Association between Actual and Perceived Obesity Weaker among Black than White Children
Maryam Moghani Lankarani1, Shervin Assari2,3
1Department of Psychiatry, University of Michigan School of Medicine, Ann Arbor, MI 48104, USA. lankaranii@yahoo.com.
Insights
Actual obesity is linked to perceived overweight in children, but this association differs by race. Black children with obesity are less likely to perceive themselves as overweight compared to White children.
Area of Science:
- Pediatric Health
- Obesity Research
- Health Disparities
Background:
- Actual obesity is generally associated with perceived overweight.
- Previous adult studies suggest this link is weaker in Black individuals compared to White individuals.
- The trend in children regarding race-based differences in obesity perception remains unclear.
Purpose of the Study:
- To investigate the association between actual and perceived obesity in a national sample of American children.
- To explore potential heterogeneity in this association based on race, gender, and their intersection.
- To inform targeted interventions for obesity management in diverse pediatric populations.
Main Methods:
- Utilized data from the Health Behavior in School-Aged Children (HBSC) 2009-2010 national study in the United States.
- Included 8860 children (74.28% White, 25.72% Black), aged 17 or younger.
- Employed linear regression models with interaction terms to analyze the relationship between actual obesity (BMI > 95th percentile) and perceived overweight, stratified by race and gender.
Main Results:
- A positive association was found between actual obesity and perceived overweight in the pooled sample.
- A significant interaction between race and obesity was identified, indicating a stronger association for White children than Black children.
- No significant effect of gender or the intersection of race and gender on the obesity perception association was observed.
Conclusions:
- The relationship between actual and perceived obesity in children is race-dependent.
- Inaccurately perceived weight may contribute to the higher obesity burden among Black children.
- Interventions aimed at improving weight perception accuracy are crucial for effective obesity reduction strategies in Black children.
Abstract:
Although actual obesity is expected to be associated with perceived overweight, some recent studies in adults have suggested that this link may be smaller for Blacks than Whites. It is unknown, however, whether the same trend holds for children or not. This study explored the heterogeneity of the association between actual and perceived obesity in a national sample of American children by race, gender, and their intersection. Health Behavior in School-Aged Children (HBSC), 2009⁻2010, is a national study of children 17 years or less in the United States. This analysis included a total number of 8860 children, including 6581 (74.28%) White and 2279 (25.72%) Black children. Actual obesity, defined as a body mass index (BMI) greater than 95% of the age- and gender-percentile, was the independent variable. Perceived overweight was the main outcome. We ran linear regression models with and without interaction terms between race, gender, and actual obesity. We also ran race- and gender-specific linear regression models. In the pooled sample, actual obesity was positively associated with perceived overweight. We found an interaction between race and obesity, suggesting stronger association between actual obesity and perceived overweight for White than Black children. Gender or intersection of race and gender did not alter the association between actual obesity and perceived overweight. The link between actual obesity and perceived overweight depends on race of the child. Inaccurately perceived weight may be one of many mechanisms behind the disproportionately higher rate of obesity burden among Black children in the United States. As perceived overweight plays a salient role for weight control behaviors, Black children with obesity may need some help to perceive themselves as obese. Training programs should target Blacks to increase the accuracy of their weight and body size evaluation and perception as an essential step for reducing the burden of obesity among Black children.
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