The association between weight perception and weight intention in middle school Appalachian students

Objectives: This study examines the relationships among self-reported body mass index (BMI), weight perception, and weight intention of rural Appalachian middle school students in southwest Virginia where there are higher rates of health disparities influenced by culture, economic distress, and geographic barriers. Study design: This was a cross-sectional observational study. Methods: Sixth and seventh grade students (n = 492) in seven, rural, southwest Appalachian Virginia middle schools participated in this study in the spring of 2015. Results: A relatively high percentage of students classified as overweight/obese based on self-reported BMI (n = 196, 39.8%), yet only 29.3% (n = 144) of students believed themselves to be overweight. More boys (48.3%) than girls (29.8%) were classified based on self-reported BMI to be overweight, yet 44.9% of girls indicated the desire to lose weight. Conclusions: Distinct differences between sexes were found, where more boys were classified as overweight/obese and more girls wanted to lose weight. Previous studies have shown that perspectives of overweight/obese differ in Appalachian communities. These results emphasize the need for both region-specific and sex-specific programs for healthy body weights particularly in rural Appalachian United States. (C) 2019 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.