Formative research to understand food beliefs and practices relating to pregnancy on Kei Besar Island, Eastern Indonesia.

BACKGROUND: Food-related beliefs and practices during pregnancy may contribute to the high prevalence of chronic energy deficiencies (CED) in Eastern Indonesia, particularly in Southeast Maluku regency, where 21.33% of pregnant women experience CED. Currently, little information on these issues is available. This study investigates food beliefs and practices related to pregnancy on Kei Besar Island in the Maluku province of Eastern Indonesia. METHODS: A qualitative study was conducted utilizing in-depth interviews, free lists, and pile sort exercises. Data collection was conducted in January 2023 and involved married pregnant women aged 18 and above (n = 12), community health volunteers (n = 2), and traditional healers (n = 3) from 9 villages in Kei Besar District. All participants must be natives of Kei Besar Island, with community health volunteers and traditional healers being respective figures recommended by the local villagers. RESULTS: The need to avoid or minimize consumption of certain foods during pregnancy, such as some kinds of fish, chili and spicy food, soda, pineapples, octopus, squid, and ice was reported by more than one-third of all participants. Consumption of prescribed foods, such as cassava leaves, papaya, coconut water, rice during early pregnancies, moringa leaves, bananas, and katok leaves was reported by five or more participants. These food proscriptions and prescriptions were due to concerns about the risks of miscarriage, adverse effects on the fetus and mother, and complications during labor. Participants also reported other practices, such as eating for two during early pregnancy and reducing food intake in late pregnancy. We found that food beliefs have shaped the dietary patterns of most participants. However, they still consumed food recommended by community health volunteers and midwives. CONCLUSIONS: Food beliefs are present and practiced in the Kei Besar community and may impact the nutritional status of women and their infants. Interventions should target training healthcare providers and community health volunteers to provide culturally appropriate health education that incorporates prescribed local ingredients and provides nutritionally adequate substitutes for the proscribed food items. TRIAL REGISTRATION: Not applicable.

The translation and psychometrics Persian version of irrational food belief scale.

BACKGROUND: This study aimed to translate into the Irrational Food Belief Scale proposed by Osberg into the Persian language and determine the psychometric properties of in Iranian culture. METHODS: Osberg's 57-item scale was translated into Persian by using the forward-backward method. The scale's validity was examined using face validity, content validity, and construct validity (exploratory and confirmatory factor analysis). Its reliability was assessed with Cronbach's alpha and McDonald's Omega coefficient. Exploratory factor analysis and confirmatory factor analysis was performed by SPSS 28 (500 subjects) and also by AMOS 26 (500 subjects). The participants completed the demographic questionnaire and the Irrational Food Belief Scale (IFBS) over the Internet. RESULTS: After translation into Persian, the validity of the scale was determined by impact score, quantitative and qualitative face validity (modification of 10 items) and qualitative content validity (modification of 8 items), and quantitative content validity (CVR, CVI and Kappa coefficient), which were greater than 0.46, 0.86, and 0.85, respectively. In exploratory factor analysis, 30 items were removed and the remaining 27 items were loaded on five factors, including behavioral and psychological aspects, nutritional attitudes, healthy eating, controlled eating, and diet, which described 30.95% of the total variance. Confirmatory factor analysis showed that the 5-factor model was the best fitting model to explain the data. CONCLUSION: Considering the need for a tool about in irrational food beliefs, this tool was unable to explain all these dimensions well. It is recommended to create a new questionnaire for the Iranian culture.

Judgments about appropriate foods for infants: Associations with parents' own food preferences.

