Self-perception of being overweight in Spanish adults

The relationship of body image and weight: A cross-sectional observational study of a Dutch female sample

Body image concerns may play a role in weight changing behaviour. The objective of this study was to assess body image in different weight groups. Participants reported satisfaction with (AE) and investment in (AO) appearance, and the discrepancy between current and ideal body size (BS). These scores were compared between weight groups based on body-mass index (BMI) using analysis of variance. One-sample t-tests and Cohen's d effect sizes examined the magnitude of differences within each weight group relative to neutral midpoints of the scales; cluster analysis identified body image profiles. A total of 27 896 women were included in this study. AE scores were highest for people with underweight and normal weight, AO scores were highest for the underweight group and lowest in class III obesity, and BS scores were largest in the obese groups (all p < .001) Cluster analysis identified eight body image profiles. In people with obesity, the most prevalent profiles included a preference for a smaller body and low satisfaction with appearance, but differed in investment in appearance (low vs. high). Most people with underweight were allocated to profiles showing high investment in their appearance, preference of a larger body, but differences in satisfaction with appearance (neutral vs. high). While people with a higher BMI have on average more body image concerns, different body image profiles exist in all weight groups. Future research should examine whether and which individuals in terms of body image profile may benefit more from weight interventions.

Self-perceptions of body weight status according to age-groups among Korean women: A nationwide population-based survey

While numerous studies have investigated body image, including body weight perception, most of which have focused on adolescents or young women, few studies have attempted to evaluate body weight perceptions in adult women according to age groups. This study was conducted to investigate the accuracy of self-perceived weight and actual body mass index (BMI) values among adult Korean women according to age. We used data from the 2016 Korean Study of Women's Health Related Issues, a population-based, nationwide, cross-sectional survey. BMI was calculated from self-reported weight and height. Participants were asked to describe their body image by choosing one of the following descriptions: very underweight, underweight, about right, overweight, or obese. The proportions of women aged 20-29, 30-39, 40-49, 50-59, 60-69, and 70-79 years who underestimated their body weight relative to their actual BMI category were 12.6%, 15.1%, 22.2%, 34.0%, 45.6%, and 50.7%, respectively; those who overestimated their body weight comprised 18.7%, 17.8%, 14.3%, 10.8%, and 7.4%. In all BMI categories, the proportion of those who overestimated their weight status increased as age decreased, while those who underestimated their weight status increased as age increased. After adjusting for possible covariates, age was strongly associated with both underestimation and overestimation. The odds ratio for underestimating one's weight status among women aged 70-79 yeas was 2.96 (95% CI: 2.10-4.18), and that for overestimation was 0.52 (95% CI: 0.35-0.79), compared to women aged 20-29 years. Age is the most important factor associated with weight perceptions among Korean women, affecting both underestimation and overestimation of weight status.

Weight underestimation for adults in Beijing and its association with chronic disease awareness and weight management

Background

Obesity is known to be a risk factor to a variety of chronic diseases. Weight misperception has an impact on weight-loss attitude and behavior. We aimed to investigate factors associated with weight underestimation, and to assess the effect of hypertension, diabetes and dyslipidemia awareness on weight underestimation and weight management for overweight and obese adults.

Methods

Data was obtained from the 2011 Beijing Non-communicable disease and risk factors Surveillance (BJNCDRS). A total of 19,932 participants with measures of weight and height were included in the analysis. Self-perception of weight was obtained by asking, “How do you describe your weight?”, and the question for weight management was “Are you taking any actions to control your body weight?”. Multiple logistic regression was used to investigate factors related to weight underestimation.

Results

For the underweight, normal weight, and overweight/obese categories, more than half of the participants perceived their weight accurately (63.6, 53.8, 66.2%, respectively). For overweight and obese adults, older age, male, rural residence, lower level of education, lower level of income, absence of hypertension, presence of diabetes and absence of dyslipidemia positively associated with weight underestimation, and awareness of having hypertension and dyslipidemia were negatively associated with weight underestimation (Adjusted OR(95%CI) were 0.70(0.61~ 0.79) and 0.71(0.62~ 0.80), respectively). Awareness of having hypertension and dyslipidemia were significantly associated with weight management (Adjusted OR (95%CI) were 1.42(1.25~ 1.62) and 1.53(1.36~ 1.72), respectively). There was no significant association between awareness of diabetes and weight underestimation(P > 0.05) or weight management(P > 0.05).

Conclusions

More than half of the participants perceived their weight accurately. For overweight/obese population, awareness of having hypertension and dyslipidemia could improve weight perception and weight management, whereas awareness of having diabetes might not.

