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Self-reported eating disorders of black, low-income adolescents: behavior, body weight perceptions, and methods of dieting.

This study identified black, low-income adolescents who thought they had anorexia nervosa or bulimia nervosa, identified behaviors common to those who thought they had the disorders, and compared their actual and perceived body weight as well as methods of dieting. Of the 1,930 students in grades 7-12 who participated, about 12% thought they might have an eating disorder. These students also reported having food-related behaviors similar to individuals with eating disorders and which differed significantly from those reported by their peers. Gender was more likely to affect food behavior than age. Though most students were within their expected weight range, those with self-reported eating disorders perceived themselves to be heavier more often than their peers and when their actual weights were compared, they were more likely to weigh more. Of those who had dieted to lose weight, fasting was the most frequently reported restrictive method used.

Adolescent↗

Weight perception of adolescent dancing school students.

OBJECTIVE: To study the hypothesis that underweight may be more prevalent among dancing school students than among nondancing school girls, and that their teachers and peers may play a role in developing this tendency. DESIGN: A case-control study on a convenience sample. SETTING: Two local dancing schools and one neighboring regular school. PARTICIPANTS: Forty ballet students, aged 13 to 17 years, from four classes and 29 age-matched girls in four regular classes. INTERVENTION: None. MEASUREMENTS/MAIN RESULTS: Each pupil was asked to classify herself and her peers as underweight, normal, or overweight; teachers were asked to classify their pupils by the same categories. Results were compared with an objective score, weight as a percentage of ideal weight for height, in which less than 85% indicates underweight; 85% to 115%, normal; and more than 115%, overweight. A higher prevalence of underweight as well as a significant tendency to overestimate self-evaluation was found among dancing students. Dancing teachers' evaluation tended to be inaccurate, especially regarding their underweight students. CONCLUSIONS: The atmosphere in dancing classes may encourage striving for thinness beyond normal limits. Ballet teachers may play a significant role in this process. We suggest that physicians and nutritionists be involved in ballet schools.

Adolescent↗

Relationships among adolescents' weight perceptions, exercise goals, exercise motivation, quality of life and leisure-time exercise behaviour: a self-determination theory approach.

Exercise has an important role to play in the prevention of child and adolescent obesity. Recent school-based interventions have struggled to achieve meaningful and lasting changes to exercise levels. Theorists have suggested that this may, in part, be due to the failure to incorporate psychosocial mediators as they relate to behaviour change. Using a sample of 580 British schoolchildren, a model grounded in self-determination theory was explored to examine the effects of exercise goals on exercise motivation, leisure-time exercise behaviour and quality of life (QoL). Results of structural equation modelling revealed that adolescents perceiving themselves to be overweight and pressurized to lose weight, endorsed extrinsic weight-related goals for exercise. Extrinsic goals negatively predicted, whereas intrinsic goals positively predicted, self-determined motivation, which in turn positively predicted QoL and exercise behaviour. Furthermore, self-determined motivation partially mediated the effects of exercise goals on reported exercise behaviour and QoL. Multi-sample invariance testing revealed the proposed model to be largely invariant across gender. Results suggest that holding extrinsic exercise goals could compromise exercise participation levels and QoL. A role for teachers and parents is proposed with the aim of orienting young people towards intrinsic goals in an attempt to enhance future exercise behaviour and QoL.

Adolescent↗

The public's response to the obesity epidemic in Australia: weight concerns and weight control practices of men and women.

