To describe (1) the prevalence of overweight and obesity and theirassociation with physical activity; (2) the effect of different cut-offpoints for body mass index (BMI) on weight status categorisation; and (3)associations of weight status with perceptions of body size, health and dietquality.

A cross-sectional study.

Secondary schools in Barbados.

A cohort of 400 schoolchildren, 11–16 years old, selected to studyphysical education practices.

Prevalence of overweight (15% boys; 17% girls) and obesity (7% boys; 12%girls) was high. Maternal obesity, as defined by the International ObesityTask Force (IOTF) BMI cut-off points, predicted weight status such thatreporting an obese mother increased the odds of being overweight by 5.25(95% confidence interval: 2.44, 11.31). Physical activity was inverselyassociated with weight status; however levels were low. Recreationalphysical activity was not associated with weight status in either category.Overweight subjects tended to misclassify themselves as normal weight andthose who misclassified perceived themselves to be of similar health statusto normal-weight subjects. The National Center for Health Statistics andIOTF BMI cut-off points produced different estimates of overweight andobesity.

Our findings suggest that inadequate physical activity and ignorance relatedto food and appropriate body size are promoting high levels of adipositywith a strong contribution from maternal obesity, which may be explained byperinatal and other intergenerational effects acting on both sexes.Prevalence studies and local proxy tools for adiposity assessment areneeded.