Body Weight Dissatisfaction Is Associated with Cardiovascular Health-Risk Behaviors among Brazilian Adolescents: Findings from a National Survey

Abstract

Body weight dissatisfaction (BWD) among adolescents may be a predictor of adoption of health-risk behaviors. The study aimed to assess the gendered association between two forms of BWD (feeling underweight/overweight) and cardiovascular health-risk behaviors among Brazilian adolescents. This cross-sectional study used data from the National Study of Cardiovascular Risks in Adolescents (ERICA) in Brazil, including 71,740 adolescents aged 12–17 years. BWD was defined as satisfied, dissatisfied feeling underweight and dissatisfied feeling overweight. We considered four health-risk behaviors: tobacco use, alcohol use, physical inactivity and skipping breakfast. Assessment of the associations between BWD and these behaviors were undertaken using logistic regression models. All analyses were stratified by gender. Analyses revealed that 14.9% of male adolescents and 14.5% of female adolescents were dissatisfied feeling underweight and 21.5% of males and 39.9% of females were dissatisfied feeling overweight. Among male adolescents, dissatisfied feeling overweight was associated with greater odds of physical inactivity and skipping breakfast. Among female adolescents, dissatisfied feeling underweight and overweight were associated with higher odds of alcohol use and skipping breakfast. These results highlight the importance of BWD and the association with a range of adolescent health behaviors increasing cardiovascular risk over the life course, depending on gender.

Body Weight Dissatisfaction and Health Risk Behaviors in Adolescents

“…The answer "as I expect" was defined as "body weight satisfaction," and the answers of "a little above than I would like" and "much above than I would like" as "dissatisfied due to overweight." This classification method was previously used by other investigators (Duarte et al, 2020;Jampel et al, 2016;Jiang et al, 2014;Ramseyer Winter et al, 2017).…”

“…Health risk behaviors are considered individual and identifiable behaviors that can have potential for harmful health effects (Rodriguez Añez et al, 2008). Among adolescents, the most prevalent risk behaviors include alcohol abuse (Duarte et al, 2020), smoking (Jiang et al, 2014; Ramseyer Winter et al, 2017) and eating disorders (Albuquerque et al, 2021). Other health risk behaviors were described as present in the adolescent population, including (a) unsafe sexual behavior, which is related to unwanted pregnancy and sexually transmitted diseases (Beksinska et al, 2020); and (b) not using seatbelts, which may be associated with lower chances of survival in traffic accidents (Hezaveh & Cherry, 2019).…”

“…Additionally, there is growing evidence of associations with traditional risk behaviors such as alcohol use (Duarte et al, 2020), smoking (Jiang et al, 2014; Ramseyer Winter et al, 2017), the use of anabolic steroids and consumption of illicit drugs (Bornioli et al, 2019; Jiang et al, 2014) with distortions in physical and mental health, such as weight status perception. In adolescents, misperceptions regarding weight status were associated with behaviors that put adolescents' health at risk, such as poor diet, inappropriate lifestyle (Jiang et al, 2014), anxiety, depression (Jiang et al, 2014) and suicidal behaviors (Claumann et al, 2018).…”

“…Although correlates of body weight dissatisfaction, such as traditional health risk behaviors are recognized (Bornioli et al, 2019; Duarte et al, 2020; Jiang et al, 2014; Ramseyer Winter et al, 2017), changes in lifestyle-related behaviors (GBD 2013 Risk Factors Collaborators, 2015), and an increase in the global burden of mental illness have been verified over the years (Vigo et al, 2016), both in Brazil (Simões et al, 2018) and in others countries (GBD 2015 Obesity Collaborators, 2017). This highlights the need to investigate other health risk behaviors that may be associated with modifiable body weight dissatisfaction.…”

Weight misperception and substance use: Brazilian Study of Cardiovascular Risks in Adolescents (ERICA)

“…Although the associations between body image concern and substance use have been described previously [30,31], reports about the Brazilian adolescent population are still scarce [32][33][34], given the dynamics of the social environment and possible associations with new factors. Hence, the aim of this study was to assess the association between weight misperception and substance use (smoking and alcohol) in a national representative sample of normal weight Brazilian adolescents.…”