Assessing Differences in Risk Perceptions About Obesity Among « Normal-Weight » and « Overweight » Adolescents – A Qualitative Study.

OBJECTIVES
To assess the differences in risk perceptions of overweight/obese and normal-weight adolescents about obesity and associated risk factors.

DESIGN
Qualitative study using focus group discussions (FGDs).

SETTINGS
Five randomly selected schools from the South Indian city of Hyderabad.

PARTICIPANTS
Seventy-nine adolescents (ages 11-14 years) participated in 10 FGDs (5 each with overweight/obese and normal-weight groups).

PHENOMENON OF INTEREST
Whether obesity-related risk perceptions differ with actual weight status or not.

ANALYSIS
FGDs were recorded, transcribed, and manually coded for thematic analysis. Results were presented according to 6 themes. At each stage of coding and analysis, reports were read independently by 2-3 researchers and the inter-coder reliability was high (ratio of number of agreements against the sum of agreements plus disagreements was over 90%).

RESULTS
Adolescents across the groups had limited understanding of nutrition during adolescence as well as causes and consequences of obesity. The optimistic bias that they were less vulnerable compared to others to the risks of obesity was evident from perceptions of overweight groups. While overweight adolescents argued that obesity was hereditary, the normal-weight participants perceived "faulty food habits" and laziness as the reasons. Adolescents across the groups considered fruits and vegetables as healthy foods.

CONCLUSIONS AND IMPLICATIONS
There were clear differences in perceptions of adolescents of different weight status. Employing the risk perception analysis framework, this study identified the following adolescent traits: responsive, avoidance, and indifference, which may be useful for developing nutrition communication programs.