Children and adolescents tend to lose weight, which may be associated with misperceptions of weight. Previous studies have emphasized establishing correlations between eating disorders and an overestimated perception of body weight, but few studies have focused on an underestimated perception of body weight. The objective of this study was to explore the relationship between misperceptions of body weight and weight-related risk factors, such as eating disorders, inactivity, and unhealthy behaviors, among overweight children who underestimated their body weight. We conducted a cross-sectional, descriptive study between December 1, 2006 and February 15, 2007. A total of 29,313 children and adolescents studying in grades 4-12 were enrolled in this nationwide, crosssectional survey, and they were asked to complete questionnaires. A multivariate logistic regression using maximum likelihood estimates was used. The prevalence of body weight misperception was 43.2% (26.4% overestimation and 16.8% underestimation). Factors associated with the underestimated perception of weight among overweight children were parental obesity, dietary control for weight loss, breakfast consumption, self-induced vomiting as a weight control strategy, fried food consumption, engaging in vigorous physical activities, and sleeping for > 8 hours per day (odds ratios=0.86, 0.42, 0.88, 1.37, 1.13, 1.11, and 1.17, respectively). In conclusion, the early establishment of an accurate perception of body weight may mitigate unhealthy behaviors.
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