title: Perception of overweight is associated with poor academic performance in US adolescents.
abstract: BACKGROUND
  To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement.
  
  
  METHODS
  We performed a cross-sectional study of 14-17-year-olds (N = 11,012) from the nationally representative 2003 Youth Risk Behavior Survey. The main outcome measure was self-reported grades (mostly A, B, C, D, or F). The primary independent variables were medically defined overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and participants' perception of their weight status.
  
  
  RESULTS
  Medically defined overweight youth were less likely to report higher grades in unadjusted analysis (OR 0.67, 95% CI: 0.60-0.76, p < .001) and after adjustment for demographics, depression, television and video game use, and physical activity (OR 0.83, 95% CI: 0.74-0.94, p = .003). Statistically significant results also were seen with medically defined obese participants. Youth who perceived themselves as overweight were less likely to report higher grades (OR 0.82, 95% CI: 0.73-0.92, p = .001) in unadjusted analysis and after adjustment for the same variables (OR 0.79, 95% CI: 0.68-0.91, p = .002). The perception of overweight was a more significant determinant of academic performance (OR 0.81, 95% CI: 0.69-0.95, p = .012) compared to medically defined obesity (OR 0.90, 95% CI: 0.77-1.05, p = .174).
  
  
  CONCLUSIONS
  Perceived overweight status is negatively associated with academic performance, regardless of actual weight status. These findings suggest that perception of overweight may be a mechanism for prior results indicating a negative association of obesity and academic achievements, and have implications for the academic health of these adolescents.
authors.affiliation: Division of Emergency Medicine, The Children's Hospital of Philadelphia, PA 19104, USA. florint@email.chop.edu
authors.forename: Todd A
authors.initials: TA
authors.lastname: Florin
authors.forename: Justine
authors.initials: J
authors.lastname: Shults
authors.forename: Nicolas
authors.initials: N
authors.lastname: Stettler
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001828:Body Image; D003430:Cross-Sectional Studies; D003863:Depression; D004521:Educational Measurement; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology; D050177:Overweight / Q000523:psychology*; D010465:Perception; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States