School- and Individual-level Predictors of Weight Status Misperception among Korean Adolescents: A National Online Survey

Abstract

BackgroundGrowing body of literature has reported that weight status estimation pattern, including accurate-, under-, and overestimation, was associated with weight related behaviors and weight change among adolescents and young adults. However, there have been a few studies investigating the potential role of school contexts in shaping adolescents’ weight status estimation pattern among Korea adolescents.ObjectiveThe aim of the present study was to investigate the association between weight status misperception patterns and factors at individual-, family-, and school-level, simultaneously, and whether there was significant between schools variation in the distribution of each weight status misperception pattern, underestimation and overestimation respectively, among Korean adolescents aged 12–18 years.MethodData from the Eighth Korea Youth Risk Behavior Web-based Survey (KYRBS), 2012, a nationally representative online survey of 72,228 students (boys = 37,229, girls = 34,999) from a total of 797 middle and high schools were used. Sex stratified multilevel random intercept multinomial logistic models where adolescents (level 1) were nested within schools (level 2) were performed.ResultsAt the school level, attending a school with higher average BMI (kg/m2) was positively associated with weight status underestimation, and inversely associated with weight status overestimation among boys and girls. Single-sex schooling was positively associated with weight status underestimation among girls. At the family level, higher household income (high/middle versus low) was inversely associated with both weight status under- and overestimation among boys and girls. Higher maternal education (equal to or more than college graduate versus equal to or less than high school graduate) was positively associated with weight status overestimation among boys, and living with both parents (compared to not living with both parents) was inversely associated with weight status underestimation among girls. At the individual level, high academic achievement (compared to low) was positively associated with weight status underestimation among boys and girls.ConclusionsWhile further research with prospective designs and objectively measured anthropometric information is needed, school environmental factors such as sex composition and school average BMI, as well as, family contexts such as socioeconomic status need to be considered when developing and implementing obesity prevention programs.

Racial/ethnic differences in body weight perception among U.S. college students

“…The response options were collapsed into three categories (underweight, normal, and overweight/obese) in line with previous research. 30,31 Body weight perception was coded into three categories comparing differences between perceived weight and BMI group: (1) overestimation (i.e., Perceived weight group is heavier than his/her BMI group); (2) accurate estimation (i.e., Perceived weight group is the same as his/her BMI group); and (3) underestimation (i.e., Perceived weight group is lighter than his/her BMI group), as done elsewhere. 30,31…”

Risk factors for disordered weight control behaviors among Korean adolescents: Multilevel analysis of the Korea Youth Risk Behavior Survey

“…By contrast, Spencer et al () revealed that women attending co‐ed colleges endorsed thinner body ideals than those attending women's colleges in the Midwestern United States. Kim and Kawachi () found that single‐sex schooling (vs. co‐ed schooling) was positively associated with weight under‐perception in Korean girls. We found that adolescent girls attending co‐educational middle/high schools (i.e., aged 12–18 years) were more likely to engage in DWCB than their counterparts attending single‐sex schools.…”

“…Despite the growing body of evidence concerning increase in ED risk in Asian countries, prior Korean studies have largely focused on individual‐level risk factors (Lee et al, ), or school‐level influences on related outcomes such as obesity (Choi, Park, & Behrman, ) and weight misperception (Kim & Kawachi, ). However, there has been a dearth of evidence pertaining to social contextual factors for DWCB among Korean youth.…”

WITHDRAWN: Correlates of highly caffeinated beverage consumption among Korean adolescents

“…School type of the participants was categorized into middle and high school. Academic achievement was asked of students to which five responses were given, and we condensed the five responses into three options: (1) low (i.e., low or middle low), (2) middle, and (3) high (i.e., high or middle-high) [29].…”

“…The household income was coded into five levels, and we regrouped five levels into three as: (1) low (i.e., very low or low), (2) middle, and (3) high (i.e., very high or high) [29]. Weekly expenditure of the participants was originally categorized into sixteen groups from 0 -< 10,000 South Korea Won (SKW) (equivalent to 0 -< USD 8.92) to ≥ 150,000 SKW (USD 133.80) and recoded into three groups: (1) < 50,000 South Korea Won (SKW) (equivalent to < USD 44.66), (2) 50,000-99,999 SKW (USD 44.66-89.32), and (3) ≥ 100,000 SKW (≥ USD 89.33).…”