Weight perception and weight-related sociocultural and behavioral factors in Chinese adolescents
Introduction
The economic transitions in China have been linked to shifts in cultural beliefs and beauty ideals among adolescents living in metropolitan areas with pervasive exposure to imported Western media (Lee and Lee, 1999). Mass media provides the major channel of information on the Western ideal body weight norms, which may be internalized by adolescents (Russell, 1992, Ogden and Mundray, 1996, Field et al., 1999, Labre, 2002, Borzekowski and Bayer, 2005, Wiseman et al., 2005). This shift may be exacerbated by other sociocultural factors including pressures from peers, relatives, parents, and other social environmental factors, and play an important role for adolescents in setting their own weight standards, even if these standards are considered unhealthy or unrealistic (Dawson, 1988, Felts et al., 1996). A growing body of evidence in Western societies suggested that weight perception and body image concerns may vary according to gender, pubertal status, and actual weight status or BMI, and may be related to social pressure, attitudes, and norms of ideal body size and physical attractiveness. Excessive weight concerns and distortion of weight perception may influence adolescents to adopt healthy, or even health compromising behaviors such as smoking cigarettes (French et al., 1994, French et al., 1995, Felts et al., 1996, Neumark-Sztainer et al., 1997, Neumark-Sztainer et al., 2002, Neumark-Sztainer and Hannan, 2000, Killen et al., 1996a, Killen et al., 1996b, Stormer and Thompson, 1996, Veron-Guidry and Williamson, 1996, Kelly et al., 1999). Studies on weight concerns and perceptions in Chinese adolescents are currently very limited. In our previous reports, we found that girls overall perceive themselves as overweight and boys as underweight, and ever linked the weight perception to some psychological factors (Xie et al., 2003, Xie et al., 2006). The present study focused specifically on exploring associations of weight perception with sociocultural factors and weight-related behaviors in Chinese adolescents.
Section snippets
Sample selection
Data were retrieved from the baseline survey of a health behavior study conducted in seven of mainland China's largest cities (China Seven Cities Study, CSCS) between October 2002 and December 2002. Detailed design and sampling procedures were reported in detailed elsewhere (Xie et al., 2006). In the present report, data including valid weight and height measures for a total of 7233 middle and high school students and their parents from four Southern cities (i.e., Hangzhou, Wuhan, Chengdu, and
Results
The general characteristics of subjects are summarized in Table 1. Boys were more likely to describe themselves as either too thin or relatively thin than girls (37.32% vs. 18.79%, P < 0.05), while girls more often considered themselves either relatively heavy or too heavy than boys (50.83% vs. 26.54%, P < 0.05). As shown in Table 2, 42% of normal weight boys perceived themselves either underweight or overweight, and 56.8% of normal weight girls considered themselves either overweight or
Discussion
Our study demonstrates that many boys and girls consider themselves either underweight or overweight, and that misperception of weight status exists in a considerable proportion of subjects after comparing their perceived weight status with their actual weight status. Results are consistent with previous observations on self-perception of body weight status in American children and adolescents (Kaplan et al., 1988, Moore, 1988, Moore, 1990, Davis and Gergen, 1994), and in Chinese adolescents (
Acknowledgments
This research was supported by the University of Southern California Transdisciplinary Tobacco Use Research Center (TTURC), funded by the National Institutes of Health (grant #1 P50 CA84735-01), and the Sidney R. Garfield Endowment. The authors thank the China Seven Cities Study (CSCS) directors and project staff at the Centers for Disease Control and Prevention in the cities of Chengdu, Hangzhou, Harbin, Qingdao, Shenyang, and Wuhan and the Institute for Health Education in Kunming, People's
References (41)
- et al.
Clustering of health-related behaviors among 18-year-old Australians
Prev. Med.
(1997) - et al.
Self-described weight status of Mexican–American adolescents
J. Adolesc. Health
(1994) - et al.
Adolescents' perceptions of relative weight and self-reported weight-loss activities: analysis of 1990 YRBS (youth risk behavior survey) national data
J. Adolesc. Health
(1996) - et al.
Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The expert committee on clinical guidelines for overweight in adolescent preventive services
Am. J. Clin. Nutr.
(1994) - et al.
Covariations of eating behaviors with other health-related behaviors among adolescents
J. Adolesc. Health
(1997) The weight-conscious adolescent: body image, food intake, and weight-related behavior
J. Adolesc. Health
(1998)- et al.
Impact of the media on adolescent body image
Child Adolesc. Psychiatr. Clin. N. Am.
(2005) - et al.
Weight perception and psychological factors in Chinese adolescents
J. Adolesc. Health
(2003) - et al.
Bone mass of Asian adolescents in China: influence of physical activity and smoking
Med. Sci. Sports Exerc.
(2003) - et al.
Body image and media use among adolescents
Adolesc. Med. Clin.
(2005)
Reliability of the youth risk behavior survey questionnaire
Am. J. Epidemiol.
Body image in boys: a review of the literature
Int. J. Eat. Disord.
Establishing a standard definition for child overweight and obesity worldwide: international survey
BMJ
Ethnic differences in female overweight: data from the 1985 national health interview survey
Am. J. Public Health
Exposure to the mass media and weight concerns among girls
Pediatrics
Weight concerns, dieting behavior, and smoking initiation among adolescents: a prospective study
Am. J. Public Health
Weight concerns and change in smoking behavior over two years in a working population
Am. J. Public Health
Development and validation of the sociocultural attitudes towards appearance questionnaire
Int. J. Eat. Disord.
Perceived weight, actual weight, and depressive symptoms in a general adolescent sample
Int. J. Eat. Disord.
Longitudinal tracking of adolescent smoking, physical activity, and food choice behaviors
Am. J. Public Health
Cited by (129)
Urbanization and systolic/diastolic blood pressure from a gender perspective: Separating longitudinal from cross-sectional association
2022, Health and PlaceCitation Excerpt :There are two potential explanations for the gender heterogeneity in the differential longitudinal association of urbanization with DBP observed in our study. First, gender differences in health risk and weight perceptions (Umberson et al., 1992; Xie et al., 2006; Huang, 2016; Leopold and Leopold, 2018) may have moderated the influence of urbanization on the healthiness of lifestyles. Because of an interplay between gendered ideology and practices, women are socialized as caregivers and more concerned with health risks, while men generally find unhealthy behaviors more acceptable and are more likely to engage in those behaviors (Gustafsod, 1998; Cheung et al., 2013).
Epidemiology and determinants of obesity in China
2021, The Lancet Diabetes and EndocrinologyNicotine use and weight control in young people: Implications for prevention and early intervention
2019, Neuroscience of Nicotine: Mechanisms and TreatmentSelf-perceived body image, dissatisfaction with body weight and nutritional status of Brazilian adolescents: a nationwide study
2020, Jornal de PediatriaCitation Excerpt :These findings are in accordance with previous studies about body image misperception among adolescents.10 However, another study involving 6863 Chinese adolescents from middle and high school classes found that girls more often considered themselves to be heavier in relation to their male counterparts.22 The increased adiposity during puberty may play a role for higher dissatisfaction among girls compared to boys.23
Body image and dietary habits in adolescents: a systematic review
2024, Nutrition Reviews