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.
*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.
Address for reprints: Tilda Farhat, MPH, PhD, Office of Science Policy, Planning, Analysis and Reporting, National Institute on Minority Health and Health Disparities, National Institutes of Health, 6707 Democracy Boulevard, Suite 200, Bethesda, MD 20892; e-mail: firstname.lastname@example.org.
This research was supported in part by the Intramural Research Program of the National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development (Contract N01-HD-5-3401) and by the Maternal and Child Health Bureau of the Health Resources and Services Administration.
Disclosure: The authors declare no conflict of interest.
At the time of the study, T. Farhat, R. J. Iannotti, and F. Summersett-Ringgold were with the Health Behavior Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD.
Received August , 2014
Accepted February , 2015