Associations Between Perceived Weight Status and Allostatic Load Among Adolescents

Abstract

Explain the relationship between allostatic load and weight perception of adolescents at a healthy weight and overweight status. Adolescence is a critical time in growth and development which can influence one’s perception of body image. Particularly, body dissatisfaction is a potential stressor among adolescents. Allostatic load is a useful tool to assess the impact of perceived stress on health. The purpose of this study was to examine the relationship between allostatic load and weight perception among healthy weight and overweight adolescents. A sample of 896 adolescents ages 12-19 years from the National Health and Nutrition Examination Survey 2015-2018 was stratified by weight status. Allostatic load was calculated based on biomarkers representing cardiovascular, metabolic and immune systems. Accuracy of weight perception was assessed using a question regarding weight perception and coding it as either accurate or inaccurate based on self-reported weight. Linear regression analyses were used to assess the relationship between allostatic load and accuracy of perceived weight status while adjusting for confounders. Allostatic load scores did not differ by weight perception in adolescents at a healthy weight (accurate perception μ =1.32; inaccurate perception μ=1.20; p=0.76). Those who accurately perceived their weight as overweight or obese had significantly higher allostatic load scores than those who inaccurately perceived their weight (μ=3.35, μ=2.69, respectively; ß=-0.67 SE=0.20, p<0.01). Among overweight or obese adolescents, those who accurately assess their weight status had higher levels of cardiovascular, metabolic and immune stress. Further research is needed to understand if allostatic load is associated with stress related to perceived weight bias.