Children's Self Perception of Weight

The purpose of this study was to determine whether there are differences in children’s self-perceptions of weight based on age, gender, actual body mass index (BMI) category, grade level, and ethnicity compared with their clinically measured BMI and to determine the association of gender, age, grade level, race/ethnicity, and actual BMI category with their perception of ideal BMI category. A total of 424 children from a rural community in New Mexico, aged 8 to 11 years and in Grades 3 through 5, participated in this study. Of this sample 70% (n = 299) is Hispanic; 19% (n = 80) is White; and 11% (n = 45) are other/multiracial. Children were assigned to one of the Centers for Disease Control and Prevention BMI categories: underweight, healthy weight, overweight, and obese. For this sample 55% (n = 235) of the children are healthy weight; 3% (n = 12) are underweight; 19% (n = 80) are overweight; and 23% (n = 97) are obese. Using the Children’s Body Image Scale the children were asked to select a figure representing their actual body perception and a figure representing their ideal body perception. Only clinically measured BMI category was found to be significantly associated with accurate perception, χ2(3) = 201.4, P < 0.001, with only 9.0% of overweight or obese children selecting figures representing their clinically measured BMI category. Actual BMI category, χ2(3) = 8.8, P = 0.032, and grade level, χ2(2) = 6.7, P = 0.036, had a significant association with selection of an underweight ideal, although only actual BMI remained significant in a follow-up logistic regression analysis. Regardless of gender, age, grade level, or race/ethnicity, prepubertal children who are either overweight or obese do not accurately perceive their weight status. However, it is concerning that 1/3 of this sample expressed a preference for not simply being thinner, but for being underweight.Robert Wood Johnson Foundation Nursing and Health Policy Collaborative; Nurse Practitioner Healthcare Foundation Astellas Promoting Heart Health Across the Age Span; University of New Mexico, College of Nursing, Dean's Scholar ProgramNursingDoctoralUniversity of New Mexico. College of NursingLobo, MarieTigges, BethShuster, GeoffGance_Cleveland, Bonni