OBJECTIVE: : To assess weight perceptions, weight concerns and weight control behaviours and related beliefs in a representative sample of adults. DESIGN: : Cross-sectional postal survey. SETTING: : The survey was conducted between October and December 1997 in the state of Victoria, Australia. SUBJECTS: : A total of 2500 subjects were selected at random from the Australian electoral roll; 900 provided usable responses. RESULTS: : At the time of the survey, 2.7% of respondents were trying to gain weight, 26.6% were trying to avoid gaining weight, 22.9% were trying to lose weight and 47.9% were not doing anything for their weight. Men (47.2%) were less likely than women (55.3%) to be attempting any form of weight control. Watching the type of food eaten (95.6%), reducing dietary fat intake (87.3%) and engaging in physical activity or exercise (84.4%) were the most common weight control strategies used. Potentially harmful strategies, such as self-induced vomiting and smoking, were used by relatively few respondents. Many adults believed that vigorous activity (26.8%) and total omission of fat from the diet (35.3%) are necessary in order to lose weight. CONCLUSIONS: : Attempts at weight control are common in the community. However, many men, including men who are already overweight, appear to be unconcerned about their weight. Obesity prevention initiatives should attempt to influence individuals' weight-related beliefs and behaviours, as well as seeking to change policies and environments to better support weight control.

Adult↗

Perception of weight status and dieting behaviour in Dutch men and women.

OBJECTIVE: To study the perception of weight status, the accuracy of self-assessment of weight status and weight control practices relative to the degree of adiposity in Dutch men and women. DESIGN: A cross-sectional study. SUBJECTS: 2155 men and 2446 women, aged 20-65y, of mostly caucasian origin, non-diabetic, not pregnant or with cancer. MEASUREMENTS: Body weight, height, waist and hip, total cholesterol, high density lipoprotein (HDL) cholesterol, blood pressure, self-administered questionnaire (including questions concerning demographic variables), weight loss practices, dietary intake, participation in sport as part of Dutch Monitoring Project on Risk Factors for Chronic Diseases (MORGEN). RESULTS: In the study population, 53% of men and 39% of women were overweight or obese. An association was shown between degree of adiposity and participation in sport for both men and women, and dietary fat intake in men. Of the subjects studied 56% of men and 52% of women described their weight as appropriate. A degree of inaccuracy in the estimation of relative body weight was observed. While dieting was prevalent, particularly among women, there was a lack of weight control action on the part of many overweight or obese individuals. This effect was most marked in men. Body Mass Index (BMI) was the strongest determinant of weight perception and dieting behaviours with some effect of educational level in men. Physical activity was not widely used as a method of weight control. CONCLUSION: These results point to a need for regular assessment of an individual's relative weight and health risk, gender specific obesity treatments and prevention strategies, and an emphasis in treatment and prevention of obesity on physical activity.

Adult↗

Weight-related perceptions among patients and physicians: how well do physicians judge patients' motivation to lose weight?

BACKGROUND: Prior studies suggest that patients and physicians have different perceptions and expectations surrounding weight; however, few studies have directly compared patients' and physicians' perspectives. OBJECTIVES: (1) To measure the extent to which obese patients and their physicians have discrepant weight-related perceptions, and (2) to explore patient and physician characteristics that may influence patient-physician discrepancy in motivation to lose weight. DESIGN AND PARTICIPANTS: Four hundred and fifty-six obese patients (302 females; mean age = 55.1 years; mean BMI = 37.9) and their 28 primary care physicians (22 males, mean age = 44.1 years) from nonmetropolitan practices completed an anonymous survey after an office visit. MEASURES: Weight-related perceptions included perceived weight status, health impact of weight, 1-year weight loss expectations, and motivation to lose weight. Correlates included patient and physician sex, age, and BMI; physicians' reported frequency, perceived patient preference, and confidence for weight counseling; and practice characteristics (e.g., years in practice). RESULTS: Physicians assigned patients to heavier descriptive weight categories and reported a worse health impact than patients perceived for themselves, whereas patients believed they could lose more weight and reported a higher motivation to lose weight than their physicians perceived for patients (P < .001). Physicians who believed patients preferred to discuss weight more often (P = .001) and who saw more patients per week (P = .04) were less likely to underestimate patient motivation. CONCLUSIONS: Patients reported more optimistic weight-related perceptions and expectations than their physicians. Further research is needed to determine how these patient-physician discrepancies may influence weight loss counseling in primary care.

