The Association between Body Weight Misperception and Psychosocial Factors in Korean Adult Women Less than 65 Years Old with Normal Weight

Association between Weight Status and Mental Health among Korean Adolescents: A Nationwide Cross-Sectional Study

This study explored the relationship between adolescents’ weight status and mental health problems. It specifically investigated the weight perceptions of obese adolescents and the effect on their mental health. This cross-sectional study was based on the data of adolescents aged 12–18 years from the Korean National Health and Nutritional Examination Survey (2010–2019). Data regarding anthropometric measurements, health conditions, and socioeconomic status were extracted, and the associations between weight status (actual, perceived, or misperceived) and mental health conditions (depressed mood, perceived stress, and suicidal ideation) were analyzed using complex sample multiple logistic regression after adjusting for possible confounders. A total of 5683 adolescents (53.1% boys and 46.9% girls) were included in this study, with a mean age of 15.1 years. Among the participants, actual, perceived, and misperceived status of being overweight were observed in 20.8%, 32.7%, and 18.4%, respectively. Additionally, depressed mood, perceived stress, and suicidal ideation were observed in 9.1%, 25.7%, and 7.4% of Korean adolescents, respectively, with higher prevalences in girls for all three conditions. Actual weight status was not significantly associated with mental health conditions in either sex. Furthermore, girls who perceived themselves to be overweight, regardless of their actual body weight, or who had overestimated their actual weight were more likely to have experienced depressed mood and stress, while boys who perceived themselves to be underweight were more likely to have experienced suicidal ideation than participants with an average weight perception or an accurate recognition of their weight status. Conversely, in overweight/obese participants, perceived weight status was not associated with mental health conditions. In conclusion, perceived weight status and its discrepancy with actual body weight were more strongly associated with an increased risk of mental health problems than actual weight status itself among Korean adolescents. Therefore, adolescents’ perceptions of their body image and weight-related attitude should be assessed to promote their mental health.

Sex Differences in Body Image Perception and Ideals: Analysis of Possible Determinants

The study analyzed the differences between sexes in body image perception and body ideals to assess possible dissatisfaction and misinterpretation in the body image considered attractive for the other sex. Moreover, the influence of anthropometric traits and sports practice on body dissatisfaction and misjudgment was evaluated. Using a cross-sectional design, 960 Italian university students were investigated. Anthropometric characteristics were measured directly. Assessment of body image perception was performed using Thompson and Gray’s silhouettes. We developed two new indexes to assess the possible discrepancy between (1) the perceived silhouette of one’s body and that of the same sex deemed attractive to the other sex (FAD); (2) the silhouette is deemed attractive to the opposite sex and the average attractive silhouette selected by the opposite sex (AMOAD). As expected, females showed greater dissatisfaction with their bodies than males concerning both their own ideal and the silhouette they considered attractive to the opposite sex. Although both sexes misjudged the attractive silhouette for the opposite sex, women were found to be more wrong. According to the outcomes of multivariate regression models, stature, body composition parameters, amount of sport, sex, and FAD were significant predictors of dissatisfaction and misjudgment. In addition to action aimed at correcting misperceptions, the study revealed the importance of sports participation in improving the perception and acceptance of one’s body image.

Bodyweight Misperception by Chinese American Females Influenced by Cultural and Social Ideals: Implication for Home Health Care

Bodyweight misperception results from the desire to achieve an ideal body emphasized by cultural mores and societal norms. It is sustained by the desire to be cultural compliant, especially for ethnic minority women such as Chinese American females. Through cultural beliefs, these women’s self-perceived weight status is distorted, which strengthens the impact of bodyweight misperception in their daily life as poor physical health, distressed psychosocial health, risky and unsafe health practices and behaviors, and diminished quality of life. Evidently, bodyweight misperception promotes maladaptive health behaviors. However, bodyweight misperception is barely captured in the current science about women’s health, and is minimally explored in research about Chinese American females’ desire and efforts to achieve the ideal body type. Therefore, the purpose of this literature review was to explore (1) body weight perception, (2) the factors associated with it, and (3) the negative health consequences triggered by it, in Chinese American females. Studies confirm that Chinese American females shape their body weight perception by internalized cultural ideals, acculturative stress, mass media, and social pressures. They overestimate their body weight more than underestimate it as evident by frequent weight-loss attempts. This internalized bodyweight misperception affects their physical and psychological health, with undesirable consequences on their quality of life. Home health care professionals interact closely with patients from diverse cultural backgrounds; remaining culturally sensitive is crucial in their practice. Knowledge from this literature review emphasizes the need for culturally appropriate weight management strategies for the delivery of competent home health care to Chinese American females.

