Perceived Weight Status Effect on Adolescent Health-Risk Behaviors: Findings from 2007 and 2009 Rhode Island Youth Risk Behavioral Survey

The goal of this study is to systematically examine the associations between perceived weight status and selected health-risk
behaviors among Rhode Island adolescents. We utilized the biennial 2007 and 2009 Rhode Island representative Youth Risk Behavior
Survey data. The combined statewide sample contained 5,423 randomly selected public high school students. Perceived weight
status was classified into very underweight, slightly underweight, about the right weight, slightly overweight, and very overweight
according to the question “How do you describe your weight?” Adolescent’s body mass index (BMI) was calculated from self-reported
height and weight. BMI percentile was categorized as extremely underweight, underweight, normal, overweight, and obese. Multivariable
logistic regression models were used to analyze perceived weight status associated with six categories of priority health-risk
factors. Perceived very underweight and very overweight were statistically significantly associated with 17 out of 22 health-risk
behaviors. The relationships can be expressed as a “U”-shaped curve in terms of odds ratios in adolescents. There were no
such similar consistent patterns between BMI percentile categories and health-risk behaviors. Perceived weight status, rather
than BMI percentile categories, has an important influence on health-risk behaviors. Our results may assist health programs
to intervene with high-risk students by changing their cognitive behaviors.