Abstract

Overall, perceptions of being at “about the right weight” appear advantageous for youth physical and mental health, regardless of BMI classification, whereas perceptions at either extreme (overweight or underweight) may negatively impact health behaviours and mental health. Instead of considering weight misperceptions as problematic, some researchers have proposed that underestimations of weight status may offer resiliency among individuals with overweight or obesity. Promoting “about right” WPs and preventing change to overweight or underweight perceptions may offer an effective public health strategy for supporting youth health over time. However, limited prospective evidence exists on factors that shape perceptions of weight status over time. The current study examined modifiable predictors of one-year change in weight perception among youths. We used 2-year linked data of 18,112 grade 9–12 students from Year 3 (Y3:2014–2015) and Year 4 (Y4:2015–2016) of the COMPASS study. Generalized Estimating Equation models tested screen use, physical activity, and bullying victimization as predictors of change from perceptions of “about the right weight” to “overweight” or “underweight” perceptions, adjusting for Y3 covariates (body mass index, ethnicity, and grade) and school cluster. Results support the value of team sports among females and resistance exercise among males as protective against changes to overweight or underweight perceptions over one year. Also, various forms of bullying victimization predicted overweight perceptions in males and females. Watching TV/movies or messaging/texting for over 2 hours/day was associated with overweight and underweight perceptions, respectively, in females only. Playing video/computer games for over 2 hours/day was associated with overweight perceptions in males and underweight perceptions in females. Findings support the potential of bullying prevention, limiting certain screen use, and supporting engagement in team sports for females and resistance exercise for males as strategies to maintain perceptions of being at “about the right weight.”

Highlights

  • Body image represents a multidimensional construct, encompassing how individuals view, feel, think, and act toward their physical appearance [1]

  • We examined whether bullying victimization, screen media use, and PA participation influenced the likelihood of youth changing from perceptions of being at “about the right weight” to reporting overweight or underweight perceptions over one year

  • Evidence suggests that perceptions of weight are stronger correlates of health behaviours and mental health than objective weight status [3, 27,28,29,30,31,32]; understanding what factors contribute to the formation of Weight perception (WP) has important public health implications

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Summary

Introduction

Body image represents a multidimensional construct, encompassing how individuals view, feel, think, and act toward their physical appearance [1]. Weight perception (WP) refers to individuals’ subjective appraisal of their body weight. Misperceptions have been said to occur when there is a discrepancy between individuals’ self-perceptions of their weight and their “objective” or measured weight status (as typically defined by body mass index (BMI) classification). WPs have long been studied in the eating disorders field and, more recently, emerged in the obesity literature. Several researchers became concerned that individuals with overweight or obesity may not perceive their weight as such and recommended correcting these perceptions to motivate weight loss [2,3,4,5]. About one-third of youths report WPs that differ from their BMI classification [6,7,8]. Consistent research indicates that such strategies are likely to have unintended and adverse consequences

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