Body Size Perceptions and Weight Status of Adults in a Nigerian Rural Community

Background:

Overweight and obesity are now recognized worldwide as increasing public health problems throughout the life course and wrong perception of one's body size may reduce the motivation for an overweight person to lose weight.

Aim:

This study was conducted to investigate how Nigerian rural dwellers perceive their body size and how their perception agrees with their body mass index (BMI).

Subjects and Methods:

A cross-sectional sample of 183 adults living in a rural community, South-West Nigeria was randomly recruited into the study. Their verbal and visual body size perceptions were assessed through structured questions and body images. Descriptive and inferential statistics were used to analyze the data.

Results:

Thirty-five percent (64/183) of participants were classified as either overweight or obese by BMI. More than half of the participants perceived themselves as normal weight. More women perceived themselves to be obese than men in both verbal and visual perceptions. Based on BMI classification, 43% (79/183) and 54% (98/183) of participants misperceived themselves in verbal and visual perception, respectively. Underestimation of body size was higher in men (38.3%, 36/94) while overestimation was higher in women (9.0%, 8/89). Men had consistently higher values of kappa coefficient which indicate greater agreement than women in both types of perception.

Conclusion:

We found considerable gender differences in body weight perception of adults in the Nigerian rural community. A large proportion of these rural dwellers could not appropriately classify their weight status; and over 30% (64/183) and nearly 50% (92/183) of them underestimated their own body weight in verbal and visual perceptions respectively.

Self- Perception of Body Weight Status in Older Dutch Adults

INTRODUCTION

OBJECTIVES

The prevalence of obesity is highest in older persons and a correct self-perception of body weight status is necessary for optimal weight control. The aim of this study was to determine self-perception of, and satisfaction with, body weight status, and to compare current versus ideal body image in a large, nationally representative sample of older people. Furthermore, determinants of misperception were explored.

DESIGN

A cross-sectional study.

SETTING

The Longitudinal Aging Study Amsterdam (LASA), conducted in a population-based sample in the Netherlands.

PARTICIPANTS

1295 men and women aged 60-96 years.

MEASUREMENTS

Body weight status was assessed using measured weight and height. Self-perceived body weight status, satisfaction with body weight and current and ideal body image were also assessed. Multiple logistic regression analysis was used to investigate the association of age, educational level and objectively measured BMI with underestimation of body weight status.

RESULTS

The prevalence of obesity was 19.9% in men and 29.3% in women. The agreement between objective and self-perceived body weight status was low (Kappa < 0.2). Among overweight and obese persons, 42.1% of men and 44.1% of women were (very) dissatisfied with their body weight status and >99% of obese participants desired to be thinner (ideal body image < current image). Only 4.4% of obese men and 12.3% of obese women perceived their body weight status correctly. Higher age (women), lower educational level (men) and higher BMI (all) were associated with greater underestimation of body weight status.

CONCLUSION

Many older persons misperceive their body weight status. Future actions to improve body weight perception in older persons are necessary to increase the impact of public health campaigns focussing on a healthy body weight in old age.

Weight status and the perception of body image in men

Understanding the role of body size in relation to the accuracy of body image perception in men is an important topic because of the implications for avoiding and treating obesity, and it may serve as a potential diagnostic criterion for eating disorders. The early research on this topic produced mixed findings. About one-half of the early studies showed that obese men overestimated their body size, with the remaining half providing accurate estimates. Later, improvements in research technology and methodology provided a clearer indication of the role of weight status in body image perception. Research in our laboratory has also produced diverse findings, including that obese subjects sometimes overestimate their body size. However, when examining our findings across several studies, obese subjects had about the same level of accuracy in estimating their body size as normal-weight subjects. Studies in our laboratory also permitted the separation of sensory and nonsensory factors in body image perception. In all but one instance, no differences were found overall between the ability of obese and normal-weight subjects to detect overall changes in body size. Importantly, however, obese subjects are better at detecting changes in their body size when the image is distorted to be too thin as compared to too wide. Both obese and normal-weight men require about a 3%–7% change in the width of their body size in order to detect the change reliably. Correlations between a range of body mass index values and body size estimation accuracy indicated no relationship between these variables. Numerous studies in other laboratories asked men to place their body size into discrete categorizes, ranging from thin to obese. Researchers found that overweight and obese men underestimate their weight status, and that men are less accurate in their categorizations than are women. Cultural influences have been found to be important, with body size underestimations occurring in cultures where a larger body is found to be desirable. Methodological issues are reviewed with recommendations for future studies.

Profile of Overweight and Obese People in a Mediterranean Region

OBJECTIVE

To assess the prevalence of excess weight (obesity and overweight) and the related environmental risk factors in a Mediterranean population. Self-perception of body weight, attitudes toward weight-control behaviors, and the associated factors were also examined.

