Correlations between weight perception and overt risk-taking among Canadian adolescents.

Objective: Perceptions of body weight represent an important health issue for Canadian adolescents. While associations between weight perception and mental health concerns like eating disorder symptomatology are well established, there is need for more Canadian evidence about how weight perception is associated with overt risk-taking among adolescents, and further how such associations differ by biological sex.

Methods: We conducted a national analysis of grade 9-10 students participating in the 2017-2018 cycle of the Health Behaviour in School-aged Children (HBSC) study in Canada. This analysis described contemporary patterns of alternate weight perception and then examined the strength and statistical significance of such associations by biological sex, with tobacco, alcohol, and cannabis use, binge drinking, fighting, and illicit drug use as outcomes. Behaviours were considered both individually and in combination. Analyses were descriptive and analytical, with regression models accounting for the nested and clustered nature of the sampling approach.

Results: Responses from 2135 males and 2519 females were available for a complete case series analysis. A total of 26% and 35% of males and females, respectively, perceived themselves as "too fat" while 20% and 9% identified as "too thin". Females perceiving themselves as "too fat" reported higher likelihoods of engaging in individual and scaled indicators of overt risk-taking. Conversely, among males, alternate weight perception was associated with lower levels of such behaviours.

Conclusion: As males and females perceive and react to weight perception differently, clinical and health promotion strategies should be developed and uniquely targeted to groups of adolescents in regards to weight perception and risk-taking.