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More Adolescents Worldwide Experience Body Weight Misperceptions, According to New Study


Underestimation of weight status increased while overestimation decreased during the last 2 decades, according to results from a study of over 745 000 adolescents.

©Protsenko Dmitriy/AdobeStock

©Protsenko Dmitriy/AdobeStock

The global prevalence of adolescents who underestimate their body weight increased during the last 2 decades, while the overestimation of weight status decreased, according to new research published in Child and Adolescent Obesity.1

Investigators who conducted the new study of more than 745 000 adolescents from 41 countries across Europe and North America, stressed that these shifting trends in body weight perception (BWP) among adolescents could reduce the effectiveness of public health interventions aimed at weight loss in this population.1

“During this impressionable age, body weight perception may influence a young person’s lifestyle choices, such as the amount and types of food they eat and their exercise habits,” said lead author Anouk Francine Jacqueline Geraets, PhD, a postdoctoral researcher from the department of social sciences at the University of Luxembourg, in a press release.2 “So it’s concerning that we’re seeing a trend where fewer adolescents perceive themselves as being overweight – as this could undermine ongoing efforts to tackle increasing levels of obesity in this age group.”

“Young people who underestimate their weight and therefore do not consider themselves to be overweight may not feel they need to lose excess weight and, as a result, they may make unhealthy lifestyle choices,” added Geraets.2

Among adolescents, body weight misperception is common and has been associated with changes in actual weight status, weight-loss intentions, and mental health conditions, according to the authors.1

Geraets and colleagues conducted the current study to examine linear time trends in BWP between 2002 and 2018 among a cross-national sample of adolescents, including gender and country differences, and to “explore the role of changes over time in country- level overweight/obesity prevalence in these trends.”1

Researchers used data from the World Health Organization’s (WHO) cross-sectional cross-national study called Health Behavior in School-Aged Children from 2002 to 2018. The final cohort included 746 121 adolescents aged 11, 13, and 15 years from 41 countries. The mean age was 13.7 years and 51% of the cohort were girls.1


Investigators found that across all survey years, 60.9% of participants had a correct weight perception, while 37.4% and 25.4% of adolescents underestimated and overestimated their weight status, respectively.1

Results showed that underestimation of weight status increased over time among both genders, however, the trend was slightly stronger among girls (odds ratio [OR] 1.022, 95% CI 1.02-1.024; P<.001) compared with boys (OR 1.015, 95% CI 1.013-1.016; P<.001). Overestimation of weight decreased among both genders, with the trend also stronger among girls (OR 0.985, 95% CI 0.984-0.986; P<.001) compared to boys (OR 0.992, 95% CI 0.990-0.993; P<.001), according to researchers.1

Over the study period, boys demonstrated a decrease in correct weight perception (OR 0.995, 95% CI 0.994-0.997; P<.001) while girls reported an increase in correct weight perception (OR 1.007, 95% CI 1.006-1.008; P<.001).1

In addition, while changes in correct weight perception, underestimation, and overestimation of weight status varied by country, “changes over time in country-level overweight/obesity prevalence could not explain these trends,” wrote Geraets et al.1

Investigators speculated that the observed differences between genders in BWP trends might support the notion that are sex differences in body ideals and changes in these ideals have occurred over time.1

“Notably, the increased underestimation and decreased overestimation of weight status over time for girls may be explained by the emergence of an athletic and strong body as the new contemporary body ideal for both boys and girls,” wrote authors.1

Geraets emphasized the clinical and public health implications of these findings.

“The increase in correct weight perception and the decrease in overestimation may have a positive effect on unnecessary and unhealthy weight loss behaviors among adolescents, while the increase in underestimation might indicate the need for interventions to strengthen correct weight perception.2

“More research is now needed to understand the factors underlying these time trends and to develop effective public health interventions,” added Geraets.2

A strength of the current study was the large number of participating countries, however, “it should be noted that the study only included countries in the WHO Europe region as well as Canada and the United States of America, thus the results cannot be generalized to other regions,” reported researchers.1


1. Geraets AFJ, Cosma A, Fismen AS, et al. Cross-national time trends in adolescent body weight perception and the explanatory role of overweight/obesity prevalence. Child and Adolescent Obesity. Published online July 2, 2023. doi:10.1080/2574254X.2023.2218148

2. Taylor & Francis Group. Fewer teens now perceive themselves as overweight – international study of more than 745,000 adolescents. T&F Newsroom. July 3, 2023. Accessed July 11, 2023. https://newsroom.taylorandfrancisgroup.com/fewer-teens-now-percieve-themselves-as-overweight-international-study-of-more-than-745000-adoloscents/

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