Relationships between Weight Perceptions and Suicidal Behaviors in Chinese Adolescents: Results from an Ongoing School-Based Survey in Zhejiang Province

Background: Weight perception has been implicated in suicidal behaviors among children and adolescents, yet little is known about the relationships in China. We examined the associations of self-perceived weight status and weight misperception with suicidal behaviors among Chinese adolescents. Methods: Data used in this analysis were from the 2017 Zhejiang Youth Risk Behavior Survey, which included 17,359 middle and high school students aged 9 to 18 years. Information on perceived weight status, as well as the actual height, weight and other related traits, was extracted by a self-reported questionnaire. Multivariate logistic regression models were used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for suicidal behaviors associated with perceived weight status and weight misperception. Results: Overall, the mean (SD) age was 15.7 (1.6) years among the study participants. Students who perceived themselves as overweight were more likely to have increased suicidal ideation and attempts reports, with ORs of 1.22 (95% CI: 1.09–1.37) and 1.32 (1.06–1.34), compared to those who perceive themselves as having about the right weight. Overestimated weight was significantly associated with greater odds of suicidal ideation (OR: 1.15, 95% CI: 1.03–1.27) and attempts (1.35, 1.10–1.65) relative to accurate weight perception. Conclusions: Controlling for potential confounders, we found that both self-perception of overweight and overestimated perception were significantly associated with suicidal ideation and attempts among Chinese adolescents.