Weight misperception among young adults with overweight/obesity associated with disordered eating behaviors

Objective The purpose of this study was to examine the cross‐sectional association between weight misperception among young adults with overweight/obesity and disordered eating behaviors. Method In a subsample of young adults with overweight or obesity participating in Wave III (2001–2002) of The National Longitudinal Study of Adolescent to Adult Health ( n  = 5,184), we examined the cross‐sectional association between weight under‐perception (i.e., perceiving oneself to be at a healthy body weight or underweight) and disordered eating (fasting/meal skipping for weight control, purging/pills for weight control, overeating/loss of control eating, and use of performance‐enhancing products/substances). Results About 20% of young adult females under‐perceived their weight compared to 48% of males. Individuals who misperceived their weight as healthy were significantly less likely to report fasting/meal skipping (Females: OR: 0.25, 95% CI: 0.14–0.43; Males: OR: 0.31, 95% CI: 0.20–0.48) and vomiting or taking diet pills/laxatives/diuretics (Females: OR: 0.10, 95% CI: 0.04–0.25; Males: OR: 0.10, 95% CI: 0.04–0.25) for weight control. Among females, those who misperceived their weight status as healthy were also less likely to report overeating or loss of control eating (OR: 0.41, 95% CI: 0.24–0.71). Greater use of performance‐enhancing products/substances was seen among males who under‐perceived their weight as healthy (OR: 2.06, 95% CI: 1.57–2.72) and among both females (OR: 2.29, 95% CI: 1.40–20.0) and males (OR: 2.27, 95% CI: 1.13–4.55) who perceived themselves to be underweight. Discussion Weight under‐perception among young adults with overweight/obesity may convey some benefit related to disordered eating behaviors, but could be a risk factor for the use of performance‐enhancing products/substances. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord ; 49:937–946)