Adult↗

Self-perception of weight appropriateness in the United States.

UNLABELLED: BACKGROUND; The self-perception of weight appropriateness is an important component of eating and weight-loss behaviors. Self-perceived weight status, however, is not fully explained by objective weight status. OBJECTIVE: To examine the influence of sociodemographic factors on Americans' perceptions of their weight appropriateness, controlling for objective weight status. DESIGN: In the Third National Health and Nutrition Examination Survey, respondents were asked, "Do you consider yourself now to be overweight, underweight, or about the right weight?" Responses to this question were compared with how respondents (n=15,593) would be classified by medical standards given their body mass index (BMI). A proportional odds logistic regression model was used to assess the predictive effects of various sociodemographic factors on weight self-perception. RESULTS: Overall, 27.5% of women and 29.8% of men misclassified their own weight status by medical standards. Of particular note, 38.3% of normal weight women thought they were "overweight," while 32.8% of overweight men thought they were "about the right weight" or "underweight." Multivariate regression analysis revealed that, controlling for BMI, numerous factors-including gender, age, marital status, race, income, and education-were independently associated with the self-evaluation of weight status. CONCLUSIONS: The self-perceived appropriateness of weight status varies in highly predictable ways among population-level subgroups, likely reflecting differences in the normative evaluation of bodily weight standards. Such evaluations may assist in the explanation of discrepancies between clinical recommendations based on weight status and actual weight control behaviors, discrepancies that are socially patterned along some of the same subgroupings.

Adult↗

Heaviness perception. IV. Weight x aperture -1 as a heaviness model in finger-grasp perception.

The present study verified that a simple division of Weight/Aperture (W/A) from information obtained from the individual cubes could describe perceived heaviness when pairs of cubic objects were haptically held one-by-one for comparison utilizing a thumb/index finger grasp. To test the effect of W/A, 15 subjects judged the heaviness between a pair of cubes in three experimental conditions with all visual and material input blocked: (1) cubes with similar ratios, but different weights; (2) cubes with different ratios, but of the same weight; and (3) cubes with dissimilar ratios and weights. The largest percentage of errors (67.4%) was made when objects with similar ratios but different weights were presented, because subjects tended to perceive these objects as being of equal weight. In the condition "equal weight and different ratio", the percentage of correct responses (17.7%) was relatively small, as the subjects tended to perceive the objects as being of different weights. These results strongly suggest that the W/A ratio is an authoritative model to explain human performance in the process of discriminating heaviness. The division model is proposed as Weight x Aperture(-1) on the basis of a recently expounded concept of multiplicative neural circuits.

Adolescent↗

Black-white differences in body size perceptions and weight management practices among adolescent females.

OBJECTIVE: This study compares body size perceptions and weight management practices of black and white adolescent females. DESIGN: Subjects were selected through a statewide, three-stage sampling procedure designed to provide a sample statistically representative of high school students in South Carolina. SUBJECTS: Participants included black (n = 1824) and white (n = 2256) females, 14-18 years of age, enrolled in South Carolina public high schools. METHODS: Respondents were asked to assess their perceived body size as overweight, underweight, or about right. Self-reported weight management practices included dieting (reducing caloric intake), exercise, and other methods (including diet pills and vomiting). Chisquare analysis was used to assess the differences in body size perception and weight management behaviors. Polychotomous logistic regression was performed to examine association while controlling for socioeconomic status. RESULTS: Forty-one percent of the white adolescents and 29% of the black adolescents perceive themselves as overweight (p < 0.005). In the week prior to the survey, 28% of the white adolescents and 13% of the black adolescents reported dieting 34% of the while versus 23% of the black adolescents reported exercising to lose weight; and 45% of the white and 16% of the black students reported both dieting and exercising. Polychotomous logistic regression analysis showed that white adolescent girls were almost twice as likely to perceive themselves as overweight as black adolescent girls. The white students had 6.04 [95% confidence interval (CI), 1.77, 20.67] times the odds of using pills and vomiting and 3.76 (95% CI, 2.99, 4.72) times the odds of engaging in dieting and exercising as methods of weight management compared to the black students. CONCLUSIONS: These findings suggest that white adolescents are more likely to perceive themselves as overweight than black adolescents and are more likely to engage in unhealthy weight management practices than black adolescents.

