• child and adolescent health;
  • emotional health;
  • health policy;
  • mental;
  • health;
  • obesity;
  • academic achievement

BACKGROUND: To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement.

METHODS: We performed a cross-sectional study of 14–17-year-olds (N = 11,012) from the nationally representative 2003 Youth Risk Behavior Survey. The main outcome measure was self-reported grades (mostly A, B, C, D, or F). The primary independent variables were medically defined overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and participants' perception of their weight status.

RESULTS: Medically defined overweight youth were less likely to report higher grades in unadjusted analysis (OR 0.67, 95% CI: 0.60-0.76, p < .001) and after adjustment for demographics, depression, television and video game use, and physical activity (OR 0.83, 95% CI: 0.74–0.94, p = .003). Statistically significant results also were seen with medically defined obese participants. Youth who perceived themselves as overweight were less likely to report higher grades (OR 0.82, 95% CI: 0.73–0.92, p = .001) in unadjusted analysis and after adjustment for the same variables (OR 0.79, 95% CI: 0.68–0.91, p = .002). The perception of overweight was a more significant determinant of academic performance (OR 0.81, 95% CI: 0.69–0.95, p = .012) compared to medically defined obesity (OR 0.90, 95% CI: 0.77–1.05, p = .174).

CONCLUSIONS: Perceived overweight status is negatively associated with academic performance, regardless of actual weight status. These findings suggest that perception of overweight may be a mechanism for prior results indicating a negative association of obesity and academic achievements, and have implications for the academic health of these adolescents.