Weight perception and psychological factors in Chinese adolescents

To investigate the pattern of weight perception and its relationship with psychological distress among Chinese adolescents.

A sub-cohort of 2179 healthy Chinese adolescents randomly selected from schools in Wuhan, China, including 1156 boys and 1023 girls 11 to 15 years of age was included in the current study. Weight, height, self-perceptions of weight status, depressive psychological symptoms including anxiety, depression, perceived peer isolation, and other constructs were measured by a structured questionnaire. A General Linear Model was used to compare psychological differences between actual and perceived weight groups.

Perceived underweight was more likely to occur in boys, whereas perceived overweight was more likely to occur in girls. Compared with objective body weight status defined by the International Obesity Task Force (IOTF) and the World Health Organization (WHO) age- and gender-specific body mass index (BMI) cutoffs, girls were more likely to misperceive themselves as overweight, whereas relatively more boys misclassified their weight status as underweight. After adjusting for age, parents' educational attainment, and urban residence, perceived overweight boys and girls were more likely to experience anxiety and depression than perceived normal and underweight subjects (p <.05). Perceived overweight girls and perceived underweight boys experienced higher peer isolation than other groups (p <.05). Significant differences were not found in social support, school connectedness, trouble with teachers, and family disharmony among different weight-perception groups.

Our results suggested distortion of weight perception was prevalent, and may have detrimental psychological influences in Chinese adolescents.