Farhat Tilda, Iannotti Ronald J, Summersett-Ringgold Faith
*Office of Science Policy, Planning, Analysis and Reporting, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD; †Department of Exercise and Health Sciences, University of Massachusetts, Boston, MA; ‡Mental Health Services and Policy Program, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
J Dev Behav Pediatr. 2015 Jun;36(5):313-23. doi: 10.1097/DBP.0000000000000172.
To examine associations between 3 weight indices (weight status, perceived weight, and weight status perception accuracy) and heath-related quality of life (HRQOL).
Data are for girls in the 2009 Health Behaviors in School-Age Children survey, a nationally representative sample of students in Grades 5 to 10 during the 2009/2010 school year (n = 5018). Controlling for sociodemographics, multivariate linear regressions examined associations between self-reported weight status (underweight/normal/overweight/obese), perceived weight (how children categorize their weight), weight status perception accuracy (underestimate/accurate perception/overestimate), and dimensions of HRQOL, including physical, emotional, social, and school functioning.
Although obesity was only associated with poor physical and emotional HRQOL, perceptions of being overweight were associated with worse physical, emotional, school, and social HRQOL. Furthermore, girls who overestimated their weight reported poorer HRQOL than those with accurate weight perceptions. Associations of perceptions of being overweight and weight status overestimation with poor HRQOL despite, in most instances, the absence of associations between weight status and HRQOL suggest that weight status perceptions may not merely be a mediator of a weight status-HRQOL association but a significant independent correlate of poor HRQOL.
These findings raise the issue of whether there is a need to prioritize intervention efforts to promote better HRQOL by redefining the population of girls most at risk. Parents, teachers, and clinicians should be aware that, rather than overweight status, perceptions of being overweight (accurately or not) are associated with a poor HRQOL among girls. Future research should examine the potential negative effect of using specific body image terminologies on adolescents' psychological health.
研究三种体重指数（体重状况、感知体重和体重状况感知准确性）与健康相关生活质量（HRQOL）之间的关联。
数据来源于2009年学龄儿童健康行为调查中的女孩，该调查是2009/2010学年5至10年级学生的全国代表性样本（n = 5018）。在控制社会人口统计学因素的情况下，多元线性回归分析了自我报告的体重状况（体重过轻/正常/超重/肥胖）、感知体重（儿童对自己体重的分类方式）、体重状况感知准确性（低估/准确感知/高估）与HRQOL维度之间的关联，HRQOL维度包括身体、情感、社交和学校功能。
虽然肥胖仅与较差的身体和情感HRQOL相关，但感知超重与较差的身体、情感、学校和社交HRQOL相关。此外，高估自己体重的女孩报告的HRQOL比体重感知准确的女孩更差。尽管在大多数情况下体重状况与HRQOL之间不存在关联，但感知超重和体重状况高估与较差的HRQOL之间的关联表明，体重状况感知可能不仅是体重状况与HRQOL关联的中介因素，而且是较差HRQOL的一个重要独立相关因素。
这些发现提出了一个问题，即是否需要通过重新定义风险最高的女孩群体来优先开展干预措施以促进更好的HRQOL。家长、教师和临床医生应意识到，对于女孩来说，与较差的HRQOL相关的是感知超重（无论准确与否），而不是超重状态。未来的研究应探讨使用特定身体形象术语对青少年心理健康的潜在负面影响。
