Abstract

Background: It remain unclear that the association between weight status, weight perception, weight satisfaction and the clustering of physical activity (PA) and dietary behaviors in adolescents. Method: A cross-sectional analysis of National Health and Nutrition Examination Survey and the US Department of Agriculture’s Food Patterns Equivalents 2007–2014 data from adolescents aged 12–17 years (n = 2965) was conducted. Multivariable logistic regression models adjusted for demographic characteristics examined the association between weight status, weight perception, weight satisfaction, and the four created lifestyle groups (healthier behaviors, healthier diet only, physically active only, unhealthier behaviors). Results: Males with obesity were more likely to be in the healthier diet only group than males with a normal weight (OR = 1.90, 95% CI: 1.02, 3.52). Similar patterns were found in males who perceived themselves as being overweight or having obesity (OR = 2.09, 95% CI: 1.09, 3.99) and males with obesity who perceived their weight status accurately (OR = 2.33, 95% CI: 1.12, 4.88). Female respondents who were satisfied with their weight were 59% less likely to be in the healthier diet only group than healthier behaviors group compared with females who were weight dissatisfied (OR = 0.41, 95% CI: 0.23, 0.75). This pattern was not observed in males. Conclusions: Clustering PA and dietary behaviors were associated with weight status and weight perception for males but not females. Weight satisfaction was associated with clustered PA and dietary behaviors for females. These findings are important for obesity prevention policies and programs to better address adolescents’ obesity and reduce health disparities in this population.

Highlights

  • 20.6% of US adolescents aged 12–19 have obesity [1]

  • Results of the current study determined that females who were satisfied with their weight were more likely to meet physical activity (PA) recommendations and have a healthful diet than those who were dissatisfied with their weight. These findings indicate that lifestyle behaviors for males differ by weight status and weight perception whereas lifestyle behaviors for females differ by weight satisfaction

  • The present study found that males who accurately perceived themselves as being overweight were more likely have unhealthier lifestyle behaviors. These findings suggest that for males recognizing oneself as being overweight may be a barrier to participating in PA and eating a healthier diet but this might not the case for males with obesity. These findings suggest that sex differences in the relationship of weight status, weight perception and lifestyle behaviors should be considered while tailoring suitable obesity prevention or intervention strategies to address the unique needs of males and females with obesity in different lifestyle behavior groups

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Summary

Introduction

20.6% of US adolescents aged 12–19 have obesity [1]. This high prevalence of obesity and its associated short- and long-term health risks [1,2] make addressing obesity in this population a public health priority. Most available studies examining the relationships between lifestyle behaviors and obesity among adolescents focus on either PA or dietary behaviors [4,5,6,7,8]. An understanding of factors associated with both PA and dietary behaviors is needed to inform obesity prevention efforts for adolescents, research examining these behaviors simultaneously is lacking. It remain unclear that the association between weight status, weight perception, weight satisfaction and the clustering of physical activity (PA) and dietary behaviors in adolescents

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