JOURNAL OF AMERICAN COLLEGE HEALTH, VOL. 59, NO.

Perceptions of Body Weight, Weight

Management Strategies, and Depressive
Symptoms Among US College Students
Holly Anne Harring, MSPH; Kara Montgomery, DrPH; James Hardin, PhD

Abstract. Objective: To determine if inaccurate body weight perception predicts unhealthy weight management strategies and to
determine the extent to which inaccurate body weight perception
is associated with depressive symptoms among US college students. Participants: Randomly selected male and female college
students in the United States (N = 97,357). Methods: Data were
from the 2006 National College Health Assessment. Analyses were
conducted on students body weight perceptions, weight loss strategies, and feelings of depression. Results: Females with an inflated
body weight perception were significantly more likely to engage
in unhealthy weight management strategies and report depressive
symptoms than were females with an accurate body weight perception. Conclusions: College women are concerned with weight and
will take action to lose weight. Colleges may need to focus more
on interventions targeting both diet and physical activity while also
promoting positive body image.

ued to increase in children and adolescents and among both

males and females.1 The prevalence of overweight among
adolescents, age 12 to 19 years has increased from 14.8% in
19992000 to 17.4% in 20032004.1 This is of serious concern because obesity in adolescence is the leading predictor
of obesity in adulthood.3
The college years are a time of transition for many young
adults, since this is the first time that most are living away
from home. With new independence, young adults are faced
with the challenges of independent meal planning and food
and beverage selection. Research indicates that college students typically consume a poor-quality diet that is high in fat,
sugar, and sodium and deficient in fruits, vegetables and lowfat dairy products.47 Furthermore, recent research demonstrates differences in dietary patterns among college students
according to body mass index (BMI).8 For instance, obese
and overweight students have been more likely to report consuming pork, legumes, and all-meat products, whereas students who were underweight have reported consuming more
cheese, green leafy vegetables, other vegetables, hot cereal,
and all-dairy products.8 Furthermore, college students have
been identified as a population segment that may be prone to
using unhealthy weight management strategies such as fasting, diet pills, laxatives, or self-induced vomiting; these behaviors are especially prevalent in underweight and normalweight college women.912
The American College Health Association (ACHA) has
developed a National College Health Assessment (NCHA),
a survey instrument designed to collect information on a
broad range of students health behaviors, health indicators,
and perceptions.13 Summaries from the 2008 NCHA items
pertaining to nutrition and weight management strategies indicate that 62.8% of females and 45.4% of males exercise
to lose weight, 42.1% of females and 24.1% of males diet
to lose weight, 3.3% of females and 0.6% of males vomit
or take laxatives to lose weight, and 3.8% of females and
1.7% of males take diet pills to lose weight.13 Moreover,

Keywords: body weight perceptions, college students, depressive

symptoms, weight management strategies

he prevalence of overweight and obesity is increasing among US adults. In 2004, 67% of US adults
were overweight and just over 33% were considered
obese compared to the 19601962 National Health and Nutrition Examination Study (NHANES), which estimated the
prevalence of overweight to be 43% and the prevalence of
obesity to be 13%.1,2 This increase in overweight and obesity transcends age, gender, and racial/ethnic groups, but
is rising more rapidly among women, young adults, Hispanics, African Americans, and people with some college
education.1 In addition, the prevalence of obesity has contin-

Ms Harring and Dr Montgomery are with the Department of

Health Promotion, Education, and Behavior at University of South
Carolina in Columbia, South Carolina. Dr Hardin is with the Department of Epidemiology and Biostatistics at University of South
Carolina.
Copyright 2010 Taylor & Francis Group, LLC
43

