P2.J195: Social Determinants and Weight Perception Among Youth with Obesity: Analysis of the National Health and Nutrition Examination Survey (NHANES) 2017-2020 Cohort Data

Background: Obesity is a risk factor for cardiovascular disease (CVD) that often begins in childhood and may persist under poor socioeconomic circumstances. A complex interaction of factors, including poverty status and food security, may influence a child’s likelihood of modifying their health behaviors.

Project Description: Using the 2017-2020 NHANES data, we analyzed 8-15-year-olds with a BMI > 95th %ile. We assessed the relationship between sociodemographic factors, poverty status, food security, and self-reported answers to self-perception of weight status, a desire to modify one’s lifestyle, and parental perception of a child’s weight. Factors associated with incorrectly self-perceiving one’s weight status were identified via multivariable logistic regression (backward selection) (p < 0.05).

Discussion: Of 529 children with obesity, 52% correctly perceived themselves as having obesity. Correct self-perception was associated with older age, self-described race-ethnicity, BMI, and parental perception but not with household poverty or food security status (Table 1). There were greater odds of incorrect self-perception of weight among Black youth and if a parent incorrectly perceived a child’s weight (OR=2.1, 95% CI 1.4 to 3.9) (Table 2).

Conclusion: We found that cultural norms and parental perception of a child’s weight status strongly influence the children’s self-perception of their weight and desire to make healthy lifestyle changes. Future efforts to reduce CVD risk factor burden should focus on parental education.