Weight misperceptions and racial and ethnic disparities in adolescent female body mass index.

This paper investigated weight misperceptions as determinants of racial/ethnic disparities in body mass index (BMI) among adolescent females using data from the National Survey of Youth 1997. Compared to their white counterparts, higher proportions of black and Hispanic adolescent females underperceived their weight status; that is, they misperceived themselves to have lower weight status compared to their clinically defined weight status. Compared to their black counterparts, higher proportions of white and Hispanic adolescent females misperceived themselves to be heavier than their clinical weight status. Oaxaca-Blinder decomposition analysis showed that accounting for weight misperceptions, in addition to individual and contextual factors, increased the total explained portion of the black-white female BMI gap from 44.7% to 54.3% but only slightly increased the total explained portion of the Hispanic-white gap from 62.8% to 63.1%. Weight misperceptions explained 13.0% of the black-white female BMI gap and 3.3% of the Hispanic-white female BMI gap. The regression estimates showed that weight underperceptions were important determinants of adolescent female BMI, particularly among black and Hispanic adolescents. Education regarding identification and interpretation of weight status may play an important role to help reduce the incidence and racial disparity of female adolescent obesity.