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BACKGROUND: To improve understanding of the mechanisms affecting the relationship between adolescent obesity and poor academic performance, we examined the association of overweight or perceived weight status with academic achievement.

METHODS: We performed a cross‐sectional study of 14–17‐year‐olds (N = 11,012) from the nationally representative 2003 Youth Risk Behavior Survey. The main outcome measure was self‐reported grades (mostly A, B, C, D, or F). The primary independent variables were medically defined overweight (body mass index [BMI] ≥ 85th percentile), obesity (BMI ≥ 95th percentile), and participants' perception of their weight status.

RESULTS: Medically defined overweight youth were less likely to report higher grades in unadjusted analysis (OR 0.67, 95% CI: 0.60‐0.76, p < .001) and after adjustment for demographics, depression, television and video game use, and …