Too big or too thin? New Caledonian adolescents' perceptions of overweight and underweight

The first aim was to examine New Caledonian adolescents' views of what constitutes an overweight or underweight person. The second aim was to assess whether an environment with a high prevalence of overweight is associated with different norms of overweight or underweight in this population.

The Stunkard Figure Rating Scale was used for a sample of 699 pluriethnic adolescents in New Caledonia. Body mass index (BMI) was assessed for each participant and weight status was determined. The factors associated with higher figure ratings were determined by linear regression modeling.

Multilinear regression analysis indicated that gender (being male) and BMI were associated with higher rating scores to designate overweight. Moreover, higher BMI z-scores were associated with higher underweight figure ratings. Ethnicity, area of residence, age, and socioeconomic status were not associated with higher ratings of body image.

These findings show that an environment with a high prevalence of overweight does not necessarily shift adolescent "norms," contrary to visual normalization theory. These results should be taken into account in educational overweight prevention programs.