The Effects of Perceived Body Weight on Dieting Behaviors and Physical Activity in Overweight and Obese American Indian and Alaska Native Adolescents

Abstract

Background: Self-perception of body weight is an important issue among adolescents, a group at risk for body dissatisfaction and negative diet-related behaviors related to weight perception. The aim of our study was to evaluate weight perception among American Indian and Alaska Native (AI/AN) overweight and obese adolescents and examine the associations between the accuracy of perceived body weight and dieting and physical activity behaviors. Methods: Using American Indian Alaska Native data from the national Youth Risk Behavior Surveillance System (2007-2011), we performed a cross sectional analysis of weight perception and dieting and physical activity among overweight and obese youth. Respondents' self-described weight status was matched with their body mass index (BMI) percentile using self-reported weight and height. Youth were classified as accurate perceivers if self-perception and BMI percentile coincided or misperceivers if the two were discordant. We evaluated the association between accurate perception versus misperception of weight and diet and physical activity outcomes using logistic regression to estimate prevalence odds ratios (aPOR) and 95% confidence intervals (CI), adjusting for sex. Results: Misperceivers were more likely to be male and 15-16 years old than accurate perceivers. Misperceivers were 80 % (95% CI: 0.13-0.31) less likely to be trying to lose weight and 36% (95% CI: 0.40-1.03) less likely to be fasting to lose weight than accurate perceivers. Misperceivers were 48% (95% CI: 1.00-2.17) more likely to engage in ≥60 minutes of physical activity on ≥5 days per week 69% (95% CI: 1.15-2.48) more likely to attend physical education classes ≥3 days per week, and 95% (95% CI: 1.34-2.85) more likely to have played on ≥1 sports teams during the previous year than accurate perceivers. Misperceivers were also 64% (95% CI: 1.11-2.43) more likely to consume the recommended daily servings of fruit than accurate perceivers. Conclusion: The finding that misperceivers were more likely than accurate perceivers to engage in physical activity and less likely to engage in unhealthy fasting behavior suggests that adolescents' self-perceived weight status should be considered when designing weight-related interventions in this population and warrants further investigation in future studies.