When infants begin to eat solid foods (recommended at around 6 months of age), parents have a huge variety of choices in terms of what foods to offer. The present studies examine parents' judgments about foods for infants. Participants included parents recruited from Prolific (n = 99), who were shown descriptions of foods offered to infants (including familiar and unfamiliar foods at 6-, 9-, and 12-months) and a set of control foods eaten by adults. Participants rated each food based on how appropriate they thought it was for an infant and how much they personally wanted to eat the food. Parents rated foods as more appropriate for infants if they were familiar (vs. unfamiliar) and offered to younger infants (6- vs. 12-month-olds, or infant foods vs. adult foods), but demonstrated the opposite pattern when considering whether they wanted to eat each food. Participants' own food pickiness was related to their judgments about what they would eat, but not whether foods were appropriate for infants. Parents' judgments of individual foods were inversely related: The more appropriate they rated each food for an infant, the less they were interested in eating that food. These findings are discussed in terms of potential barriers to engaging in social modeling (i.e., parents demonstrating eating and liking the foods they offer to their infants).

Community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia: an explorative qualitative study.

BACKGROUND: Dietary related misconceptions during pregnancy affect the heath of mothers and their growing babies. Misconceptions vary from place to place and from community to community. Understanding of a given community's food perceptions during pregnancy helps policy makers able to design cultural appropriate interventions. In Ethiopia, however, evidences on food beliefs and perceptions during pregnancy are limited. Therefore, this study is aimed at qualitatively assessing community food beliefs during pregnancy in rural kebeles of Ofla Woreda, Northern Ethiopia. METHODS: We conducted 10 in-depth interviews (n = 10) and four focus group discussions (n = 32) among purposively selected community groups including pregnant mothers, religious leaders, and elders in rural kebeles of Ofla Woreda, Northern Ethiopia. Data were transcribed word-for-word, translated into English, and uploaded into ATLAST ti version 7.5.1.6. Data were analyzed following the principles of thematic analysis. Line-by-line coding was applied to identify codes; identified codes were categorized based on their similarities and differences and themes were developed inductively. RESULTS: Three main themes were identified inductively; foods positively and negatively linked with pregnancy; perceived benefits and harms of alcoholic drinks during pregnancy; and religion and fasting. In this study, consumptions of animal source foods such as egg were discouraged because such foods were perceived to increase the risk of having big baby that could delay delivery. However, intakes of locally produced alcoholic drinks during pregnancy were encouraged by the local community. Furthermore, avoidance of animal source foods and meal skipping during religious fasting-periods were also common practices among pregnant mothers in the study area. CONCLUSIONS: This study explored misconceptions on food intakes during pregnancy. Positive attitude towards intake of "soft" alcoholic drinks might result in alcohol related teratogenic effects. Restriction on the intakes of nutrient rich diets due to religious fasting and other misconceptions would lead to insufficient nutrient intake both to the mothers and their growing fetus. Culturally appropriate intervention to improve awareness on healthy dietary intake during pregnancy is needed.

Are beliefs and attitudes about COVID-19 associated with self-perceived changes in food consumption? Results from a nationwide survey during lockdown.

This study aimed to understand how beliefs and attitudes regarding COVID-19 are associated with self-perceived changes in food consumption during lockdown between March 19 and May 2, 2020. We conducted a cross-sectional study with a non-probabilistic weighted sample of the Portuguese population. Data were collected using an online survey and telephone interviews. The association between agreement with sentences about food and COVID-19 and perceived changes in food consumption were assessed by multinomial logistic regression models. Overall, 5858 citizens were included, with a mean age of 38.2 (17.3) years. Exclusive agreement with the belief "SARS-CoV-2 can be transmitted by food" (27.5%) was associated with decreased odds of perceived positive changes (e.g., increased consumption of fruit and vegetables). Agreement only with the attitudinal sentence "I started to consume foods that may protect against COVID-19" (11.9%) was associated with positive perceived consumption changes (e.g., increasing fruit and vegetables, and decreasing soft drinks and snacks). Cumulative agreement (with both sentences; 10.6%) was also associated with mostly positive food consumption changes. Specific beliefs and attitudes regarding COVID-19 and food are associated with self-perceived changes in food consumption. Longitudinal research is needed to understand how beliefs and/or attitudes about the role of food in infectious diseases act as determinants of eating behavior modification.

