title: The association of body image distortion with weight control behaviors, diet behaviors, physical activity, sadness, and suicidal ideation among Korean high school students: a cross-sectional study.
abstract: BACKGROUND
  The identification of predictors for body image distortion would be an especially important first step in targeting a vulnerable population and developing a nutrition intervention program. We aimed to investigate the prevalence of body image distortion and the factors associated with body image distortion among Korean high school students.
  
  
  METHODS
  We selected 20,264 normal weight high school students from the 10(th) Korea Youth Risk Behavior Web-based Survey using nationally representative data in 2014. With multivariate logistic regression, we assessed the association of body image distortion with individual demographic and socio-economic factors, weight control behaviors, and mental health characteristics.
  
  
  RESULTS
  The over-estimation group of body weight status, compared with the correct estimation group, was significantly more likely to be a 3(rd) year high school student [adjusted odds ratio (AOR): 1.27, 95% confidence interval (CI): 1.16-1.39], to be female [AOR: 3.52, 95% CI: 3.25-3.81], to employ unhealthy weight control behaviors [AOR: 1.54, 95% CI: 1.37-1.72], and to have a sadness [AOR: 1.25, 95% CI: 1.16-1.35] and suicidal ideation [AOR: 1.20, 95% CI: 1.08-1.33]. The under-estimation group, compared with the correct estimation group, was significantly less likely to be female [AOR: 0.23, 95% CI: 0.21-0.25] and to employ unhealthy weight control behaviors [AOR: 0.50, 95% CI: 0.43-0.59] but were more likely to have a sadness [AOR: 1.12, 95% CI: 1.03-1.21] and suicidal ideation [AOR: 1.12, 95% CI: 1.00-1.25].
  
  
  CONCLUSIONS
  Not only the over-estimation but also the under-estimation of body weight is prevalent among high school students in South Korea. Body image distortion was significantly associated with sadness and suicidal ideation.
authors.affiliation: Department of Nutrition Education, Graduate School of Education, Kyonggi University, Gyeonggido, 443-760, South Korea. joungheelee@kgu.ac.kr.
authors.forename: Jounghee
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Food and Nutrition, Seoul Women's University, 621 Hwarangro, Nowongu, Seoul, 139-774, South Korea. ymlee@swu.ac.kr.
authors.forename: Youngmin
authors.initials: Y
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001828:Body Image; D001835:Body Weight; D003430:Cross-Sectional Studies; D004032:Diet / Q000523:psychology; D004644:Emotions; D015444:Exercise / Q000523:psychology; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology; D016017:Odds Ratio; D056910:Republic of Korea; D013334:Students; D059020:Suicidal Ideation; D011795:Surveys and Questionnaires; D014892:Weight Perception