Obesity-related knowledge, attitudes, and behaviors in obese and non-obese urban Philadelphia female adolescents

Objectives: To examine relationships between knowledge, attitudinal and behavioral factors, and obesity and to determine how these factors influence obesity status in west Philadelphia female adolescents. Research Methods and Procedures: A matched-pairs study was conducted with 32 stature- and age-matched pairs of obese (body mass index and triceps skinfold greater than or equal to 95th percentile of National Health and Nutrition Examination Survey I) and non-obese (body mass index and triceps skinfold between the 15th and 85th percentiles of National Health and Nutrition Examination Survey I) female African American adolescents (aged 11 to 15 years), selected from a school-based study sample, based on obesity status and matching criteria. Adolescents were compared on the following measures: physical activity, inactivity, dietary intake, eating attitudes, health behavior knowledge, body image, self-esteem, and maturation status. Differences between obese and non-obese females were tested using paired t tests and Wilcoxon matched-pairs signed-rank tests. Results: Physical activity, inactivity, and perception of ideal body size emerged as the most important contributory factors to obesity status. There were no statistically significant matched-pair differences in macronutrient and micronutrient intakes, self-esteem, eating attitudes, health behavior knowledge, or maturation status of these adolescents. Obese adolescents had significantly lower levels of physical activity, higher inactivity, and a larger perception of ideal body size than non-obese adolescents. Discussion: Knowledge and attitudinal factors (with the exception of perception of ideal body size) had far less association with obesity than activity-related behavioral factors. These findings suggest that future intervention strategies should pay particular attention to physical activity, inactivity, and body image attitudes.