Gender and race/ethnic differences in inaccurate weight perceptions among U.S. adolescents

Inaccurate weight perceptions may lead to unhealthy weight control practices among normal weight adolescents and to a greater risk of adult obesity and related morbidities for overweight adolescents. To examine which U.S. adolescents are at risk of these outcomes, we examine gender and racial/ethnic differences in weight perception inaccuracy. This is the first study of weight perception inaccuracy to include Latino/a and Asian American adolescents.

Among the 12,789 Wave II participants of the National Longitudinal Study of Adolescent Health, we estimate multivariate models that reveal how gender, race/ethnicity, and clinical weight categories predict weight perception inaccuracy.

Relative to boys, girls have lower odds of underestimating their weight and greater odds of overestimating their weight. In particular, among overweight and obese adolescents, girls are more accurate than boys, but among normal weight adolescents, boys are more accurate. Compared with Whites, African Americans are more likely to underestimate their weight, particularly among overweight girls and obese boys. Overall and particularly among girls and normal weight adolescents, African Americans are less likely to overestimate their weight than their White counterparts. Finally, Asian American girls are more likely to underestimate their weight than White girls.

These findings have important implications for identifying and intervening with adolescents at the greatest risk of long-term weight problems, weight-related morbidity, and unhealthy weight control practices.