Body Weight Misperception in Adolescence and Incident Obesity in Young Adulthood

Misperceptions of one's weight are common in adolescence. Adolescents of normal weight who misperceive themselves as being overweight tend to engage in unhealthy dieting practices and behaviors that are conducive to obesity. To examine whether this misperception is associated with a risk of obesity during early adulthood, we analyzed data from the National Longitudinal Study of Adolescent Health (N = 6,523; mean age at baseline = 16 years; 58% female). Adolescents who misperceived themselves as being overweight had greater odds of becoming obese over the 12-year follow-up period than adolescents who perceived their weight accurately (odds ratio = 1.41, 95% confidence interval = [1.22, 1.64]). Although the increase in the odds associated with misperception of weight was apparent for both sexes, it was significantly stronger among boys (1.89 greater odds) than among girls (1.29 greater odds). The present research indicates that weight-based self-stigmatization, much like weight-based social stigmatization, is a powerful risk factor for incident obesity. This finding underscores the importance of addressing inaccurate body weight perceptions, even among adolescents of normal weight.