Association of Perceived Weight Status versus Body Mass Index on Adherence to Weight-modifying plan Among Iranian Children and Adolescents: The CASPIAN-IV Study

Objective: To identify risk-groups adhering to weight-changing plans for body dissatisfaction in a National sample of Iranian students. Design: Cross-sectional. Setting: Primary, Middle and high-schools. Participants: 13486 students (mean age, 12.5 y). Main outcome measures: Demographic and anthropometric characteristics were collected via valid instruments. Body image and adherence to weight- changing diets were assessed by using validated questionnaires. Results: 46.5% students were satisfied with their weight and 12.5% declared that they had attempts for weight control, this was significantly higher among adolescent girls (13.8%, P=0.0005). Participants who perceived themselves as overweight and obese, were more likely (OR= 5.32) to follow weight-reduction diets than their peers with normal-weight perception. Actual overweight-BMI and obese-BMI individuals had greater odds for being on a diet (1.3 and 1.47, respectively) compared to their normal-BMI counterparts. Conclusion: Promoting strategies to improve body image concerns and prevent adverse outcomes of chronic dieting among adolescents are necessary.