What is driving rates of obesity in Chinese boys?

Over recent decades, alongside economic development, China has undergone a rapid nutrition transition that has resulted in a dramatic acceleration of obesity. Unlike other countries across the world, like the USA and UK, where childhood obesity rates have stabilised, the prevalence in China continues to worsen.

This crisis in China is also unique in terms of how it presents between genders. Dissimilar to other countries, obesity is higher in boys than girls. Boys are almost twice as likely to have obesity. Up until now, there has been limited evidence explaining why these unique sex differences have emerged.

Using a cross-sectional national health survey, Wang and colleagues revealed, as would be expected, that adolescent boys were much more likely to have energy intakes exceeding expectations. Importantly however, it found significantly different self-perceptions by sex, with boys much more likely to underestimate their weight and be satisfied with their current health behaviours.

These weight perceptions were supported by mothers, who were more accurate in predicting their daughter’s weight vs those with a son. Clearly, weight-related beliefs in China have a role to play in the increasing – and widening – rates of obesity in children.