Creencias alimentarias en estudiantes universitarios mexicanos: una aproximación cualitativa / Eating beliefs among Mexican university students: a qualitative approach

Objetivo: Identificar las creencias conductuales, normativas y de control que subyacen a la alimentación saludable en estudiantes de la Universidad de Guadalajara, México. Método: Estudio cualitativo y exploratorio, basado en la Teoría del Comportamiento Planeado realizado a partir de 3 grupos focales (n= 25). La información se analizó con la técnica Análisis Temático a partir de tres categorías definidas a priori: creencias conductuales, normativas y de control. Resultados: Los universitarios creen que alimentarse de manera saludable beneficia la salud física y mental, dentro de las desventajas de este tipo de alimentación se encuentra que la compra y preparación de alimentos saludables es más costosa y les toma mucho más tiempo que alimentarse en base a comida rápida. Paralelamente, declaran que implementar una alimentación saludable sería más sencillo si vivieran en familia y sus madres se hicieran cargo (creencias de control). Con respecto a las creencias normativas, señalaron que sus figuras parentales serían más felices si los participantes se alimentaran sanamente, pero que en lo concreto, no sienten ninguna presión social por alimentarse adecuadamente. Conclusión: Las características poco saludables de la conducta alimentaria de los universitarios, está condicionada por las creencias que subyacen a ella. Al profundizar en estas creencias se puede comprender la perspectiva del estudiante frente a su alimentación, siendo esta información clave y contextualizada para diseñar intervenciones efectivas en las universidades.

The aim of this study was to inquire into the behavioral beliefs, normative beliefs and control beliefs underlying the healthy eating in students of the Guadalajara University, México. Methods: Qualitative and exploratory study based on Ajzen's Theory of Planned Behavior, 3 focus group interviews were carried out (n:25). The information was analyzed using the Thematic Analysis method from three previously defined categories: behavioral beliefs, normative beliefs and control beliefs. Results: University students considered healthy eating to be beneficial for physical and mental health, they also believed that healthy food purchases and preparation were expensive and time consuming (behavioral beliefs). In parallel, they informed that implementing a healthy diet would be easier if their mothers helped them and if they lived in a family (control beliefs). Regarding normative beliefs, they stated that their parental figures would be happy if the participants made changes in their diet but they did not feel any particular social pressure to eat healthier. Conclusions: The eating behavior of the university students is conditioned by the beliefs that underlie the eating decision making process. By understanding student eating beliefs, we can obtained key and contextualized information to design effective interventions in the university.

Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

BACKGROUND: Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. METHODS: Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. RESULTS: Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. CONCLUSIONS: The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

Using a cultural-ecological framework to explore dietary beliefs and practices during pregnancy and lactation among women in Adivasi communities in the Nilgiris Biosphere Reserve, India.

This article explores maternal dietary beliefs and practices gathered through interviews with mothers of infants and young children in Adivasi communities in the Nilgiris Biosphere Reserve, India. Guided by focused ethnographic study methods, interviews were conducted with 33 key informants. We used a cultural-ecological framework to analyze and interpret the texts that were elicited from women about dietary beliefs and eating patterns during pregnancy and lactation. We identify differences between what women were advised to eat, felt they should eat, and reported consuming. The findings offer guidance for interventions to improve maternal diets in this vulnerable population.

"When a woman is pregnant, her grave is open": health beliefs concerning dietary practices among pregnant Kalenjin women in rural Uasin Gishu County, Kenya.

BACKGROUND: Reducing malnutrition remains a major global challenge especially in low- and middle-income countries. Lack of knowledge on the motive of nutritional behaviour could ultimately cripple nutrition intervention outcomes. The purpose of this study was to investigate how health beliefs influence nutritional behaviour intention of the pregnant Kalenjin women of rural Uasin Gishu County in Kenya. The study findings provide useful information for culturally congruent nutrition counselling and intervention. METHODS: In this qualitative study semi-structured interviews were conducted with 42 pregnant and post-natal (with children less than one year) Kalenjin women in selected rural public health facilities of Uasin Gishu County Kenya. Furthermore, key informant interviews took place with 6 traditional birth attendants who were also pregnancy herbalists, two community health workers and one nursing officer in charge of Maternal and Child Health (MCH) for triangulation and provision of in-depth information. Content analysis of interview transcripts followed a grounded theory (Protection Motivation Theory) approach, using software MAXQDA version 12.1.3. RESULTS: Abstracted labour (big babies and lack of maternal strength), haemorrhage (low blood), or having other diseases and complications (evil or bad food) were the major perceived health threats that influence nutritional behaviour intention of the pregnant Kalenjin women in rural Uasin Gishu County in Kenya. CONCLUSION: The pregnancy nutritional behaviour and practices of the Kalenjin women in rural Uasin Gishu County act as an adaptive response to the perceived health threats, which seem to be within the agency of pregnant women. As a result, just giving antenatal nutritional counselling without addressing these key health assumptions that underlie a successful pregnancy outcome is unlikely to lead to changes in nutritional behaviour.

