Measured body mass index, body weight perception, dissatisfaction and control practices in urban, low-income African American adolescents

BACKGROUND Current understanding of the associations between actual body weight status, weight perception, body dissatisfaction, and weight control practices among low-income urban African American adolescents is limited. The knowledge can help direct future intervention efforts. METHODS Cross-sectional data including measured weight and height and self-reported weight status collected from 448 adolescents in four Chicago Public Schools were used. RESULTS The prevalence of overweight and obesity (BMI > or = 85th percentile) was 39.8%, but only 27.2% considered themselves as obese, although 43.4% reported trying to lose weight. Girls were more likely to express weight dissatisfaction than boys, especially those with BMI > or = 95th percentile (62.9% vs. 25.9%). BMI > or = 85th percentile girls were more likely to try to lose weight than boys (84.6% vs. 66.7%). Among all adolescents, 27.2% underestimated and 67.2% correctly judged their own weight status. Multinomial logistic models show that those with BMI > or = 85th percentile, self-perceived as obese, or expressed body dissatisfaction were more likely to try to lose weight; adjusted odds ratios and 95% confidence intervals were 4.52 (2.53-8.08), 18.04 (7.19-45.30), 4.12 (1.64-10.37), respectively. No significant differences were found in diet and physical activity between those trying to lose weight and those not trying, but boys who reported trying to lose weight still spent more television time (P < 0.05). CONCLUSION Gender differences in weight perception, body dissatisfaction, and weight control practices exist among African American adolescents. One-third did not appropriately classify their weight status. Weight perception and body dissatisfaction are correlates of weight control practices. Adolescents attempting to lose weight need be empowered to make adequate desirable behavioral changes.