RESEARCH METHODS AND PROCEDURES

A cross-sectional nutritional survey was carried out in the Balearic Islands between 1999 and 2000. A random sample (n = 1200) of the adult population (20 to 60 years old) was interviewed. Dietary questionnaires and a global questionnaire incorporating questions related to sociodemographic and lifestyle variables were utilized. Anthropometric measurements were also obtained.

RESULTS

Nearly one-half of the population of the Balearic Islands is above the normal weight range (BMI > 25). The predictors of overweight and obesity in the Balearic Islands are to be over 40 years old, to be married, to form part of the lowest educational levels, and to have a sedentary lifestyle. A large percentage of excess-weight individuals tend to underestimate their BMI, are not concerned about their weight status, tend to snack more often, and have never dieted.

DISCUSSION

Although the likely causes of the rise in obesity prevalence are difficult to elucidate from this study, we have identified the profile of individuals with excess weight in the Balearic Islands as well as their attitudes toward their body image.

Underestimation of weight and its associated factors among overweight and obese adults in Pakistan: a cross sectional study

BACKGROUND

Weight loss is known to decrease the health risks associated with being overweight and obese. Awareness of overweight status is an important determinant of weight loss attempts and may have more of an impact on one's decision to lose weight than objective weight status. We therefore investigated the perception of weight among adults attending primary care clinics in Karachi, Pakistan, and compared it to their weight categories based on BMI (Body Mass Index), focusing on the underestimation of weight in overweight and obese individuals. We also explored the factors associated with underestimation of weight in these individuals.

METHODS

This was a cross sectional study conducted on 493 adults presenting to the three primary care clinics affiliated with a tertiary care hospital in Karachi, Pakistan. We conducted face to face interviews to gather data on a pre-coded questionnaire. The questionnaire included detail on demographics, presence of comorbid conditions, and questions regarding weight assessment. We measured height and weight of the participants and calculated the BMI. The BMI was categorized into normal weight, overweight and obese based on the revised definitions for Asian populations. Perception about weight was determined by asking the study participants the following question: Do you consider yourself to be a) thin b) just right c) overweight d) obese. We compared the responses with the categorized BMI. To identify factors associated with underestimation of weight, we used simple and multiple logistic regression to calculate crude odds Ratios (OR) and adjusted Odds Ratios (AOR) with 95% Confidence Intervals.

RESULTS

Overall 45.8% (n = 226) of the study participants were obese and 18% (n = 89) were overweight. There was poor agreement between self perception and actual BMI (Kappa = 0.24, SE = 0.027, p < 0.001). Among obese participants a large proportion (73%) did not perceive themselves as obese, although half (n = 102) of them thought they may be overweight. Among the overweight participants, half (n = 41) of them didn't recognize themselves as overweight. Factors associated with misperception of weight in overweight and obese participants were age ≥ 40 years (AOR = 3.4; 95% CI: 1.8-6.4), male gender (AOR = 2.97; 95% CI: 1.6-5.5), being happy with ones' weight (AOR = 6.4; 95% CI: 3.4-12.1), and not knowing one's ideal weight (AOR = 2.45, 95% CI: 1.10-5.47).

CONCLUSION

In this cross sectional survey, we observed marked discordance between the actual and perceived weight. Underestimation of individual weight was more common in older participants (≥ 40 years), men, participants happy with their weight and participants not aware of their ideal weight. Accurate perception of one's actual weight is critical for individuals to be receptive to public health messages about weight maintenance or weight loss goals. Therefore educating people about their correct weight, healthy weights and prevention of weight gain are important steps towards addressing the issue of obesity in Pakistan.

Accuracy, determinants, and consequences of body weight self-perception in type 2 diabetes: the Fremantle Diabetes Study

OBJECTIVE

To assess the accuracy, determinants, and consequences of body weight self-perception in type 2 diabetes.

METHODS

We studied 1272 community-based patients and a 518-patient overweight/obese subset who returned for ≥4 annual reviews. Multiple logistic regression was used to identify baseline predictors of correct weight self-perception and to determine whether correct weight self-perception predicted future weight loss. Overweight and obesity were defined as body mass indices of 25.0-29.9 and ≥30.0 kg/m(2), respectively.

RESULTS

Of the patients who were overweight (40.0%) or obese (41.8%) at baseline, 52.8% and 83.7%, respectively, correctly self-identified their weight category. Overweight/obese participants who self-identified correctly were more likely to have been informed they were overweight (P<.001), predominantly by their general practitioner (80.1%). Overweight participants had less self-awareness if they were not abdominally obese, did not speak English fluently, were male, or had a low income. Obese participants were more likely to consider themselves overweight if they had better diabetes knowledge and higher educational attainment. Correct weight self-perception did not influence subsequent weight loss.