Adolescent↗

The relationship of weight-related perceptions, goals, and behaviors with fruit and vegetable consumption in young adolescents.

BACKGROUND: The effect of dieting and weight-control perceptions, goals, and behaviors on food intake, including fruit and vegetable (F&V) consumption, is not completely understood. We examined these associations in 1,755 young adolescents. METHODS: Data from the Teens Eating for Energy and Nutrition at School (TEENS) study were analyzed separately by gender using mixed linear modeling. Surveys completed at the beginning and end of 7th grade asked students to self-report fruit and vegetable consumption, weight-related perceptions, goals, and behaviors, and demographic variables. RESULTS: Underweight boys reported 0.8 fewer F&V servings per day than boys who reported their weight to be 'about right' (P = 0.002), while overweight girls reported 0.7 fewer F&V than girls who reported their weight to be 'about right' (P = 0.005). Boys with weight-related goals consumed significantly more F&V than did boys not wanting to do anything about their weight (P < 0.05). Girls engaging in weight-related behaviors reported 0.7 more F&V than girls who did not engage in weight-related behaviors (P = 0.006). CONCLUSIONS: Because F&V intake is low among all adolescents, population interventions should take place to increase F&V intake. These data support the inclusion of gender-specific intervention components related to weight-related perceptions, goals, and behaviors.

Adolescent↗

The relationship of body image perception and weight status to recent change in weight status of the adolescent female.

This descriptive correlational study investigated the relationship of body image perception and weight status to recent change in weight status of the adolescent female. Based on earlier research findings supporting the position that obese adolescent females demonstrate a negative body image perception as compared to the nonobese, this investigation identified the need to study body image perception as it applies to all adolescent females and to include a recent change in weight status as it may affect that perception. A convenience sample of 90 adolescent females between the ages of 13 and 17 years was selected from health and gym classes at a large midwestern metropolitan high school. Subjects were grouped into three categories: nonobese, overweight, and obese based on height, weight, and skinfold measurement. They were administered two questionnaires: the Body-Cathexis Scale and a self-report recent change in weight status and demographic questionnaire. Results indicated a significant positive correlation for the overall association of body image perception and weight status. When the analysis was partialled according to defined weight groups, the relationship held only for the overweight group. Differences in body image scores were obtained in association with each of the recent change-in-weight-status questions. Findings confirmed the need to study the association between body image perception and weight status to recent change in weight status with a more heterogeneous group of adolescent females.

Adolescent↗

Black and white adolescents' perceptions of their weight.

Black and white adolescents' perceptions of their weight were examined in this study. A 22-item questionnaire on weight perceptions and weight control was administered to 341 adolescents from two inner city schools in the midwest (138 black and 193 white students). Students were classified as thin, normal, or heavy based on National Health Survey data on height and weight measurements for youth ages 12-17. Significant differences (p less than .05) occurred in how the heavy black and white males and females perceived their weight in comparison to actual weight. All heavy white females perceived they were heavy, in comparison to only 40% of heavy black females; 78% of heavy white males labeled themselves heavy vs. 36% of heavy black males. Thin black and white females were dieting and exercising to lose weight and thin white males were exercising to lose weight. Black males were significantly more likely to believe emotions did not affect their weight when compared to white males. Black females believed exercise levels accounted for their weight, while white females attributed their weight to eating habits. Beliefs about exercise and eating contributed 23% to the variance found in perceived weight status of black males. White males believed access to food and their emotions accounted for their perceived weight. Leading sources of weight control information regardless of ethnicity were television, family members, friends and magazines for females; males used TV, family members, and athletic coaches.

