„What’s a normal weight?“ – Weight assessment standards in Origin- and Receiving Country and Immigrant Adolescents’ Weight-Status Self-Assessment

Background: Many young people struggle with correctly assessing their weight-status, often leaving over- or underweight to go unnoticed thereby preventing adequate intervention.
The prevalence of weight-status misperception differs considerably cross-nationally, indicating that individual weight-status assessment is informed by culturally transmitted standards of evaluation.
For adolescents with a migration background, this brings up the problem of multiple frames of reference, as their perception of weight-status may be influenced by different cultural standards.
Objective: We investigate the extent to which the assessment of one's own weight-status is based on standards of the heritage country or the receiving country.
Methods: Data are retrieved from the 2014 Health Behaviour in School-Aged Children study. The cross-national design of the study enabled us to aggregate weight-evaluation standards for 41 countries and subsequently identify a large sample of 8132 immigrant adolescents in 23 receiving countries from 41 heritage countries. The influence of heritage- and receiving country standards of evaluation was assessed using cross-classified multilevel models.
Results: Descriptive analyses reveal considerable differences in weight-evaluation standards between the countries. We find evidence of a significant influence of both heritage- and receiving culture standards of evaluation, with a stronger impact of receiving culture standards. Stratified analyses reveal a stronger influence of heritage culture standards among first- than among second-generation immigrants, and a stronger influence of receiving culture standards among second- than among first-generation immigrants.
Conclusions: The results corroborate our expectations regarding the persistency of cultural standards and help to understand inter-ethnic differences in weight-status assessment.