Introduction and Objectives: Body size perception has been described as the image of our own shape created in our imagination. Body image perception determines the adolescent engagement in weight control activities, such as bulimia and anorexia. A misperception of body size may lead the adolescent into engagement in weight control activities that may be injurious to adolescent’s health. This study assessed the perceived body size and weight control practices among adolescents in different settings.

Methodology: A cross-sectional, multistage cluster sampling method was used to recruit 913 adolescents in Ibadan North Local Government, Ibadan, Nigeria who were interviewed using a semi-structured, self-administered questionnaire. Anthropometric measurements were taken; perceived body size were determine by Stunkard Figure Rating Scale Silhouette. Analysis was done using the Chi-square statistic and p<0.05 level of significance.

Results: Over four-fifths (87.4%) of the adolescents wrongly perceived their actual body size. Body size overestimation was reported by both females and males. About 11.3% respondents recorded making an effort to reduce weight whereas, 12.7% recorded they were also involved in gaining weight. Over twice as large urban respondents (14.7%) engaged in weight reduction habits contrast to rural (6.8%). Majority of females with normal weight perceived themselves overweight (l²=50.06, p=0.000). More males were involved in weight gain practise (l²=6.94, p=0.031).

Conclusion: The increased frequency of body weight misperceived within rural/urban adolescents and the reported influence and motivation of weight control behaviours, makes adolescent education on assessment of their weight and BMI imperative in adolescent health care services.