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      The association between BMI and body weight perception among children and adolescents in Jilin City, China

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          Abstract

          Objectives

          We evaluated the association between BMI and body weight perception in a sample of children and adolescents.

          Methods

          A cross-sectional school-based study was conducted among 7–18 year-olds (N = 9727) from 4 districts in Jilin City, China. We calculated BMI from measured weight and height and assessed body weight perception using a single questionnaire item. We analyzed these data using SPSS version 20.0.

          Results

          Approximately 19.8% of these youth perceived themselves as underweight, 57.8% as normal weight, and 22.4% as overweight. In reality, 4.9% were underweight, 64.3% were normal weight, and 30.8% were overweight. Furthermore, approximately 66.4% of these Chinese youth correctly perceived their body image, 28.2% underestimated their true body image, and 5.4% overestimated their weight status. Girls were more likely than boys to overestimate their weight ( χ 2 = 135.4, p < 0.05). Adolescents 13–18 years old were more likely than children 7–12 years old to overestimate their weight ( χ 2 = 248.4, p < 0.05). Senior high school students were the most likely to overestimate their weight ( χ 2 = 297.6, p < 0.05). Kappa tests revealed significant differences in consistency analysis of BMI and body weight perception ( Kappa = 0.352, p < 0.05). Kappa < 0.4, the consistency of BMI and body weight perception was poor.

          Conclusions

          A mismatch existed between BMI and body weight perception among these children and adolescents. Thus, schools and parents should take steps to help them improve weight management and overall health awareness.

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          Most cited references32

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          Health consequences of obesity in youth: childhood predictors of adult disease.

          W Dietz (1998)
          Obesity now affects one in five children in the United States. Discrimination against overweight children begins early in childhood and becomes progressively institutionalized. Because obese children tend to be taller than their nonoverweight peers, they are apt to be viewed as more mature. The inappropriate expectations that result may have an adverse effect on their socialization. Many of the cardiovascular consequences that characterize adult-onset obesity are preceded by abnormalities that begin in childhood. Hyperlipidemia, hypertension, and abnormal glucose tolerance occur with increased frequency in obese children and adolescents. The relationship of cardiovascular risk factors to visceral fat independent of total body fat remains unclear. Sleep apnea, pseudotumor cerebri, and Blount's disease represent major sources of morbidity for which rapid and sustained weight reduction is essential. Although several periods of increased risk appear in childhood, it is not clear whether obesity with onset early in childhood carries a greater risk of adult morbidity and mortality. Obesity is now the most prevalent nutritional disease of children and adolescents in the United States. Although obesity-associated morbidities occur more frequently in adults, significant consequences of obesity as well as the antecedents of adult disease occur in obese children and adolescents. In this review, I consider the adverse effects of obesity in children and adolescents and attempt to outline areas for future research. I refer to obesity as a body mass index greater than the 95th percentile for children of the same age and gender.
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            Childhood Obesity: Causes, Consequences, and Management.

            One-third of North American children are overweight or obese. Pathologic obesity accounts for only a small percentage of these cases. The vast majority are the result of a complex interaction of genetic and hormonal, nutritional, physical activity, and physical and social environmental factors. Obesity increases the risk for various cardiometabolic, pulmonary, and psychosocial complications for children, which often continues into adulthood. Multidisciplinary care, focusing on family-centered behavior change, is an evidence-based, essential part of the treatment, along with pharmacologic and surgical options for more complex cases. Prevention and early intervention strategies are key to reversing the obesity epidemic.
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              Social, educational, and psychological correlates of weight status in adolescents.

