Health ratings for underweight, overweight and obese adolescents: disparities between adolescent's own report and the parent's report.

In many Asian countries, overweight and obese children are sometimes considered healthier than their underweight or normal weight counterparts. Using Taiwan as an example, this research aims to examine the relationship between inappropriate weight and self-rated health (SRH) for adolescents, and inappropriate weight and the parent's impression of their adolescent's general health. We analyzed data from 1,879 adolescents (933 boys and 946 girls) from the third year (2003) of a panel survey conducted by the Academia Sinica of Taiwan. Adolescents were identified as underweight, normal weight, overweight and obese using body mass index (BMI). Kappa statistic was used to determine agreements between adolescent's own report and their health as reported by their parent. Logistic regression was used to determine odds of reporting reduced health by adolescents with inappropriate weight. A separate regression was carried out using the parent's reports for these adolescents. We found that underweight boys were more likely to report reduced health (OR=2.15, p<0.01). Overweight girls had lower odds of reporting reduced health compared with normal weight girls (OR=0.42, p<0.01). Parents were more likely to report reduced health for underweight girls (OR=2.10, p<0.01). For boys, parents were less likely to report reduced health for overweight boys compared with reports for normal weight subjects (OR=0.51, p<0.01). Being underweight is associated with poor perceived health by both the adolescents and their parents. This contrasts with overweight and obesity, which are not. Health educational programs could help in adjusting perceptions concerning the health consequences associated with overweight and obesity.