Harring et al

estimated BMI classifications based on self-reported height

and weight indicated that 28.8% of females are overweight or
obese and 39.4% of males are overweight or obese. However,
38% of females describe themselves as overweight whereas
30.8% of males describe themselves as overweight.13 This
inaccurate body weight perception, specifically among females, suggests that body image and other normative beliefs
may be influencing students awareness of what is considered a healthy body weight and what is considered appropriate weight management. Although programming targeted towards improving body image is needed, additional efforts by
colleges and universities may be garnered to address healthy
weight management strategies.
In addition to rising obesity rates and the prevalence of
harmful weight management strategies employed by college
students, 2008 NCHA data suggest that stress is the number 1 reported health impediment to students academic performance, with depression and anxiety ranked number 5.13
Research on stress and food consumption suggests that continual work stress is associated with greater energy consumption, specifically increased saturated fat and sugar intake, and
weight gain among restrained eaters.14 Furthermore, social
situations perceived to be stressful lead to increased consumption of foods that are higher in fat, sugar, and overall
more energy dense.15 In addition, research examining predictors of dieting concerns and binge eating in college females
concluded that dysfunction at the familial level leads to depressive symptoms and negative body image. Thus, dieting
may be employed as a coping mechanism that predisposes
one to additional eating problems such as binge eating.16
Including stress management techniques within weight management and eating disorder presentations may help educate
college students on the important role stress plays in their
eating behavior and body image.
The increasing rates of both obesity and unhealthy eating
behaviors among college students have led researchers to examine the psychosocial issues related to the weight management strategies among this population. A study conducted on
weight loss practices and body weight perceptions among US
college students, using data from the 20022003 NCHA, concluded that 12% of respondents had inaccurate body weight
perception and that men and women with inaccurate body
weight perception were significantly more likely to engage
in inappropriate weight management strategies compared to
respondents with accurate body weight perception.17 Furthermore, another study examined the relationship between
eating disturbance, body image, and academic achievement
and concluded that academic interference may be an outcome
for individuals who experience eating problems and body
image disturbance.18 Yet, little research exists investigating
the relationship between inaccurate body weight perception,
weight management strategies, and depressive symptoms.
The purposes of this study were (1) to determine if inaccurate body weight perception predicts unhealthy weight
management strategies in the 2006 NCHA reference group,
and (2) to examine the extent to which inaccurate body weight
perception may be associated with depressive symptoms.
44

METHODS
Data were collected during the Spring 2006 semester using
the NCHA. The NCHA is a survey instrument designed to
collect information on a broad range of students health behaviors, health indicators, and perceptions. Of the 300 items
in the NCHA, specific items of interest in this study include
nutrition, weight management strategies, body image, body
weight, impediments to academic performance, and feelings
of depression and hopelessness. An interdisciplinary team of
college health professionals developed the NCHA and pilottested it in 19981999 for reliability and validity.19 Construct
and measurement validity analyses were conducted by comparing results of the ACHA-NCHA with nationally representative databases.19 We assessed reliability by comparing relevant percentages with nationally representative databases,
and we assessed item reliability comparing overlapping items
with a nationally representative database.19
One hundred twenty-three North American postsecondary
institutions self-selected to participate in the Spring 2006
NCHA, resulting in 97,357 surveys. However, the NCHA
Spring 2006 Reference Group included data from only those
institutions that utilized random sampling techniques.13 The
final sample consisted of 94,806 students on 117 campuses.
The overall mean response rate was 35%. The response rate
for schools administering paper surveys in randomly selected
classrooms was 85.8% and 23.2% for schools conducting
randomized Web-based surveying.13 Although institutions
utilized random sampling techniques, the 35% response rate
indicates that nonresponse bias is an inherent concern in
this data set and it may not be representative of the general
population.
Data were cleaned for missing responses pertinent to the
items used in our analyses. Only participants with calculated
body mass index (BMI) data were included. We categorized
participants as underweight (BMI < 18.5), normal weight
(BMI = 18.524.9), and overweight (BMI 25). After these
adjustments, 90,484 respondents were included in these findings.
Participants provided demographic information such as
age, sex, ethnicity, and relationship status. Participants also
answered questions regarding height, weight, self-perception
of weight, weight-loss goals, weight-loss strategies, health
impediments to academic performance, and feelings of depression and hopelessness. Specifically, participants were
asked: How do you describe your weight? (very underweight, slightly underweight, about the right weight, slightly
overweight, very overweight); Are you trying to do any of
the following about your weight? (I am not trying to do
anything about my weight, stay the same weight, lose weight,
gain weight); Within the last 30 days, did you do any of
the following? (exercise to lose weight, diet to lose weight,
vomit or take laxatives to lose weight, take diet pills to lose
weight, I didnt do any of the above); Within the last school
year, how many times have you felt? (things were hopeless, overwhelmed by all you had to do, exhausted, very sad,
so depressed it was difficult to function, seriously considered suicide, attempted suicide). For this study, vomiting,
JOURNAL OF AMERICAN COLLEGE HEALTH

