back Weight perception and psychological factors in Chinese adolescents B. Xie Purpose: In this study, the pattern of weight perception and its relationship with psychological distress among Chinese adolescents was investigated. Methods: A sub-cohort of 2179 healthy Chinese adolescents including 1156 boys and 1023 girls with an age range of 11 to 15 years was included in the current study. Weight, height, self-perceptions of weight status, depressive psychological symptoms including anxiety, depression, perceived peer isolation and other constructs were measure by structures questionnaire survey. A General Linear Model was used to compare psychological differences between actual and perceived weight groups. Results: Perceived underweight was more likely to occur in boys, whereas perceived overweight was more likely to occur in girls. Compared to objective body weight status defined by IOTF and WHO age- and sex-specific BMI cutoffs, girls were more likely to misperceive themselves as overweight, while relatively more boys misclassified their weight status as underweight. After adjusting for age, parent?s educational attainment and urban residence, perceived overweight boys and girls were more likely to experience anxiety and depression that perceived normal and underweight subjects (p<0.05). Perceived overweight girls and perceived underweight boys experienced higher peer isolation that other groups (p<0.05). Significant differences were not found in social support, school connectedness, trouble with teachers and family disharmony among different weight-perception groups. Conclusions: Our results suggested distortion of weight perception was prevalent, and may have detrimental psychological influences in Chinese adolescents.