Weight status misperception and the health behaviors of obese adolescents

Background: Weight underestimation among U.S. adolescents is common, but the ramifications of this misperception are not yet well known. Purpose: To determine the relationship between weight self-perception and participation in health behaviors among obese adolescents. Methods: The sample consisted of 1,210 obese male and female 7^th and 11^th graders. Participants completed the Personal Wellness Profile - Teen Edition, a general self-report measure of adolescent health functioning, and had their BMI's measured. Data were analyzed using X² tests and logistic regression models. Results: Underestimated weight status was associated with higher reported rates of participation in health behaviors (physical activity, healthy diet, weight management, overall healthy lifestyle) as well as greater self-efficacy in one's ability to engage in these behaviors. Self-efficacy either partially or fully mediated the relationship between weight underestimation and the health behaviors. Discussion: Both weight perception and self-efficacy should be considered when attempting to understand and predict which adolescents with obesity are likely to engage in health behaviors. For some adolescents it is possible that intervention efforts that emphasize fostering self-efficacy in regard to weight loss behaviors may be more effective than focusing on increasing self-awareness of obese status and the associated risks.