Objective: To examine trends in perceived overweight among US adolescents, including trends in perceived overweight among overweight and nonoverweight adolescents overall and by sex and race/ethnicity.
Design: Trend analyses of serial cross-sectional data.
Setting: National Youth Risk Behavior Surveys conducted in 1999, 2001, 2003, 2005, and 2007.
Participants: Nationally representative samples of US high school students in each survey year.
Main outcome measures: All students with a body mass index at or higher than the 85th percentile were considered "overweight," while those with a body mass index lower than the 85th percentile were considered "nonoverweight." Students who perceived themselves as "slightly overweight" or "very overweight" were considered to perceive themselves as overweight.
Results: Among all students and among most subgroups, the prevalence of overweight increased from 1999 to 2007. The prevalence of perceived overweight did not change. Among nonoverweight students, the prevalence of perceived overweight decreased overall, among white males, and among white, black, and Hispanic females. Among overweight students, few trends in the prevalence of perceived overweight were detected; only among overweight black males did the prevalence of perceived overweight increase.
Conclusions: Weight perception is an important predictor of diet and weight management behaviors. Decreases in the prevalence of perceived overweight among nonoverweight students have positive implications for reducing unhealthy weight control behaviors. Among overweight students, interventions are needed to increase their recognition of being overweight because those who do not perceive themselves as overweight are unlikely to engage in weight control practices.