Body Weight, Weight Management, and Depressive Symptoms

use of laxatives, and use of diet pills are categorized as unhealthy weight management strategies, whereas dieting to
lose weight and exercising to lose weight are categorized as
healthy weight management strategies, although these can
be abused.
Self-reported height and weight were used to calculate
BMI and categorize participants using National Institutes of
Health (NIH) guidelines, despite limitations that pertain to
self-report data that will be discussed. As demonstrated in a
previous study, we categorized participants as having an inflated body weight perception if they perceived themselves
to be overweight or very overweight when their BMI was
either normal weight or underweight.17 Additionally, participants were categorized as having a deflated body weight
perception if their BMI was overweight yet they perceived
themselves as normal weight or under weight.
Frequencies were tabulated for all demographic variables,
BMI categories, body weight perceptions, weight management goals, weight management strategies, depressive symptoms, and impediments to academic performance. Binary logistic regression models were estimated to assess the extent to
which inaccurate body weight perception was associated with
weight management goals, unhealthy weight management
strategies (vomiting, laxatives, diet pills), and depressive
symptoms. Odds ratios for binary predictors were converted
to approximate risk ratios following Zhang and Yu.20 Demographic characteristics such as age, sex, and race/ethnicity
were controlled for in the regression models. All statistical
analyses were conducted in SPSS version 14.0. Differences
were considered significant at p = .05, and risk ratios were
considered significantly different if 95% confidence intervals
did not include 1. The University of South Carolina Institutional Review Board approved the study.
RESULTS
Among the sample respondents, 63.5% were female,
72.8% were white, and 53.4% were single. The mean age
of the respondents was 22.3 years (SD = 5.6). Among male
and female respondents, 36.2% perceived themselves to be
overweight or obese (see Table 2), whereas 31.3% were actually overweight or obese according to their BMI category.
In addition, 28% of all respondents suffered from an inaccurate body weight perception. Among these respondents,
46.2% perceived that they were in a higher BMI category
(inflated body weight perception) and 53.8% perceived that
they were in a lower BMI category (deflated body weight
perception). Among respondents who suffered from an inflated body weight perception, 83% were female and 16.9%
were male. Among respondents who suffered from a deflated
body weight perception, 29.4% were female and 70% were
male. Despite that only one-third of respondents were considered overweight or obese by their BMI category, 51.3%
of respondents indicated that they were trying to lose weight.
Among the respondents who indicated that they were trying
to lose weight, only 45.5% were actually overweight. Although 55.8% of respondents exercised to lose weight and
VOL 59, JULY/AUGUST 2010

35% dieted to lose weight, only 30% used a combined approach of diet and exercise in order to lose weight.
Sex-specific results, presented in Table 1 indicated that
39.2% of males were classified as overweight, compared
to 25.7% of females, a significant difference ( 2[1, N =
88,587] = 1041.693, p < .0001). Additionally, 61.2% of
females and 34.1% of males were currently trying to lose
weight, which was significantly different (Z = 38.82; N =
90,397; 95% confidence interval [CI] = .131 to .119; p <
.0001). Women were also significantly more likely to suffer
from an inflated body weight perception than were men (Z =
46.61; N = 88,587; 95% CI = .105 to .113).
Results from the binary logistic regression analyses for
males and females with an inflated body weight perception
are presented in Table 2. The results demonstrated that females with an inflated body weight perception were significantly more likely to engage in unhealthy weight management practices than were males with an inflated body weight
perception. Males with an inflated body weight perception
were no more likely to engage in unhealthy weight management practices than were males with an accurate body
weight perception. Males with an inflated body weight perception were actually less likely to vomit to lose weight than
were males with an accurate body weight perception. These
results demonstrate that inaccurate body weight perception
has a significant effect on the weight management practices
among females, whereas it seems to exert no effect on the
weight management practices among males.
Among overweight females with an accurate body weight
perception, binary logistic regression analyses indicated that
overweight females were more than 21/2 times as likely to use
diet pills to lose weight (RR = 2.74; 95% CI = 2.512.99;
p < .0001). This relationship was also found to be significant
among overweight males (RR = 1.46; 95% CI = 1.291.64;
p < .0001). In addition, overweight males (RR = 1.31; 95%
CI = 1.291.34; p < .001) and females (RR = 1.47; CI =
1.451.50; p < .0001) with an accurate body weight perception were more likely to lose weight by exercising. Interestingly, overweight females with a deflated body weight perception were 1.63 times more likely to use diet pills to lose
weight than were normal weight females with an accurate
body weight perception (RR = 1.63; 95% CI = 1.282.07;
p < .0001). No significant relationship existed for overweight
males with a deflated body weight perception.
Significant relationships also existed for females and males
regarding inaccurate body weight perception (inflated and
deflated) and depression. Normal weight females with an inflated body weight perception were significantly more likely
to report feeling depressed in the last year (RR = 1.29; 95%
CI = 1.221.355; p < .0001). No significant relationship
existed for males with an inflated body weight perception.
However, overweight males with a deflated body weight perception were significantly less likely to report feeling depressed in the last year (RR = .72; 95% CI = .66.78;
p < .0001). This relationship did not exist for overweight
females with a deflated body weight perception. Alternatively, overweight females with an accurate body weight
45

