Perceived Weight, Actual Weight, and Risky Behaviors: Racial and Gender Disparities in U.S. Adolescents

This dissertation is the first to investigate the relationship between weight misperceptions and adolescent body mass index (BMI), the importance of weight misperceptions as determinants of racial/ethnic disparities in BMI, the differential effect of weight misperceptions across the adolescent BMI distribution, as well as the importance of different measures of weight as determinants of adolescent risky sex, using a nationally representative panel of adolescents. The results suggest that weight under-perceptions are significantly associated with adolescent BMI even after controlling for time constant individual-level unobservables. Oaxaca-Blinder decomposition analysis shows that accounting for weight misperceptions, in addition to individual and contextual factors, increases the total explained portion of the black-white BMI gap but only slightly increases the total explained portion of the Hispanic-white gap. Individual level fixed effects quantile regressions show that weight under-perceptions are significantly associated with adolescent BMI, particularly for adolescents about at or above the 75th quantile. Analyses stratified by race/ethnicity and SES show complex patterns of associations. Turning to the relationship between measures of weight and adolescent risky sex, results show that youth who have actual weight categories or perceived weight categories that are seen as unattractive by their cultural/social group (i.e., overweight white and underweight black and Hispanic adolescents) are more likely to postpone sexual debut. Among sexually active adolescents, actual weight or perceived weight that is seen as unattractive by one’s cultural/social group is associated with increased number of sex partners and with decreased odds of contraceptive use. School programs aimed at teaching correct weight identification and interpretation may be an invaluable tool in addressing both the obesity crisis and risky behavior prevention.