Food beliefs and practices among the Kalenjin pregnant women in rural Uasin Gishu County, Kenya.

BACKGROUND: Understanding food beliefs and practices is critical to the development of dietary recommendations, nutritional programmes, and educational messages. This study aimed to understand the pregnancy food beliefs and practices and the underlying reasons for these among the contemporary rural Kalenjin communities of Uasin Gishu County, Kenya. METHODS: Through semi-structured interviews, data was collected from 154 pregnant and post-natal Kalenjin women about restricted and recommended foods, and why they are restricted or recommended during pregnancy. Respondents were purposively selected (based on diversity) from those attending Maternal and Child Health (MCH) care in 23 rural public health facilities. Key informant interviews (n = 9) with traditional Birth Attendants (TBA) who were also herbalists, community health workers, and nursing officers in charge of MCH were also conducted. Quantitative data was analysed using SPSS software. Data from respondents who gave consent to be tape recorded (n = 42) was transcribed and qualitatively analysed using MAXQDA software. RESULTS: The restriction of animal organs specifically the tongue, heart, udder and male reproductive organs, meat and eggs, and the recommendation of traditional green vegetables and milk was reported by more than 60% of the respondents. Recommendation of fruits, traditional herbs, ugali (a dish made of maize flour, millet flour, or Sorghum flour, sometimes mixed with cassava flour), porridge and liver, and restriction of avocadoes and oily food were reported by more than 20% of the respondents. The reasons for observing these dietary precautions were mainly fears of: big foetuses, less blood, lack of strength during birth, miscarriages or stillbirths, and maternal deaths as well as child's colic and poor skin conditions after birth. CONCLUSION: Pregnancy food beliefs were widely known and practised mainly to protect the health of the mother and child, and ensuring successful pregnancy outcome. Given the deep-rooted nature of the beliefs, it is advisable that when nutritious foods are restricted, nutritional interventions should rather search for alternative sources of nutrition which are available and considered to be appropriate for pregnancy. On the other hand, nutritional advice that does not address these health concerns and assumptions that underlie successful pregnancy and delivery is unlikely to be effective.

The importance of thinking styles in predicting binge eating.

Impulsivity, Body Mass Index, negative emotions and irrational food beliefs are often reported as predictors of binge eating. In the current study we explored the role played by two thinking styles, namely food thought suppression and desire thinking, in predicting binge eating among young adults controlling for established predictors of this condition. A total of 338 university students (268 females) participated in this study by completing a battery of questionnaires measuring the study variables. Path analysis revealed that impulsivity was not associated with binge eating, that Body Mass Index and negative emotions predicted binge eating, and that irrational food beliefs only influenced binge eating via food thought suppression and desire thinking. In conclusion, thinking styles appear an important predictor of binge eating and they should be taken into consideration when developing clinical interventions for binge eating.

Tempting foods and the affordability axiom: Food cues change beliefs about the costs of healthy eating.

Many consumers report that healthy eating is more expensive than unhealthy eating (the affordability axiom). We hypothesize that endorsement of this belief may be driven by the motivation to eat unhealthy foods. We tested this hypothesis in three studies. Study 1 revealed that the affordability axiom is associated with poorer eating habits and higher Body Mass Index (BMI). Study 2 found that the presence of a tasty food cue in the environment increased endorsement of affordability axiom. Study 3 found that these effects were moderated by one's food intake goals. Food cues led non-dieters to increase endorsement of the affordability axiom, but had the opposite effect among those seeking to restrict their calorie intake. The affordability axiom might persist as a means of validating unhealthy food choices.

