To explore the relationship of self-reported weight status and dieting to actual weight and height in a cross-sectional nationally representative sample of young adolescents.
Weights and heights were obtained on 1932 adolescents aged 12 to 16 years enrolled in the National Health and Nutrition Examination Survey III. Information on adolescents' perception of weight status, desired weight, and weight loss attempts was obtained by questionnaire.
Adolescents' reports of whether they considered themselves overweight or normal weight correlated poorly with medical definitions of overweight: 52% of girls who considered themselves overweight were, in fact, normal weight (body mass index ≤85th percentile), while only 25% of boys who considered themselves overweight were normal weight (P<.001). Adolescent white girls were significantly more likely to consider themselves overweight, even when their weight status was normal, than black girls (P<.001), black boys (P<.001), and white boys (P<.001). Adolescent white girls were also more likely to diet than black girls (P<.001), black boys (P<.001), and white boys (P<.001). Dieting behavior was associated with whether adolescents viewed themselves as overweight independent of whether they actually were overweight. Racial differences between dieting and self-perceived weight status were limited to girls. There were no significant differences in self-perceived weight status (P=.28), dieting behaviors (P=.99), and desire to weigh less (P=.95) among black and white boys.
Significant sex and racial differences existed in weight perception, desired weight, and dieting. A high proportion of normal-weight white girls consider themselves overweight and have attempted to lose weight.