Does Perception of Body Weight During Adolescence Influence Dietary Intake?

Adolescents seem to be vulnerable to feeling dissatisfied with their weight and body shape (Clay et al., 2005). Their perception of their body image (i.e., their Diet-Perceptual Relationship) may be shaped by the opinions of their family and friends; what they see in television, movies, and magazines (Silva et al. 2021); and all forms of social media (i.e., their Diet-Psychosocial Relationship). At the same time, it’s crucial that adolescents develop a healthy body image since it can affect mental and physical health — especially if their perception differs from their actual weight and nutritional status.

 

There is emerging evidence of a connection between body perception and diet.

 

There is emerging evidence of a connection between body perception and diet. For instance, researchers have found that Greek adolescents were less likely to be overweight or obese if they accurately guessed their weight status and adhered closely to a “healthy foods” dietary pattern, compared to those who followed a diet consisting of unhealthy/high-fat or starchy, protein-rich foods (Kanellopoulou et al., 2021). Unsurprisingly, many research papers have suggested that certain dietary patterns (typically those labeled “healthy” and/or “traditional”) can protect people against being obese/overweight. 

Based on such findings, it’s purported that an accurate perception of one’s weight in conjunction with healthy dietary intake habits may play into obesity prevention strategies. Let’s take a closer look at a cross-sectional research study on this topic by Silva et al. (2021), which examined the relationship between weight misperception and dietary patterns among Brazilian adolescents. 

 

Accurate weight perception in conjunction with healthy dietary habits could help prevent obesity.

 

For this study, the researchers recruited Brazilian teenagers from urban and rural schools in cities with populations larger than 100,000 across Brazil. Only adolescents deemed to be of normal weight were included. Their height and weight were measured and used to calculate their body mass index (BMI), and in turn their nutritional status (BMI relative to age). 

Next, the researchers assessed the participants’ perception of their own weight. The students were asked questions such as “Are you satisfied with your weight?” and “In your opinion, at what level is your current weight?” If they indicated feeling “not satisfied” and “below the ideal” regarding their weight, they were placed in the underestimation group. Those who answered “not satisfied” and “above the ideal” or “far above the ideal” were assigned to the overestimation group. The participants in these groups were considered to experience weight misperception. To understand the subject further, their dietary intake patterns were examined using 24-hour dietary recalls.

       

34% of the study sample (over 52,000 normal-weight adolescents) misjudged their own weight.

 

The data showed that 34% of the 52,038 normal-weight adolescents in Brazil misjudged their own weight, with higher incidence rates reported in girls (42.6%) than boys (25.6%). In addition, a higher proportion of girls perceived themselves as heavier than they actually were (weight overestimation) compared to boys (25.7% vs. 8.2%). The authors theorized that this higher prevalence of weight overestimation in girls could be attributed to gendered social constructs — in this case, perhaps the expectation of achieving a “perfect” body. While girls tend to overestimate their weight, boys are more likely to describe themselves as too thin (Park, 2011). Nowadays many young people are concerned about their body shape and size due to social pressures to conform to a thin, ideal body (Yan et al., 2018).

 

The higher incidence of weight overestimation in girls may be connected to the idea of a “perfect” body.

 

In this study, the female students showing weight overestimation were less likely to follow the “processed meat, sandwiches, and coffee,” “ultra-processed and sweet foods,” and “traditional Brazilian” dietary patterns (the latter is characterized by rice, beans, vegetables, and meat). This suggests a sense of apprehension towards eating — of restriction. A different study in South Korea demonstrated that girls with weight overestimation tend to have poor eating habits and employ unhealthy dieting methods to lose weight (Lim et al. 2014). In short, normal-weight adolescents who perceive themselves as overweight seem to put effort into losing weight — intentions that do not exactly translate into healthy weight loss behaviors. 

Similar to the girls, the normal-weight boys with weight overestimation were less inclined to adhere to a “traditional Brazilian” dietary pattern. As noted above, this “traditional” diet consists of several unprocessed or minimally processed foods, which are recommended by the Food Guide for the Brazilian Population. Worth mentioning is that this dietary guide does not recommend the intake of ultra-processed foods, warning Brazilians to avoid several of these food items found in the “ultra-processed and sweet foods” dietary pattern.  

For girls who underestimated their weight, the “ultra-processed and sweet foods” and the “traditional Brazilian” dietary patterns were more likely to be adopted. In boys, weight underestimation was directly associated with greater adherence to the “processed meat, sandwiches, and coffee” and “ultra-processed and sweet foods” dietary patterns. 

 

Weight underestimation showed correlations with the “ultra-processed and sweet foods” dietary pattern in both sexes.

 

Weight underestimation showed correlations with the “ultra-processed and sweet foods” dietary pattern in both sexes. Coupled with the association between weight overestimation and lower adherence to the “traditional Brazilian” dietary pattern, these results highlight that weight misperception is related to unhealthy eating habits among adolescents. 

Awareness of the adolescent Diet-Perceptual Relationship in children and adolescents can be an important element for policymakers in developing and implementing intervention programs to support accurate self-perceptions of body weight. Successful efforts on this front could contribute to the adoption of better eating habits and enhanced overall general health in youth. 

 

References

Clay, D., Vignoles, V.L. and Dittmar, H. (2005), Body image and self-esteem among adolescent girls: testing the influence of sociocultural factors. Journal of Research on Adolescence, 15: 451-477. https://doi.org/10.1111/j.1532-7795.2005.00107.x

Cuypers, K., Kvaløy, K., Bratberg, G., Midthjell, K., Holmen, J., & Holmen, T. L. (2012). Being normal weight but feeling overweight in adolescence may affect weight development into young adulthood-an 11-year followup: the HUNT Study, Norway. Journal of obesity, 2012, 601872. https://doi.org/10.1155/2012/601872

Lim, H., Lee, H. J., Park, S., Kim, C. I., Joh, H. K., & Oh, S. W. (2014). Weight misperception and its association with dieting methods and eating behaviors in South Korean adolescents. Nutrition research and practice, 8(2), 213–219. https://doi.org/10.4162/nrp.2014.8.2.213

Park, E. (2011). Overestimation and underestimation: adolescents’ weight perception in comparison to BMI-based weight status and how it varies across socio-demographic factors. The Journal of school health. 81. 57-64. 10.1111/j.1746-1561.2010.00561.x.

Silva, S., Alves, M. A., Vasconcelos, F., Gonçalves, V., Barufaldi, L. A., & Carvalho, K. (2021). Association between body weight misperception and dietary patterns in Brazilian adolescents: A cross-sectional study using ERICA data. PloS one, 16(9), e0257603. https://doi.org/10.1371/journal.pone.0257603

Yan, H., Wu, Y., Oniffrey, T., Brinkley, J., Zhang, R., Zhang, X., Wang, Y., Chen, G., Li, R., & Moore, J. B. (2018). Body Weight Misperception and Its Association with Unhealthy Eating Behaviors among Adolescents in China. International journal of environmental research and public health, 15(5), 936. https://doi.org/10.3390/ijerph15050936