknowledgements

HBSC is an international study carried out in collaboration with WHO/EURO. The international coordinator of all three waves of data was Candace Currie, University of St Andrews, Scotland, and the data bank manager was Oddrun Samdal, University of Bergen, Norway. A complete list of the participating researchers can be found on the HBSC website (www.HBSC.org). This research was also supported in part by the intramural research program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (contract no. N01-HD-5-3401) and by the Maternal and Child Health Bureau of the Health Resources and Services Administration.

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Authors and Affiliations

  1. Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development/NIH, Bethesda, MD, USA

    V Quick, T R Nansel, D Liu & L M Lipsky

  2. Child and Adolescent Health Research Programme, The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark

    P Due

  3. College of Nursing and Health Sciences, University of Massachusettes Boston, Boston, MA, USA

    R J Iannotti

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  1. V Quick
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Correspondence to V Quick.

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Quick, V., Nansel, T., Liu, D. et al. Body size perception and weight control in youth: 9-year international trends from 24 countries. Int J Obes 38, 988–994 (2014). https://doi.org/10.1038/ijo.2014.62

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