Metacognitions about desire thinking predict the severity of binge eating in a sample of Italian women.

In this study, our principal aim was to investigate whether metacognitions about desire thinking predict the severity of binge eating in women and, if so, whether this relationship is independent of age, self-reported body mass index (BMI), negative affect, irrational food beliefs and craving. One hundred and four women, consisting of 32 consecutive patients with binge eating disorder undergoing initial assessment for cognitive therapy for eating disorders, 39 moderate binge eaters, and 33 non-binge eaters (both from the general population), completed the following measures: Self-reported BMI, Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, General Craving Scale, Metacognitions about Desire Thinking Questionnaire, and Binge Eating Scale. A series of Spearman's rho correlation analyses revealed that self-reported BMI, anxiety, depression, irrational food beliefs, craving, and all three factors of the metacognitions about desire thinking questionnaire were significantly associated with the severity of binge eating. A stepwise regression analysis identified self-reported BMI, craving, and negative metacognitions about desire thinking as significant predictors of the severity of binge eating. These results, taken together, highlight the possible role of metacognitions about desire thinking in predicting the severity of binge eating. The clinical implications of these findings are discussed.

Parents' beliefs about the healthfulness of sugary drink options: opportunities to address misperceptions.

OBJECTIVE: To assess potential misperceptions among parents regarding the healthfulness of sugary drinks for their children. DESIGN: Online survey of parents. Participants identified the categories and specific brands of sugary drinks they provided for their children. They also indicated their perceptions of sugary drink categories and brands as healthy options for children, perceived importance of on-package claims in purchase decisions and their concerns about common sugary drink ingredients. SETTING: Online market research panel. SUBJECTS: Parents (n 982) of 2- to 17-year-olds, 46 % non-white or Hispanic. RESULTS: Ninety-six per cent of parents provided on average 2·9 different categories of sugary drinks for their children in the past month. Flavoured waters, fruit drinks and sports drinks were rated as the healthiest sugary drink categories. Across all categories and brands, parents who purchased specific products rated them as significantly healthier than those who did not (P<0·05). Over half of parents reported concern about caffeine, sugar and artificial sweeteners in sugary drinks that their children consume and approximately one-third reported that on-package ingredient claims were important in their purchase decisions. CONCLUSIONS: Nearly all parents provide sugary drinks for their children and many believe that some sugary drinks are healthy options for children, particularly flavoured waters, fruit drinks and sports drinks. Furthermore, many parents rely upon on-package claims in their purchase decisions. Given excessive consumption of added sugar by children in the home, there is a continuing need to address parents' misperceptions about the healthfulness of many sugary drink products.

Nutritional behaviour and beliefs of ski-mountaineers: a semi-quantitative and qualitative study.

BACKGROUND: Endurance athletes are advised to optimize nutrition prior to races. Little is known about actual athletes' beliefs, knowledge and nutritional behaviour. We monitored nutritional behaviour of amateur ski-mountaineering athletes during 4 days prior to a major competition to compare it with official recommendations and with the athletes' beliefs. METHODS: Participants to the two routes of the 'Patrouille des Glaciers' were recruited (A, 26 km, ascent 1881 m, descent 2341 m, max altitude 3160 m; Z, 53 km, ascent 3994 m, descent 4090 m, max altitude 3650 m). Dietary intake diaries of 40 athletes (21 A, 19 Z) were analysed for energy, carbohydrate, fat, protein and liquid; ten were interviewed about their pre-race nutritional beliefs and behaviour. RESULTS: Despite belief that pre-race carbohydrate, energy and fluid intake should be increased, energy consumption was 2416 ± 696 (mean ± SD) kcal · day(-1), 83 ± 17% of recommended intake, carbohydrate intake was only 46 ± 13% of minimal recommended (10 g · kg(-1) · day(-1)) and fluid intake only 2.7 ± 1.0 l · day(-1). CONCLUSIONS: Our sample of endurance athletes did not comply with pre-race nutritional recommendations despite elementary knowledge and belief to be compliant. In these athletes a clear and reflective nutritional strategy was lacking. This suggests a potential for improving knowledge and compliance with recommendations. Alternatively, some recommendations may be unrealistic.

