OBJECTIVES: To evaluate dose-response associations between misperceived weight and 32 health risk behaviors in a nationally representative sample of US adolescents.
METHODS: Participants included 13,864 US high school students in the 2011 Youth Risk Behavior Survey. Comparing the degree of agreement between perceived and reported actual weight, weight misperception was determined as 5 categories. Multivariable-adjusted logistic regression analyses evaluated associations of weight misperception with 32 health risk behaviors.
RESULTS: Both underestimated and overestimated weight were statistically significantly associated with all 32 health risk behaviors in a dose-response manner after adjustment for age, sex and race/ethnicity, where greater weight misperception was associated with higher engagement in health risk behaviors.
CONCLUSIONS: Understanding potential impacts of weight misperception on health risk behaviors could improve interventions that encourage healthy weight perception and attainment for adolescents.