Effect of unawareness of obesity on perceptions of obesity and food/diet among adolescents living with obesity and their caregivers: subanalysis from the ACTION Teens global study

초록

Background: This subanalysis of the ACTION Teens study aimed to explore perceptions of obesity and food/diet among adolescents living with obesity (ALwO) and caregivers of ALwO (CGs) who were unaware of their/their child’s obesity. Methods: The global, cross-sectional ACTION Teens survey study (NCT05013359) assessed perceptions, attitudes and behaviours among 5275 ALwO (aged 12–<18 years), 5389 CGs and 2323 healthcare professionals who treat ALwO. ALwO and CGs were categorized based on their perception of their/their child’s weight: believes weight is normal/below normal = ‘obesity-unaware’; believes weight is slightly/a lot/extremely above normal = ‘obesity-aware’. Proportions were compared with a Z-test; # indicates significant difference (p<0.05). Results: In total, 24% of ALwO were obesity-unaware; among ALwO with obesity class I, II or III, 26%, 14% and 27% were obesity-unaware, respectively (obesity class I vs class II#; obesity class II vs class III#). Only 12% of ALwO who were obesity-unaware received an obesity diagnosis from their doctor, compared with 54%# of obesity-aware ALwO. Fewer ALwO who were obesity-unaware were highly motivated to lose weight than those who were obesity-aware (29 vs 50%#). Obesity-unaware ALwO more often agreed that they have a healthy relationship with food (60 vs 29%#) and less often agreed that they eat food for comfort (41 vs 61%#) than obesity-aware ALwO. Overall, 34% of CGs were unaware that their ALwO had obesity; among CGs with ALwO with obesity class I, II or III, 39%, 20% and 36% were obesity-unaware, respectively (obesity class I vs class II#; obesity class II vs class III#). More CGs who were obesity-unaware thought that their child would slim down naturally as they age than those who were obesity-aware (54 vs 41%#). Conversely, compared with obesity-unaware CGs, those who were aware of their ALwO’s obesity more often agreed that their child could lose weight if they set their mind to it (57 vs 73%#) and that their child is highly motivated to lose weight (25 vs 44%#). Obesity-unaware CGs more often agreed that they themselves have a healthy relationship with food than obesity-aware CGs (63 vs 49%#). Conclusions: A subset of both ALwO and CGs were obesity-unaware. ALwO who were obesity-aware appeared more motivated to lose weight but had a poorer relationship with food than obesity-unaware ALwO. Among CGs, the perception that ALwO will lose weight naturally over time was more common when CGs were obesity-unaware.