CONCLUSIONS

Health care professionals can facilitate body weight self-awareness in type 2 diabetes. Education programmes should recognise the impact of gender and socio-demographic variables on accurate weight self-perception.

Relation of college students' self-perceived and measured health-related physical fitness

This study examined the relation of college students' self-perceived and measured physical fitness. Students (30 men, 30 women; M age = 20.1 yr., SD = 1.4) completed the Physical Self-description Questionnaire and four fitness tests: air displacement plethysmography, submaximal treadmill test, curl-up test, and sit-and-reach test. Significant correlations were obtained for self-perceived physical fitness with measured body composition, cardiorespiratory endurance, muscular endurance, and flexibility (r = .33-.62). Significant correlations were also found between self-perceived overall fitness and actual body composition, cardiorespiratory endurance, and muscular endurance (|r| = .26-.55). These findings suggest that college students can gauge their own fitness in terms of four distinct health-related components with some accuracy.

Body mass index, physical activity, and the risk of decline in overall health and physical functioning in late middle age

OBJECTIVES

We examined the relation between body mass index, exercise, overall health, and physical functioning.

METHODS

We studied 7867 adults aged 51 to 61 years in 1992 to 1996. Adjusted relative risks for health decline and new physical difficulties were determined with logistic regression.

RESULTS

Overweight and obesity were independently associated with health decline (adjusted relative risk [ARR] = 1.29 and 1.36) and development of a new physical difficulty (ARR = 1.27 and 1.45). Regular exercise significantly reduced the risk of health decline and development of a new physical difficulty, even among obese individuals.

CONCLUSIONS

Maintaining ideal body weight is important in preventing decline in overall health and physical functioning. However, regular exercise can reduce the risk of health decline even among individuals who cannot achieve ideal weight.

BMI change and leisure time physical activity (LTPA): an 11-y follow-up study in apparently healthy men aged 20–69 y with normal weight at baseline

OBJECTIVE

To study the association between self-reported leisure time physical activity (LTPA) at baseline and change in body mass index (BMI).

DESIGN

Prospective observational study with a 11-y follow-up period.

SETTING

A total population-based health survey in one county was performed in 1984-1986 (HUNT 1) and repeated in 1995-1997 (HUNT 2).

PARTICIPANTS

In total, 21 685 men participated in both surveys. In the present study, we included only apparently healthy 20-69-y-old men participating in both surveys and who had a normal body weight (BMI 18.5-24.9 kg/m(2)) at baseline-leaving 8305 men for the analyses. In all, 6945 men answered all questions about LTPA and 6749 men had complete data in the multiple analyses.

MEASUREMENTS AND MAIN RESULTS

At HUNT 1, the participants answered questions (self-reported) about the intensity, frequency and duration of LTPA. The association between change in BMI and LTPA was investigated in multiple linear regression analyses. Adjusted for smoking, education, age and BMI at baseline, the physical active cohort gained less weight than the inactive cohort. Low, moderate and high levels of LTPA showed a U-shaped effect adjusted for smoking, education, age and BMI at baseline. Adjusted for BMI and age at baseline, the high-intensity part of the physically active cohort gained less weight than the low-intensity group.

CONCLUSION

This study has demonstrated a moderate BMI effect of LTPA at the population level; however, even a high level of LTPA did not prevent weight gain during the 11-y follow-up period.

Leisure Time Physical Activity and Change in Body Mass Index: An 11-Year Follow-Up Study of 9357 Normal Weight Healthy Women 20–49 Years Old

OBJECTIVE

To study the association between self-reported leisure time physical activity at baseline (1984-1986) and change in body mass index (BMI) during an 11-year follow-up period (1995-1997). The study population was 9357 healthy women, aged 20-49 years, who had a normal body weight (BMI 18.5-24.9 kg/m2) at baseline.

METHODS

A general population-based health survey was performed both in 1984-1986 (HUNT 1) and 1995-1997 (HUNT 2). Leisure time physical activity at HUNT 1 was categorized into high, moderate, and low levels based on self-reported intensity, duration, and frequency. Women who at baseline reported diabetes, stroke, angina, myocardial infarction, or long-term illnesses impairing their activities of living were excluded.

RESULTS

Physical activity was a significant predictor of BMI at HUNT 2 adjusted for BMI,age, and education at HUNT 1. Low level of leisure time physical activity compared with high level at baseline was significantly associated with a higher BMI 11 years later. Those with high level of activity gained 0.18 kg/m2 (95% CI 0.05, 0.32) less than those with low level of physical activity over 11 years.

CONCLUSIONS

This study has demonstrated that leisure time physical activity has a moderate effect on BMI. However, not even a high level of leisure time physical activity was sufficient to prevent weight gain and BMI increase in all subgroups of the study population.