Desire thinking: A risk factor for binge eating?

In the current study we explored the role of desire thinking in predicting binge eating independently of Body Mass Index, negative affect and irrational food beliefs. A sample of binge eaters (n=77) and a sample of non-binge eaters (n=185) completed the following self-report instruments: Hospital Anxiety and Depression Scale, Irrational Food Beliefs Scale, Desire Thinking Questionnaire, and Binge Eating Scale. Mann-Whitney U tests revealed that all variable scores were significantly higher for binge eaters than non-binge eaters. A logistic regression analysis indicated that verbal perseveration was a predictor of classification as a binge eater over and above Body Mass Index, negative affect and irrational food beliefs. A hierarchical regression analysis, on the combined sample, indicated that verbal perseveration predicted levels of binge eating independently of Body Mass Index, negative affect and irrational food beliefs. These results highlight the possible role of desire thinking as a risk factor for binge eating.

Studying the nutritional beliefs and food practices of Malagasy school children parents. A contribution to the understanding of malnutrition in Madagascar.

Madagascar is severely affected by the problem of children malnutrition. The present study aimed at exploring school children Malagasy parents' food practices and beliefs structures about the nutritional value of foods, to better understand the causes of this malnutrition. A combination of Focus Groups (72 participants), and questionnaires (1000 interviewees) was used to evaluate the food beliefs and the nutritional habits of low income parents of school age children in urban and rural areas of Antananarivo and Antsiranana. The respondents' beliefs were shown to focus not only on the nutrient and energetic composition of food, but also to involve more general relations between food and health and particularly the sanitary properties of food. Compared with such sanitary properties, nutrient content was not considered to be the priority in food choice and food preparation. The food category considered to be the most nutritive was cereals, ahead of protein foods, or vegetables and fruit. Nutritional beliefs were not the same in the Antananarivo and Antsiranana areas, nor between urban and rural areas of Antsiranana. Different socio-economic contexts, food availability and information may explain these differences. This study could guide actors involved in nutrition promotion to adapt to specific areas their nutrition programmes in the fight against malnutrition.

Perception of weight and psychological variables in a sample of Spanish adolescents.

BACKGROUND: This study explored the relationship between body mass index (BMI) and weight perception, self-esteem, positive body image, food beliefs, and mental health status, along with any gender differences in weight perception, in a sample of adolescents in Spain. METHODS: The sample comprised 85 students (53 females and 32 males, mean age 17.4 ± 5.5 years) with no psychiatric history who were recruited from a high school in Écija, Seville. Weight and height were recorded for all participants, who were then classified according to whether they perceived themselves as slightly overweight, very overweight, very underweight, slightly underweight, or about the right weight, using the question "How do you think of yourself in terms of weight?". Finally, a series of questionnaires were administered, including the Irrational Food Beliefs Scale, Body Appreciation Scale, Self Esteem Scale, and General Health Questionnaire. RESULTS: Overall, 23.5% of participants misperceived their weight. Taking into account only those with a normal BMI (percentile 5-85), there was a significant gender difference with respect to those who perceived themselves as overweight (slightly overweight and very overweight); 13.9% of females and 7.9% of males perceived themselves as overweight (χ(2) = 3.957, P < 0.05). There was a significant difference for age, with participants who perceived their weight adequately being of mean age 16.34 ± 3.17 years and those who misperceived their weight being of mean age 18.50 ± 4.02 years (F = 3.112, P < 0.05). CONCLUSION: Misperception of overweight seems to be more frequent in female adolescents, and mainly among older ones. Misperception of being overweight is associated with a less positive body image, and the perception of being very underweight is associated with higher scores for general psychopathology.