Prospective effects of weight perception and weight comments on psychological health among Chinese adolescents

Aim: To investigate the prospective effects of weight perception of self and weight comments by others on psychological health problems among Chinese adolescents. Methods: In the Hong Kong Student Obesity Surveillance project, 8716 adolescents (41.3% boys) aged 14.2 ± 1.7 years were followed prospectively. Logistic regression yielded odds ratios (ORs) for psychological health problems at 1-year follow-up by weight comments received and weight perception at baseline (2006), adjusting for each other sociodemographic factors and body mass index. Results: Perceived fatness at baseline predicted subsequent headache and feeling stressful with adjusted ORs (95% confidence intervals) of 1.17 (1.03-1.33) and 1.20 (1.03-1.39), respectively. Perceived thinness at baseline did not predict any subsequent health problems. Receiving incorrect weight comments at baseline also predicted headache, feeling stressful and feeling depressed at follow-up, with adjusted ORs of 1.19 (1.08-1.31), 1.26 (1.04-1.53) and 1.38 (1.10-1.74) respectively. No gender difference was found in the effects of weight perception and weight comments on psychological outcomes. Conclusions: In adolescents, perceived fatness and incorrect weight comments predicted psychological health problems at 1-year follow-up. Family members, peers and other social contacts should realize the potential adverse effects of their weight comments, and adolescents should be taught how to correctly assess their weight status.