US Pharm. 2023;48(8):4.

A recent study involving more than 745,000 adolescents from Europe and North America identified an increase in the number of teenagers who underestimate their body weight. Tracking data from 2002 to 2018, findings published in Child and Adolescent Obesity demonstrate a noticeable decrease in those who overestimate their weight, too.

The team of experts who carried out the research warn these shifting trends in body weight perception could reduce the effectiveness of public health interventions aimed at weight reduction in young people.

“During this impressionable age, body weight perception may influence a young person’s lifestyle choices, such as the amount and types of food they eat and their exercise habits,” said lead author Anouk Geraets from the Department of Social Sciences, University of Luxembourg.

“It’s concerning that we’re seeing a trend where fewer adolescents perceive themselves as being overweight, as this could undermine ongoing efforts to tackle increasing levels of obesity in this age group. Young people who underestimate their weight and therefore do not consider themselves to be overweight may not feel they need to lose excess weight and may make unhealthy lifestyle choices.”

A person’s perception of his or her body weight may not accurately reflect the actual weight. A discrepancy in body weight perception (BWP) may be either an underestimation (where actual weight is higher than perceived weight) or an overestimation (where actual weight is lower than perceived weight).

The researchers examined survey data from 746,121 11-, 13-, and 15-year-olds from 41 countries collected at 4-yearly intervals in the International Health Behavior in School-Aged Children, a World Health Organization collaborative study.

The team modeled trends in BWP among adolescents across different countries over time, making adjustments for age, gender, and family socioeconomic status. They found that underestimation of weight status increased and overestimation of weight status decreased over time among both sexes, with stronger trends for girls. The researchers also noted that correct weight perception increased over time among girls and decreased among boys.

The authors speculated that the observed differences between girls and boys in BWP may support the idea there are sex differences in body ideals and that these body ideals have changed over time. Notably, the increased underestimation and decreased overestimation of weight status over time for girls may be explained by the emergence of an athletic and strong body as a new contemporary body ideal for both sexes.

“This study has clinical and public health implications. The increase in correct weight perception and the decrease in overestimation may have a positive effect on unnecessary and unhealthy weight-loss behaviors among adolescents, while the increase in underestimation might indicate the need for interventions to strengthen correct weight perception,” said Dr. Geraets.

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