title: The role of underestimating body size for self-esteem and self-efficacy among grade five children in Canada.
abstract: OBJECTIVE
  Underestimating body size hinders healthy behavior modification needed to prevent obesity. However, initiatives to improve body size misperceptions may have detrimental consequences on self-esteem and self-efficacy.
  
  
  METHODS
  Using sex-specific multiple mixed-effect logistic regression models, we examined the association of underestimating versus accurate body size perceptions with self-esteem and self-efficacy in a provincially representative sample of 5075 grade five school children. Body size perceptions were defined as the standardized difference between the body mass index (BMI, from measured height and weight) and self-perceived body size (Stunkard body rating scale). Self-esteem and self-efficacy for physical activity and healthy eating were self-reported.
  
  
  RESULTS
  Most of overweight boys and girls (91% and 83%); and most of obese boys and girls (93% and 90%) underestimated body size. Underestimating weight was associated with greater self-efficacy for physical activity and healthy eating among normal-weight children (odds ratio: 1.9 and 1.6 for boys, 1.5 and 1.4 for girls) and greater self-esteem among overweight and obese children (odds ratio: 2.0 and 6.2 for boys, 2.0 and 3.4 for girls).
  
  
  CONCLUSIONS
  Results highlight the importance of developing optimal intervention strategies as part of targeted obesity prevention efforts that de-emphasize the focus on body weight, while improving body size perceptions.
authors: School of Public Health, University of Alberta, Edmonton, Canada. Electronic address: katerina.maximova@ualberta.ca.
authors: Katerina
authors: K
authors: Maximova
authors: School of Public Health, University of Alberta, Edmonton, Canada.
authors: Mohammad K A
authors: MK
authors: Khan
authors: Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA; Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA.
authors: S Bryn
authors: SB
authors: Austin
authors: School of Health and Human Performance, Dalhousie University, Halifax, Canada.
authors: Sara F L
authors: SF
authors: Kirk
authors: School of Public Health, University of Alberta, Edmonton, Canada.
authors: Paul J
authors: PJ
authors: Veugelers
mesh_terms: D001828:Body Image / Q000523:psychology*; D015992:Body Mass Index; D049628:Body Size; D002648:Child; D004032:Diet / Q000523:psychology*; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009674:Nova Scotia / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology / Q000523:psychology*; D063766:Pediatric Obesity / Q000453:epidemiology / Q000523:psychology; D012111:Residence Characteristics; D012649:Self Concept; D020377:Self Efficacy; D057566:Self Report; D012959:Socioeconomic Factors
keywords: Body size perceptions; Children; Prevention; Public health; Self-efficacy; Self-esteem