Weight misperception and psychosocial health in normal weight Chinese adolescents

Objective. To investigate the association between weight misperception and psychosocial health problems among normal weight Chinese adolescent boys and girls. Methods. In the Youth Smoking Survey 200304, 20 677 normal weight students aged 1118 years from 85 randomly selected schools throughout Hong Kong were analysed. Students who perceived themselves as very thin, thin, fat or very fat were classified as having weight misperception in contrast to the reference group who correctly perceived themselves as normal weight. Psychosocial health outcomes included headache, feeling stressful, feeling depressed, poorer appetite, sleepless at night, having nightmares and less confidence in getting along with friends. Logistic regression yielded adjusted odds ratios (ORs) for each outcome by weight misperception in boys and girls separately. Results. In girls, misperceived fatness was associated with all outcomes, while misperceived thinness was associated with poorer appetite and less confidence. Boys who misperceived themselves as very thin or fat had greater odds of all outcomes except having nightmares. In general, greater ORs were observed for misperceived fatness than thinness in girls, but similar ORs were observed in boys. Misperceived thinness and fatness accounted for 0.6% to 45.1% of the psychosocial health problems in adolescents. Conclusions. Normal weight adolescents with weight misperception were more likely to have psychosocial health problems, and the associations were stronger for extreme misperceptions (i.e., very fat or very thin) in both boys and girls.