Do Weight Perception Transitions in Adolescence Predict Concurrent and Long-Term Disordered Eating Behaviors?

Perceiving one's weight as "overweight" is associated with disordered eating in adolescence. Yet, it is unknown whether weight perceptions change during adolescence, or whether these weight perception transitions predict disordered eating. This study aims to: (1) characterize weight perception transitions from early to late adolescence among a population-based sample and (2) examine whether weight perception transitions in adolescence predict concurrent and future disordered eating into young adulthood.

Eating and Activity in Teens and Young Adults (N = 1,414) survey data were used to examine correlates of weight perception transitions from early (M_age = 14.9 ± 1.6 years) to late adolescence (M_age = 19.4 ± 1.6 years). Adjusted generalized estimating equations were used to determine whether weight perception transitions in adolescence predicted concurrent and future disordered eating in emerging adulthood (M_age = 25.2 ± 1.6 years) and young adulthood (M_age = 31.0 ± 1.6 years).

Weight perceptions were stable from early to late adolescence for 77.2% of adolescents, whereas 15.5% transitioned to perceiving their weight as "overweight" and 7.3% stopped perceiving "overweight" in late adolescence. Perceived "overweight", especially in late adolescence, was associated with higher concurrent and long-term disordered eating up to 10 years later. For example, the predicted prevalence of binge eating in young adulthood among individuals who perceived their weight as "overweight" throughout adolescence was 20.1% compared to 6.6% for those who never perceived their weight as "overweight" in adolescence.

Adolescent weight perception was relatively stable in this population-based sample. However, weight perception transitions that involved perceiving "overweight", particularly in late adolescence, were associated with long-term higher risk of disordered eating.