Harring et al

TABLE 1. Percentage of Participants Body Mass Index (BMI), Body Weight Perception, Body Weight
Distortion, Weight Management Goals, and Weight Management Strategies, by Sex
Category
BMI
Underweight
Normal weight
Overweight/Obese
Body weight self-perception
Underweight
About the right weight
Slightly overweight
Very overweight
Body weight distortion
Inflated
Deflated
Weight management goals
Do nothing
Lose weight
Stay the same
Gain weight
Weight management strategies
Exercise
Diet
Vomit
Diet pills
Diet and exercise

Total (N = 90,484)

Women (n = 57,456)

Men (n = 38,028)

4.5
64.2
31.3

5.6
67.6
26.7

2.6
58.2
39.2

10.5
53.1
32.5
3.9

7.5
53.1
34.8
4.6

15.6
53.2
28.4
2.8

12.9
13.7

16.8
6.3

5.9
26.7

17.1
51.3
24.3
7.2

13.4
61.2
23.4
2.0

23.7
34.1
26.0
16.2

55.7
34.9
2.5
3.6
30.0

62.7
42.4
3.6
4.6
36.4

43.7
22.1
0.7
1.9
19.0

Note. BMI categories: underweight < 18.5, normal weight 18.624.9, overweight/obese 25. Individuals were classified as suffering
from an inflated body weight distortion when they perceived themselves to be overweight when they were normal weight or underweight
on the basis of BMI. Individuals were classified as suffering from a deflated body weight distortion when they perceived themselves to
be normal weight or underweight when they were overweight on the basis of BMI.

perception were more likely to report feeling depressed in

the last year than were overweight males with an accurate
body weight perception (RR = 1.45; 95% CI = 1.391.51;
p < .0001).

less overweight than they actually were. This is consistent

with findings from the Behavioral Risk Factor Surveillance
System (BRFSS), which concluded that more women in the
United States were dieting to lose weight than men, though
men had higher average BMI than did women.21 Furthermore, this study supports the findings from a smaller study
that concluded that the majority of college normal and overweight females (83%) reported that they have consciously
tried to lose weight.22 It is evident that there is an ongoing weight concern among college females of both normal
and overweight BMI categories, yet this concern is less apparent among overweight males and not at all apparent in
normal weight males, which is consistent with previous research.17,21,22

COMMENT
Our results further demonstrate the need to examine the
role of body weight perception in the weight management
strategies of college women. In this study, fewer females
than males were considered overweight, yet significantly
more females than males indicated that they were trying to
lose weight. In addition, females were more likely to perceive
themselves as being more overweight than they actually were,
and males were more likely to perceive themselves as being