Adolescent↗

Body image, acculturation, and substance abuse among boys and girls in the Southwest.

This study explored body image as measured by perceptions of weight and appearance and its impact on adolescent drug use among predominately Mexican American middle school students in the southwest. Outcomes analyzed included lifetime and recent alcohol, cigarette, and marijuana use and antidrug norms. Disliking one's looks was more of a risk factor for boys, whereas negative weight perceptions were more of a risk factor for girls. Relative to more acculturated (English-dominant) Latinos (N=903), non-Latino Whites (N=121), and other non-Latino youth (N=107), less acculturated (Spanish-dominant) Latino youth (N=212) reported the poorest body image. However, more acculturated Latino youth with poor body image had the greatest risk of substance use. More acculturated Latino boys who disliked their looks reported relatively greater amounts of recent alcohol use, and those who rated their bodies as too thin reported higher lifetime cigarette use, a greater amount and frequency of recent cigarette use, and weaker antidrug norms. More acculturated Latina girls who thought they were too fat reported a greater amount and frequency of recent cigarette use. These findings suggest that low levels of acculturation may protect some Latino youth with poor body image from coping via substance use. In addition, they suggest that poor body image among some Latinos may result less from adoption of American thinness ideals but rather from attitudes and behaviors that devalue the characteristics of Latino appearance.

Acculturation↗

High prevalence of abnormal eating and weight control practices among U.S. high-school students.

OBJECTIVE: This study sought to determine the prevalence and to identify correlates of abnormal eating and weight control practices in U.S. high-school students. METHOD: A three-stage cluster design technique was used to select 15,349 students from 144 different high schools. Each completed the 1999 Youth Risk Behavior Survey (YRBS) Questionnaire. RESULTS: Abnormal eating and weight control practices during the past month were reported by over 26% of female students and 10% of male students. Rates of abnormal eating and weight control practices varied by ethnicity and geographic location. Other correlates of abnormal eating and weight control practices included having an underweight body mass index (BMI): (OR=1.39, 95% CI=1.01-1.91), exercising to control weight in past 30 days (OR=1.51, 95% CI=1.30-1.76), dieting to control weight in past 30 days (OR=3.89, 95% CI=2.65-5.73), and interactions between gender and both weight perception and weight satisfaction. DISCUSSION: The high proportion of U.S. high-school students who have participated in abnormal eating and weight control practices in the past month demands immediate attention. The identified correlates may help target prevention and control programs.

Adolescent↗

Health and sociodemographic factors associated with body weight and weight objectives for women: 2000 behavioral risk factor surveillance system.

BACKGROUND: The increasing body mass index (BMI) of women in the United States gives rise to concerns about associated comorbid conditions and decreases in life expectancy. Also of concern are underweight women, especially as the result of an eating disorder or undernutrition. METHODS: Data from a national sample of women aged > or =18 years (n = 98,387) are used to examine the relationship between health and sociodemographic factors (diabetes, physical activity, self-rated health, smoking status, weight loss attempts, age, and education) and body weight (BMI, desired weight). Models are stratified by race. RESULTS: Roughly 70% of the women in each race/ethnic group (72.0% white women, 68.3% black women, 69.4% Hispanic women) wanted to weigh less, and just under one half of the women were actively trying to lose weight. A notable percentage of women who were classified as obese indicated that they were at their ideal weight and desired no weight change. Most women had not received advice from a health professional in the past year regarding their weight, and most were not engaging in the optimally recommended level of physical activity. CONCLUSIONS: Results document the range of satisfaction with current weight among adult women and capture low levels of health practitioner involvement in issues of weight. Perception of weight, combined with BMI, will need to be assessed to determine how best to proceed toward an ideal weight and satisfaction with that weight.

