Weight Misperception and School Absenteeism in Adolescents

Objective : Increased body weight is associated with excessive school absenteeism among children, but less prior literature focuses on adolescents and whether it’s perception or measured body weight that matters for those at a healthy weight.

Methods : We used the data from 3,172 adolescents ages 12-19 who were surveyed in the National Health and Nutrition Examination Surveys (NHANES) conducted from 2003-2008. Actual Body Mass Index was measured during the physical examination, while self-perception of body image and the number of school days missed was assessed using the questionnaires. An average of 1 or more day missed per school month (≥10 days throughout the duration of the school year) was defined as “excessive school absenteeism.”

Results : For the adolescents aged 16-19 years with healthy weight, the prevalence of excessive school absenteeism was two times higher among those who perceived themselves as “overweight” compared to healthy weight peers who self-perceived their weight as ”just right” [21.0% (SE= 4.5) vs. 11.4% (SE = 1.4)]. The adjusted prevalence ratio (PR) of excessive school absenteeism for healthy weight adolescents who incorrectly perceived themselves as “overweight” was 1.91 (1.10 – 3.32) compared with healthy weight peers who correctly perceived their weight as being “just right”(reference).

Conclusions : According to the National Health and Nutrition Examination Surveys (NHANES) conducted from 2003-2008, body weight misperception rather than actual body weight significantly influences school absenteeism among healthy weight adolescents. Correcting the misperception of body weight may help to reduce school absences among adolescents.