Introduction: Body weight perception refers to the personal evaluation of one's weight irrespective of actual BMI. Body perception does not always reflect reality and can be influenced by external factors. Methods: This paper explores the association between adolescents’ body perception, demographic characteristics and residential location using both binary and multinomial logistic regressions regression analysis to assess 1) perception accuracy, 2) the association between demographic characteristics and perception accuracy and 3) the relationship between perception and residence. Results: Results showed that half of adolescents misestimate (either under or over categorize) their body weight and that discordant perception is more prevalent among men, the overweight, blacks, younger adolescents and those enrolled in school. The type of misestimation varies by residential location. Rural residents are less likely to overestimate their weight while suburban residents are more like to underestimate their body weight compared to urban residents. Discussion and Conclusion: By examining both overestimation and underestimation of body weight, this study identified trends in adolescent weight perception by region. Rural residents are less likely to over- and suburban residents are more like to over-estimate their body weight compared to urban dwellers. Both are problematic. Underestimation can signify that actual overweight is being ignored. Overestimation may motivate overweight youth to eat healthier and be more active but could encourage unhealthy weight control behaviors. Therefore, intervention programs should be careful to promote healthy weight and weight perception.
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