Adult↗

Prevalence of overweight misperception and weight control behaviors among normal weight adolescents in the United States.

Weight perceptions and weight control behaviors have been documented with underweight and overweight adolescents, yet limited information is available on normal weight adolescents. This study investigates the prevalence of overweight misperceptions and weight control behaviors among normal weight adolescents in the U.S. by sociodemographic and geographic characteristics. We examined data from the 2003 Youth Risk Behavior Survey (YRBS). A total of 9,714 normal weight U.S. high school students were included in this study. Outcome measures included self-reported height and weight measurements, overweight misperceptions, and weight control behaviors. Weighted prevalence estimates and odds ratios were computed. There were 16.2% of normal weight students who perceived themselves as overweight. Females (25.3%) were more likely to perceive themselves as overweight than males (6.7%) (p < 0.05). Misperceptions of overweight were highest among white (18.3%) and Hispanic students (15.2%) and lowest among black students (5.8%). Females (16.8%) outnumbered males (6.8%) in practicing at least one unhealthy weight control behavior (use of diet pills, laxatives, and fasting) in the past 30 days. The percentage of students who practiced at least one weight control behavior was similar by ethnicity. There were no significant differences in overweight misperception and weight control behaviors by grade level, geographic region, or metropolitan status. A significant portion of normal weight adolescents misperceive themselves as overweight and are engaging in unhealthy weight control behaviors. These data suggest that obesity prevention programs should address weight misperceptions and the harmful effects of unhealthy weight control methods even among normal weight adolescents.

Adolescent↗

Effortful touch with minimum movement: revisited.

The ecological static moment-torque model proposed by C. Carello, P. Fitzpatrick, I. Domaniewicz, T.C. Chan, and M.T. Turvey (1992) does not uniquely explain the perception of rod length by static holding. Guided by a mechanical analysis of the gravitational forces and torques produced in the hand as it statically holds rods of different lengths and materials at different orientations, we offer 2 additional theoretical explanations, the force-torque and weight-percept models. Experiment 1 demonstrates that all 3 models predict perceived rod length with considerable success. Experiment 2 provides clear experimental support for the force-torque and weight-percept models over the static moment-torque model. Experiment 3 pits the former 2 models against each other. Current results favor the weight-percept model. Implications for theories of haptic weight perception and design of a new tactile sensor are also considered.

Adolescent↗

Maternal perceptions of weight status of children.

OBJECTIVE: We quantified maternal misclassification of child weight status and examined determinants associated with maternal perceptions of child weight status. METHODS: Data from the Third National Health and Nutrition Examination Survey (1988-1994) were used. The sample included 5500 children (aged 2-11 years) with maternal interview data. Maternal perceptions of children's weight status were compared with measured weights and statures from which body mass index (BMI; weight/stature2; kg/m2) percentiles and z scores were determined. Frequency analyses determined the percentages of mothers considering their child to be "overweight," "underweight," or "about the right weight." Multivariable logistic regression analyses determined predictors of maternal misclassification of overweight children (> or =95th BMI-for-age percentile) and those at risk for overweight (> or =85th to <95th BMI-for-age percentile). RESULTS: Nearly one third (32.1%) of mothers reported their overweight child as "about the right weight." Younger children and those with lower BMI-for-age z scores had significantly greater odds of maternal underclassification of child overweight status. For children at risk for overweight, 14.0% of mothers reported sons to be "overweight," whereas 29.0% considered daughters to be "overweight." Odds of maternal misclassification of at-risk children as "overweight" were significantly greater for daughters, older children, children with higher BMI-for-age z scores, and children whose mothers had a lower BMI. Race/ethnicity was not a significant predictor in either model. CONCLUSIONS: Nearly one third of mothers misclassify overweight children as being lower than their measured weight status. Mothers are more likely to identify daughters who are at risk of overweight as being "overweight" than they are sons.

Body Mass Index↗