Body weight misperception among school going adolescents in Cameroon

BACKGROUND: Body weight misperception (discordance between perceived and measured body weight among adolescents) among adolescents is linked to unhealthy weight-control practices and adverse mental health outcomes. However, evidence on body weight misperception among adolescents from Sub-Saharan Africa remains limited. This study assessed the prevalence and correlates of body weight misperception among school-going adolescents in rural and urban settings in Yaoundé, Cameroon. METHODS: We conducted a cross-sectional survey among 3,153 adolescents aged 12-19 years from ten secondary schools in the urban and peri urban localities in Yaoundé, Cameroon (September-October 2018). Data on weight perception, weight-control behaviours, and mental health were collected using the WHO Global School-based Student Health Survey questionnaire. Body Mass Index (BMI) for age z-score was calculated from measured height and weight using WHO Anthro plus. Logistic regression models were used to identify factors associated with misperception. RESULTS: Overall, 33.7% of adolescents showed discordance between perceived and measured weight status. Discordance was significantly more prevalent among females (43.2%) than males (56.8%) (p = 0.01) and among adolescents who were overweight or obese (69.0%) compared with those of normal weight (p < 0.001). Compared with those who correctly perceived their weight, adolescents with discordant weight perception had higher odds of attempting to lose (aOR 1.75; 95% CI 1.39-2.19) or gain weight (aOR 1.90; 95% CI 1.47-2.45), restricting calorie intake (aOR 1.49; 95% CI 1.20-1.85), and using laxatives (aOR 1.45; 95% CI 0.94-2.24). They were more likely to report suicide attempts (aOR 1.46; 95% CI 1.07-1.99), and concentration difficulties. CONCLUSION: One in three school-going adolescents in Cameroon showed a discordance between their perceived and measured weight status. Discordant weight perception is associated with unhealthy weight-control practices and poorer mental health. School- and community-based interventions should address body image and promote accurate weight perception to support adolescent well-being.