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.

Associations between asthma and body weight misconceptions among South Korean adolescents: Nationwide cross-section study

Objectives: As the numbers of adolescents with asthma are increasing, appropriate recognition of the importance of body weight is necessary. This study explored body weight misconceptions and related factors in adolescent asthma patients. Methods: Web-based self-reported data from the Korean Youth Risk Behavior Web-Based Survey of 60,974 physician-diagnosed adolescents with asthma were used in this study. Self-reported questionnaires were employed to assess socioeconomic status, health behavior, and psychological factors. Multiple logistic regression after adjustment for confounding factors was used to explore body weight misconception. Results: A total of 28,771 (47.2%) respondents incorrectly classified their weight status, with 13,684 (22.5%) under-assessing and 15,087 (24.7%) over-assessing their weight. Body weight misconceptions were positively associated with middle school attendance (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.02-1.06), co-educational school attendance (OR 1.07, 95% CI 1.01-1.11), living without parents (OR 1.11, 95% CI 1.03-1.19), self-rated poor health status (OR 1.04, 95% CI 1.00-1.10), self-rated unhappiness (OR 1.15, 95% CI 1.09-1.20), moderate-to-severe stress (OR 1.14, 95% CI 1.11-1.18), depressive mood (OR 1.10, 95% CI 1.06-1.14), suicidal ideation (OR 1.09, 95% CI 1.04-1.13), and suicide attempts (OR 1.12, 95% CI 1.05-1.21); negatively associated with male gender (OR 0.86, 95% CI 0.83-0.89) and higher level academic achievement (OR 0.92, 95% CI 0.88-0.96), respectively. Conclusion: Negative psychological factors and school type were found to be associated with body weight misconceptions in adolescents with asthma. Our study shows that more efforts are needed to improve such misconceptions and to develop healthy behaviors in adolescents with asthma.

Relationship between body image and weight status in east Asian countries: comparison between South Korea and Taiwan

BACKGROUND

There are many studies examining the relationship between body image and weight status that compare Western and Asian countries. One limitation of these past studies was assuming that all Asian countries are a homogeneous group. To fill the gap in the literature, this study examined the relationship between body image and weight status between participants from two Asian countries.

METHODS

This study utilized data from the 2010 module of the East Asian Social Survey from South Korea (n = 1576) and Taiwan (n = 2199), which contained questions related to body image. Body image was originally measured using a five-point Likert-type question, which was collapsed into three categories for the analysis. Weight status was derived from body mass index scores, which were calculated using self-reported weight and height. A set of multinomial logistic regression analyses were used to investigate the relationship between body image and weight status, stratified by country.

RESULTS

A significant relationship between body image and weight status after controlling for relevant covariates was reaffirmed in this study in the South Korean and Taiwanese. Results indicated that the relationship between body image and weight status of the Taiwanese sample was similar to the relationship in the South Korean sample. However, the results from a further analysis showed that the strength of the relationship across the two Asian countries appeared to be different.

CONCLUSIONS

The weight over-perception was more evident in South Korea than in Taiwan. Females were more vulnerable to societal pressures for thinness and the misperception of the ideal body than males. Interventions to improve distorted body image perception were needed in both countries.

Body weight misperception and psychological distress among young South Korean adults: the role of physical activity

Background

Emerging evidence suggests that body weight misperception may be associated with psychological distress among people in developed countries. Participating in physical activity (PA) may negate the association between weight misperception and psychological distress given the well-known benefits of PA on psychological health. This study examined the role of PA in associations between body weight misperception and psychological distress among young South Korean adults.

Methods

Data from individuals aged 20 to 39 years who participated in the Fifth Korean National Health and Nutrition Examination Surveys 2010–2012 (N = 6055) was included in the logistic regressions.

