Knoxville (WVLT) -- Nearly one-third, 32.5 percent, of Knox county high school students describe themselves as overweight.
In actuality, the percentage is about half that, 16.2 percent.
Still, the perception is driving some teenagers to take desperate measures to lose weight.
We're covering East Tennessee health with the warning signs you need to know as a parent that your child may be engaging in high risk behavior to lose weight.
From vomiting or taking laxatives.
To pills, powders or liquids.
Teenagers are constantly discovering new and dangerous ways to lose weight, and trying them.
"Adolescents are very susceptible to these things. You know, their body image is very important to them at this time in their life, and so they're willing to try lots of different things and almost anything sometimes to be what they perceive is appropriate."
Tennessee Weight Loss and Surgery Center Registered Dietitian Tesa Finn says teenagers will even use illegal drugs to achieve heroine chic, "You've all probably seen the pictures of the prom queen who became the meth user and what that's done to their body in basically three to six months."
Aneisa McDonald is a health specialist for Knox County schools.
She says even more alarming than the obesity epidemic among children is the drastic measures some are willing to take to lose weight, "When other methods don't seem to be working, that they will resort to an illegal drug just for the mere chance that it will help them lose weight."
Even over the counter weight loss drugs can have sudden and severe side effects, including insomnia, increased blood pressure, irritability and nervousness.
Less obvious, but tell tale signs of an eating disorder such as anorexia and bulimia are changes to the hair, teeth and nails.
The lack of vitamins and nutrients in a severely calorie restricted diet can cause hair loss.
And bingeing and purging may result in tooth decay and brittle nails.
McDonald says, "Some people would rather be dead than to be overweight, and where have we gotten in our society?"
Besides the physical side effects, also note changes in behavior.
If your teenager is acting secretive or withdrawn that could be a sign of a problem.
McDonald says this issue emphasizes the importance of child well visits.
Your family doctor will note any changes in weight.
And your dentist may be first to suspect bulimia due to the amount of tooth decay.