TABLE 2. Risk Ratios (RRs) for Involvement in Unhealthy Weight Management

Practices Among Participants With an Inflated Body Weight Perception
Women

46

Men

Category

OR

95% CI

OR

95% CI

Vomit to lose weight

Diet pills to lose weight
Exercise to lose weight

1.76
2.23
1.19

1.571.96
2.012.47
1.141.45

.45
ns
ns

.31.67
ns
ns

JOURNAL OF AMERICAN COLLEGE HEALTH

Body Weight, Weight Management, and Depressive Symptoms

In this study, weight loss was important to participants,

yet only 36.4% of females and 19% of males were using a
combined strategy of diet and exercise to lose weight. This
is an important implication for college wellness programming because the Dietary Guidelines specifically emphasize
that combined physical activity and healthy eating are recommended for weight management.23 A lack of awareness
among college students of the efficacy of employing both
changes in diet and physical activity may be a reason why
the 2 strategies were not reported together among the majority. In addition, some college students may find changes
to their diet hard to implement, whereas other students may
find increasing physical activity to be a real challenge. Colleges should promote the Dietary Guidelines as a resource
for students who want to lose weight.23
Independent meal planning is a challenge with which
young adults are faced in college, and eating habits formed
in college often continue into adulthood. Another factor that
may influence an individuals decision to engage in weight
control behavior is normative beliefs. Clemens et al found
that normative beliefs appeared to be a large determinant
of an individuals weight management strategy.24 For example, among both sexes, perceptions of same-sex, close
friends weight-control practices were the single best discriminators of the low- and high-involvement weight-control
groups. Therefore, these findings suggest that close friends
may have an influence on weight control behavior.24 Thus,
an effective strategy for college health professionals to diversify their weight management programming may be to
openly communicate with students in their peer groups (eg,
residence halls, Greek organizations, sports teams, etc) about
healthy and unhealthy dieting practices. Through this targeted communication, students can learn appropriate weight
management strategies and also become aware of the health
consequences associated with unhealthy dieting behaviors.
Findings from this study support the findings of a previous study that found dieting by college females is a common weight management strategy, irrespective of weight
status.22 Additionally, Malinauskas et al found that females
perceive healthy and attractive weights to be lower than current weight, and that media influence contributes pressure to
be a certain weight.22 Furthermore, a related study reported
that female dieters had low body satisfaction and suggested
that to improve health, it is important to address body image
dissatisfaction with chronic dieting, despite the weight status
of the dieter.25 Our findings were consistent with previous
research, in that we found that normal weight females with
an inflated body weight perception were much more likely
to engage in unhealthy weight management strategies such
as vomiting and taking diet pills to lose weight. Moreover,
overweight females who had an accurate body weight perception were almost 3 times as likely to use diet pills to lose
weight than their normal-weight counterparts. Even overweight females who perceived themselves to be of normal
weight were more likely to use diet pills to lose weight. No
such relationships existed for males. These findings have pertinent implications for college health professionals. Weight
VOL 59, JULY/AUGUST 2010

management programs for the college population must emphasize body image issues and the extent to which they are
predictive of unhealthy weight management practices. Targeted messages and programs must promote regular exercise
and healthy eating, but also focus on body image and body
satisfaction, while being sensitive to the extent to which inaccurate body weight perception predisposes females to unhealthy weight management strategies and possibly eating
disorders.
It has been established in the literature that exercise behavior is associated with increased depression and anxiety
among women with eating disorder symptoms.26 A previous study that examined the relationship among exercise,
disordered eating, and psychological health among college
students found that among women with high Eating Attitudes
Test (EAT-26) scores, exercise had a negative effect and was
associated with higher levels of depression and anxiety.27 Exercise did not produce this negative effect among women who
had low EAT scores.27 Although this present study did not
examine the effect exercise had on depression and anxiety,
we did investigate the association between inaccurate body
weight perception and depressive symptoms. Our findings
support previous research such that normal weight females
with an inflated body weight perception were significantly
more likely to report feeling depressed in the last year, as
were overweight females with an accurate body weight perception. These conclusions are critical in the college health
programming for females in that college health professionals
need to be aware that exercise can be a negative adaptive behavior for females suffering from eating disorder symptoms
and more attention may need to be placed on addressing body
image issues and eating disorders before recommending formal exercise programs. Introducing activities designed to
promote mind and body awareness, such as yoga and tai chi,
may be a therapeutic alternative to more vigorous activities
that focus on burning calories.
A related area that has received limited attention is the role
that body image disturbances might play in interfering with
optimal cognitive performance. Wardle et al concluded that
restrained eaters tended to eat more calories, fat, and sugar
when exposed to work stress and stress from social situations.14 Furthermore, Yanover and Thompson examined the
relationship between eating disturbance, body image, academic achievement among a large sample of college undergraduates and concluded that higher levels of eating disturbance and body dissatisfaction were associated with higher
levels of interference in academic achievement.18 Our results support these findings, that normal weight females with
an inflated body weight perception were significantly more
likely to report that stress impacted their academic performance. This relationship was only observed among females
with an inflated body weight perception and not among any
other group. This is important for college administrators because of the established link between health and retention.28
Efforts need to be focused on students emotional health and
on addressing the stressors our students are facing in order
to promote optimal academic performance.
47