              The purpose of this research was to examine the social, educational, and psychological correlates of weight status in an adolescent population. It was hypothesized that obese adolescents would differ on psychological, social, and educational variables compared with their non-overweight peers. In this cross-sectional study, a population-based sample of 4742 male and 5201 female public school students in the 7th, 9th, and 11th grades responded anonymously to a classroom administered questionnaire. Body mass index was calculated from self-reported height and weight and categorized into four classes of weight status: underweight ( 85th to 95th percentile), and obese (>95th percentile). The questionnaire also included questions about social experiences, psychological well-being, educational experiences, and future goals. Associations of weight status with social, psychological, and educational variables and future goals were explored. After adjustment for grade level, race, and parental socioeconomic status, obese girls, when compared with their average weight counterparts, were 1.63 (95% confidence interval [CI]: 1.16, 2.30) times less likely to hang out with friends in the last week, 1.49 (95% CI: 1.12, 1.98) times more likely to report serious emotional problems in the last year, 1.79 (95% CI: 1.20, 2.65) times more likely to report hopelessness, and 1.73 (95% CI: 1.21, 1.98) times more likely to report a suicide attempt in the last year. Obese girls were also 1.51 (95% CI: 1.09, 2.10) times more likely to report being held back a grade and 2.09 (95% CI: 1.35, 3.24) times more likely to consider themselves poor students compared with average weight girls. Compared with their average weight counterparts, obese boys were 1.91 (95% CI: 1.43, 2.54) times less likely to hang out with friends in the last week, 1.34 (95% CI: 1.06, 1.70) times more likely to feel that their friends do not care about them, 1.38 (95% CI: 1.08, 1.76) times more likely to report having serious problems in the last year, 1.46 (95% CI: 1.05, 0.03) times more likely to consider themselves poor students, and 2.18 (95% CI: 1.45, 3.30) times more likely to expect to quit school. Compared with average weight boys, underweight boys were 1.67 (95% CI: 1.30, 2.13) times more likely to report hanging out with friends in the last week, 1.22 (95% CI: 1.01, 1.49) times more likely to report disliking school, and 1.40 (95% CI: 1.06, 1.86) times more likely to consider themselves poor students. Associations of weight status with social relationships, school experiences, psychological well-being, and some future aspirations were observed. Among girls, the pattern of observations indicates that obese girls reported more adverse social, educational, and psychological correlates. Obese as well as underweight boys also reported some adverse social and educational correlates. These findings contribute to an understanding of how adolescent experiences vary by weight status and suggest social and psychological risks associated with not meeting weight and body shape ideals embedded in the larger culture.
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                Author and article information

                Contributors
                Role: Formal analysisRole: InvestigationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: SupervisionRole: Writing – review & editing
                Role: Formal analysis
                Role: InvestigationRole: Visualization
                Role: Formal analysis
                Role: Investigation
                Role: Investigation
                Role: Investigation
                Role: Investigation
                Role: Investigation
                Role: Investigation
                Role: ConceptualizationRole: Funding acquisitionRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 March 2018
                2018
                : 13
                : 3
                : e0194237
                Affiliations
                [1 ] Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
                [2 ] Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin, China
                University of Kansas Medical Center, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0002-7763-1201
                http://orcid.org/0000-0003-3286-8667
                Article
                PONE-D-17-17512
                10.1371/journal.pone.0194237
                5868793
                29579108
                d8bbf1f9-9ea4-4d8a-8161-c6a86b33e6f7
                © 2018 Wang et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 7 May 2017
                : 27 February 2018
                Page count
                Figures: 0, Tables: 4, Pages: 10
                Funding
                Funded by: the Health and Family Planning Commission of Jilin Province, China
                Award ID: 2015R022
                Award Recipient :
                This study was supported by grant from the Health and Family Planning Commission of Jilin Province, China (Grant Number: 2015R022, http://wsjsw.jl.gov.cn/) to Xiumin Zhang. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Social Sciences
                Sociology
                Education
                Schools
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                People and Places
                Population Groupings
                Age Groups
                Children
                Adolescents
                People and Places
                Population Groupings
                Families
                Children
                Adolescents
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Earth Sciences
                Geography
                Geographic Areas
                Rural Areas
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Earth Sciences
                Geography
                Geographic Areas
                Urban Areas
                Research and Analysis Methods
                Research Design
                Survey Research
                Questionnaires
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

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