Cross-Sectional and Longitudinal Associations Between Weight Perception and Cardiometabolic Health Among Adolescents...

Several US public health and clinical initiatives notify adolescents of body mass index (BMI) or weight status; however, few studies have examined whether weight perception is independently associated with objective cardiometabolic markers. We assessed cross-sectional and longitudinal associations between weight perception and cardiometabolic health among adolescents followed into emerging adulthood.

We analyzed wave 4 (mean [SE] age, 19.2 [0.04] y) and wave 7 data collected 3 years later from the NEXT PLUS Generation Health Study, a nationally representative cohort of US adolescents followed into emerging adulthood (analytic n = 454 at wave 4; n = 330 at wave 7). To assess cross-sectional and longitudinal associations between weight perception (perceived their weight as overweight vs did not perceive their weight as overweight) and cardiometabolic outcomes (fasting blood glucose, hemoglobin A_1c, high-sensitivity C-reactive protein, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein [LDL] cholesterol, systolic blood pressure, diastolic blood pressure, and waist circumference), linear regressions adjusting for sociodemographic variables were performed with and without additional adjustment for BMI.

In cross-sectional models adjusted for sociodemographic characteristics and BMI, participants who perceived their weight as overweight had higher adjusted mean total cholesterol (mean difference, 12.3 mg/dL; P = .045) and LDL cholesterol (mean difference, 8.3 mg/dL; P = .04). In longitudinal models, perceiving one's weight as overweight was not associated with cardiometabolic outcomes after adjustment for BMI.

Perceiving one's weight as overweight is associated with worse cardiometabolic health. Health professionals should consider the possible implications of policies aimed at informing adolescents of their BMI status before implementation. Future studies are warranted to explore the causal pathway of this association.