Results

The proportions of the respondents under- and over-perceiving their body weight were 66.9% and 0.8% among men and 16.3% and 15.6% among women respectively. A moderating effect of PA participation was observed on the relationship between body weight over-perception and depressed mood (Odds Ratio [OR] = 0.55; 95% Confidence Intervals [95% CI] = 0.34, 0.89). Among individuals who did not meet the recommended vigorous-intensity PA (≥ 20 min/session and ≥ 3 day/week), body weight over-perception was associated with depressed mood (OR = 1.71, 95% CI = 1.19, 2.46) compared to the accurate-perception group. However, no association was observed among those who met the recommended vigorous-intensity PA (OR = 1.52, 95% CI = 0.45, 5.22). Similar patterns were found among physically active versus inactive individuals (recommended walking not met: OR = 2.02, 95% CI = 1.29, 3.15; recommended walking met: OR = 1.28, 95% CI = 0.66, 2.49; muscular strengthening exercises for < 2 day/week: OR = 1.74, 95% CI = 1.21, 2.51; muscular strengthening exercises for ≥ 2 day/week: OR = 1.38, 95% CI = 0.37, 5.14). No relationship existed between body weight over-perception and depressed mood after adjusting for PA.

Conclusions

Participating in regular PA may buffer a potential negative impact of body weight over-perception on depressive mood.

The impact of weight misperception on health-related quality of life in Korean adults (KNHANES 2007-2014): a community-based cross-sectional study

BACKGROUND/OBJECTIVES

Weight perception, especially misperception, might affect health-related quality of life (HRQoL); however, related research is scarce and results remain equivocal. We examined the association between HRQoL and weight misperception by comparing obesity level as measured by body mass index (BMI) and weight perception in Korean adults.

METHODS

Study subjects were 43 883 adults aged 19 years or older from cycles IV (2007-2009), V (2010-2012) and VI (2013-2014) of the Korean National Health and Nutrition Examination Survey. Multiple regression analyses comprising both logit and tobit models were conducted to evaluate the independent effect of obesity level as measured by BMI, weight perception and weight misperception on HRQoL after adjusting for demographics, socioeconomic status and number of chronic diseases. We also performed multiple regressions to explore the association between weight misperception and HRQoL stratified by BMI status.

RESULTS

Obesity level as measured by BMI and weight perception were independently associated with low HRQoL in both separate and combined analyses. Weight misperception, including underestimation and overestimation, had a significantly negative impact on HRQoL. In subgroup analysis, subjects with BMI ranges from normal to overweight who misperceived their weight also had a high risk of low HRQoL. Overestimation of weight among obese subjects associated with low HRQoL, whereas underestimation of weight showed no significant association.

CONCLUSIONS

Both obesity level as measured by BMI and perceiving weight as fat were significant risk factors for low HRQoL. Subjects who incorrectly perceived their weight relative to their BMI status were more likely to report impaired HRQoL, particularly subjects with BMI in the normal to overweight range. Based on these findings, we recommend political and clinical efforts to better inform individuals about healthy weight status and promote accurate weight perception.

Body Misperception and Its Associated Factors among Cancer Survivors in Korea

Background: As the number of cancer survivors is increasing, the importance of their healthcare management is becoming emphasized. For this purpose, appropriate recognition of the importance of body weight is necessary. This study concerned misconceptions about body weight and related factors among cancer patients. Methods: This cross-sectional study involved 1,159 participants who participated in the 2007-2012 Korean National Health and Nutrition Examination Survey. Self-reported questionnaires were used to assess cancer information, socioeconomic status, health behavior, and psychological factors. Results: Men had a higher rate of underestimation and a lower rate of overestimation of body weight than women (34.7% vs. 22.9%; 10.9% vs. 15.5%, respectively). Underestimation of body weight was positively associated with a self-assessment of being in poor health in men (OR 2.44, 95% CI 1.58- 3.75) and in elderly women (OR 3.70, 95% CI 2.44-5.23). Overestimation of body weight was positively associated with depression in men (OR 2.17, 95% CI 1.01-4.63) and a high educational level/high-income level and having tried to control weight in women (OR 1.92, 95% CI 1.16-3.18; OR 1.57, 95% CI 1.00-2.47; OR 3.24, 95% CI 1.82-5.77, respectively). Conclusions: Higher socioeconomic status (SES), depression, self-rated health status, age, and weight control trials were found to be associated with underestimation and overestimation of body weight in cancer survivors. From this study, it is evident that more efforts are needed to remove misperceptions and to develop healthy behavior for cancer survivors by various means.