Abstract
Background/Objectives:Body weight is negatively associated with adolescent Health-Related Quality of Life (HRQoL). Despite this well-established relationship, some adolescents with obesity do not display the expected HRQoL decreases. This study hypothesised weight perception as a moderator of the association between weight status and adolescent HRQoL.Subjects/Methods:Subjects were secondary school students from an obesity prevention project in the Barwon South-West region of Victoria, Australia, entitled It's Your Move (N=3040). Measures included standardised body mass index (BMI-z; World Health Organization growth standards), weight perception and HRQoL, measured by the Paediatric Quality of Life Inventory. Linear regression and average marginal effect analyses were conducted on cross-sectional baseline data to determine the significance of any interaction between weight perception and measured weight status in shaping adolescent HRQoL.Results:The BMI-z/perceived weight status interaction was significantly associated with adolescent HRQoL outcomes. Adolescents with BMI z-scores in the overweight/obesity range who perceived themselves as overweight had lower HRQoL than those who perceived themselves as ‘about right.' Conversely, adolescents with BMI scores in the lower end of the normal range or in the thinness range who perceived themselves as underweight had lower HRQoL than those with ‘about right' perceptions.Conclusions:This was the first study to report third-variable impacts of a body-perception variable on the relationship between adolescent weight status and HRQoL. Adolescents' weight perceptions significantly moderated the relationship between overweight/obesity and reduced HRQoL. Adolescents who were outside the normal weight range and misperceived their objectively measured weight status enjoyed a higher HRQoL than adolescents whose weight perception was concordant with their actual weight status. These findings suggest that practitioners may need to exercise caution when educating adolescents about their weight status, as such ‘reality checks' may negatively impact on adolescent HRQoL. It is suggested that more research be conducted to examine this potential effect.
Highlights
The negative impact of obesity on the physical and psychiatric health and well-being of individuals has been well documented.[1,2]Adolescent obesity is a chronic condition and a known risk factor for the later development of other diseases.[3]
The levels of concordance between measured weight status and self-reported weight perception are presented in Table 2, together with χ2 analysis to test the association between the two variables
There was a significant association between measured weight status and weight perception, there remained a clear proportion of the sample that did not accurately perceive their weight status; overall, 21.8% of participants with a body mass index (BMI) in the normal/thinness range thought they were underweight ( o2% of the sample had a BMI in the thinness range) and 9.4% of normal weight participants thought they were overweight
Summary
Adolescent obesity is a chronic condition and a known risk factor for the later development of other diseases.[3] Recently, studies have broadened the focus to include physical as well as psychological outcomes associated with obesity in adolescence. These studies consistently identify negative associations between weight status and subjective measures of functioning and wellbeing.[4]. The survey found 15.2% of students to be obese and 13% to be overweight.[5] Similar prevalence figures have been recorded among Australian adolescents; combined overweight/obesity prevalence was 28% in 2008.6 Obesity during this developmental period is associated with increases in blood pressure, high cholesterol levels, metabolic risk, cardiovascular disease and asthma.[1]
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