Picture a crowded beach at the height of summer. Boys and girls of all shapes and sizes cavort in the waves and lounge on beach towels. It's the skin-baring season—and that can exacerbate body image woes for many teens. Who do you think is most unhappy with their bodies? Underweight or overweight? Girls or boys?
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If you guessed overweight girls, think again. Recent research has found that underweight males are at high risk for depressive symptoms, as are female "weight pessimists"—girls who think they are overweight but are actually normal weight.
"Underweight boys are extremely distressed, and are far more likely to be upset about their bodies than boys who are heavier," explains Jason N. Houle, graduate student in sociology and demography. As for girls, "Parents often worry about overweight girls' mental health, but our findings show that it is girls who have a healthy weight but perceive being overweight who are most likely to feel depressed."
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Houle was part of a Penn State research team, supported by the National Institute of Child Health and Human Development, which looked at data from 6,557 male and 6,126 female participants in Wave II of the National Longitudinal Study of Adolescent Health. This dataset included the participants' actual weight; whether they thought they were under-, over-, or about the right weight; and their scores on the Center for Epidemiologic Studies Depression Scale, a questionnaire that identifies symptoms of clinical depression. The analysis accounted for socioeconomic factors, parental obesity, health status, physical activity, race, ethnicity, and family structure.
The findings, published in the Journal of Health and Social Behavior, suggest that society may have been overly focused on the wrong adolescents. "We focus on how overweight girls feel," notes Molly A. Martin, assistant professor of sociology and demography and study co-author. "But they may not suffer as many symptoms as we suspected. Past researchers may have missed the key groups: normal weight girls who think they are overweight, and underweight boys."
It's not just weight that troubles kids, it's the combination of weight and weight perceptions, notes Houle. A concept called "health congruency" may be at work. Simply stated, health congruency is the degree to which your view of yourself is in line with reality. Anorexia is the most publicized example of unrealistic body image, but not the only one. "Clinicians cannot assume that healthy weight adolescents know their weight is healthy or feel good about it," says Michelle L. Frisco, assistant professor of sociology and demography, and the study's third author.
While eighty percent of overweight girls know they are overweight, only forty percent of overweight boys think they are overweight. For overweight girls, being realists turns out to be good for their mental health: kids whose perceptions match reality are relatively unscathed, while those who look in the mirror and can't accurately describe themselves run the greatest risk of depression.
"Society emphasizes healthy body image, but it also equates thinness with beauty," says Frisco. "These mixed messages may produce weight pessimism that is distressing for adolescents."
On the other hand, according to Houle, "Overweight teenagers may not be as emotionally troubled as we think."
Jason N. Houle is a doctoral candidate in sociology and demography, and can be reached at jnh143@psu.edu.