Harring et al

Limitations
Several limitations to this research should be noted. First,
the cross-sectional data collection precludes causal interpretations of the findings, though patterns of association may
be observed. Second, the generalizability is limited because
universities self-selected to participate in this study, although
participants were selected at random. Moreover, it must be
pointed out that the study response rate of the NCHA in 2006
was 35% and thus nonresponse bias is an inherent concern.
Although the Web survey response rate was lower than the
paper and pencil survey, the ACHA has examined the difference between the 2 survey types and found negligible differences.29 Specifically, the students who responded online
tended to live on campus and were slightly younger than those
who used paper surveys.30 Additionally, institutions that
were not members of the ACHA were charged an additional
fee to participate in the NCHA and this may represent another
source of bias. However, results gathered in this study were
consistent with previously gathered, national data.11 Finally,
data were self-reported, which introduces additional biases
to the findings. Survey items were not extensive enough to
define what is considered dieting or differentiate between
various kinds of diet pills. Malinauskas et al concluded that
dieting strategies have become so main stream in our society, that one may not be aware of the behaviors that are being
used to consciously lose or control ones weight.22 Therefore,
participants in our study were forced to utilize their own definition of dieting, which may have biased our findings.
Additionally, the use of BMI may be a limitation because it
does not account for body composition. There is the potential
that some of our participants were classified as overweight
based on their self-reported weight and height, yet would
not be clinically considered overweight as a result of their
muscle mass. For instance, this occurrence likely skewed the
proportionally large number of males who were identified
as having a deflated body image and thus explains the weak
associations between males with a deflated body image and
the outcome variables. On the contrary, overweight college
females tend to underestimate their self-reported weight and
height and this could negatively impact overall prevalence
rates in the study.31 Despite these discrepancies, overall, BMI
is a population-based measure that has been found in clinical
settings to be a good approximation for assessment of total
body fat for a majority of patients.31a,31b Although a major
strength of this study is the large sample size, it is important
to distinguish between clinically significant and statistically
significant results. With a sample size of more than 90,000
respondents, we were careful to report only the practically
meaningful findings. Additionally, the NCHA has been extensively validated by a panel of health experts.13,19 Furthermore, although universities self-selected to participate, only
universities who used random selection of participants were
included in this sample.

management strategies, and psychological distress. There is

an absence in the literature on the weight management programming needs of college males, yet this study shows that
college males could use health programming designed to
educate them on what is a healthy weight and appropriate
strategies for nutritious eating and adequate physical activity. College males share issues related to weight concern with
their female counterparts. A study found that overweight and
obese college men have body dissatisfaction. In the same
study, underweight college males were concerned about losing muscle mass.32 Body image issues related to weight management strategies in males and females still exist and more
evidence-based interventions need to be developed to address the extent to which body image perceptions have a
negative impact on health. Future programming should address health concerns related to both those students who are
trying to lose weight, as well as those who are trying to gain
muscle. Both groups need to focus on achieving their goals
in a healthful manner that includes both diet and physical
activity.
In terms of future research and programming, studies could
examine the differences among female college students by
ethnicity or race using focus groups to identify more specific
differences regarding weight, body image, and body weight
perception. In addition, focus groups may present an opportunity to discern what impact concerns about weight have on
socioemotional health, in a more detailed manner than can
be provided via a survey. Recent research regarding differences in body dissatisfaction by race/ethnicity among women
is very inconsistent,3542 future research among college students could add an important perspective.
Additionally, future research should focus on the relationship between body image, stress, and academic achievement.
Developing theory-based interventions that include more
holistic approaches to well-being may be effective in addressing some of the psychosocial effects resulting from an
inaccurate body weight perception. On the basis of these findings, we suggest that college health professionals continue
their work on body image and weight management programming4345 while incorporating both exercise and nutrition
components. In addition, future research is needed to elucidate how complimentary programming, such as biofeedback
and self-hypnosis, may be integrated into more traditional
efforts to help college students address body image concerns and help them to identify ways in which they can improve self-image and engage in healthy weight management
strategies. Implementing theory-based interventions that incorporate complimentary programming along with practical
determinants of healthy weight loss, such as knowledge of
the preparation and selection of healthy foods, social support
of friends and peer groups, and improved self-efficacy for
engaging in physical activity, may help students to maintain
a healthy weight and appropriate body image.

Conclusions
Despite limitations of this study, the findings shed light
on the relationship between body weight perception, weight

NOTE
For comments and further information, address correspondence to Holly Anne Harring, MSPH, Department of Health

48

JOURNAL OF AMERICAN COLLEGE HEALTH

Body Weight, Weight Management, and Depressive Symptoms

Promotion, Education, and Behavior, University of South

Carolina, 800 Sumter Street, Columbia, SC 29208, USA (email: harrinhamailbox.sc.edu).
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