University of Minnesota, Department of Pediatrics, Division of General Pediatrics, 717 Delaware St SE, 3rd Floor West, Minneapolis, MN 55414, USA.
Pediatrics. 2010 Mar;125(3):e452-8. doi: 10.1542/peds.2009-0185. Epub 2010 Feb 8.
The goal of this study was to examine weight misperception among overweight adolescents in recent years and compare the demographic characteristics and weight-related behaviors of overweight adolescents who accurately and inaccurately perceive their weight status.
We used data from the nationally representative Youth Risk Behavior Surveillance System, collected every 2 years from 1999 through 2007. On the basis of self-reported height and weight, BMI percentile for age and sex was calculated. Overweight and obese respondents (BMI > or = 85th percentile) were classified into 2 groups: (1) misperceivers (weight perception "about right" or "underweight") or (2) accurate perceivers (weight perception "overweight"). We examined the proportion of misperceivers at each time point. Using the 2007 data, we compared demographic characteristics and weight-related behaviors of accurate perceivers and misperceivers with bivariate and multivariate analyses.
Among overweight adolescents, the overall proportion of misperceivers ranged between 29% and 33% from 1999 through 2007. In 2007, 23% of overweight girls and 40% of overweight boys were misperceivers (P < .001). Both male and female accurate perceivers were significantly more likely than misperceivers to report trying to maintain or lose weight, exercising for weight control, and eating less for weight control. Adjusting for age, race/ethnicity, and BMI percentile, no significant differences in unhealthy weight-related behaviors were found between accurate perceivers and misperceivers in boys or girls. Male accurate perceivers were significantly less likely to report achieving recommended levels of fruit and vegetable intake and physical activity.
Nearly 3 in 10 overweight adolescents do not consider themselves overweight. Those with an accurate weight perception reported some healthy weight-related behaviors but not higher levels of unhealthy weight-related behaviors. With the substantial prevalence of weight misperception, clinicians should consider their patients' perceived weight status when pursuing patient-centered counseling of overweight adolescents.
本研究旨在探讨近年来超重青少年的体重感知偏差，并比较准确和不准确感知体重状况的超重青少年的人口统计学特征和与体重相关的行为。
我们使用了全国代表性的青少年风险行为监测系统的数据，该系统每隔两年从 1999 年到 2007 年进行收集。根据自我报告的身高和体重，计算出年龄和性别对应的 BMI 百分位数。超重和肥胖的受访者（BMI≥85 百分位数）分为 2 组：（1）误报者（体重感知“正常”或“体重不足”）或（2）准确感知者（体重感知“超重”）。我们检查了每个时间点的误报者比例。利用 2007 年的数据，我们通过双变量和多变量分析比较了准确感知者和误报者的人口统计学特征和与体重相关的行为。
在超重青少年中，1999 年至 2007 年期间，误报者的总体比例在 29%至 33%之间。2007 年，23%的超重女孩和 40%的超重男孩是误报者（P<.001）。无论是男孩还是女孩，准确感知者都明显更有可能报告试图保持或减轻体重、为控制体重而锻炼以及为控制体重而少吃。在调整年龄、种族/族裔和 BMI 百分位数后，男孩或女孩中，准确感知者和误报者之间在不健康的与体重相关的行为方面没有显著差异。男性准确感知者明显不太可能报告达到水果和蔬菜摄入量以及身体活动的推荐水平。
近 1/3 的超重青少年不认为自己超重。那些准确感知体重的人报告了一些与体重相关的健康行为，但没有更高水平的与体重相关的不健康行为。鉴于体重感知的普遍存在，临床医生在对超重青少年进行以患者为中心的咨询时，应考虑患者的体重感知。
