Association between body shape misperception and unhealthy eating behaviors among Korean adolescents

BACKGROUND/OBJECTIVES

Body shape misperception (BSM) is the disagreement between the subjectively perceived body size and body mass index. This study investigated the association between BSM and unhealthy eating behaviors (UEB) among Korean adolescents.

SUBJECTS/METHODS

This cross-sectional study used data from the 2019 Korea Youth Risk Behavior Web-based Survey with 55,748 participants. UEB were measured according to the weekly consumption frequency of caffeinated energy drinks, fast food, carbonated beverages, and sugar-sweetened beverages. The covariates included demographic and socioeconomic characteristics and health-related factors. Multiple logistic regression analysis determined the association between BSM and UEB.

RESULTS

Among the participants, 37,607 (67.5%) reported UEB. The gap between UEB among those with BSM was the largest between the underestimated and accurately estimated groups. Participants who underestimated their body shape were likelier to engage in UEB (adjusted odds ratio [AOR], 1.18; 95% confidence interval [CI], 1.11-1.25). Both sexes with underestimation of body size showed an association with UEB compared to those with accurate estimations (girls: AOR, 1.19; 95% CI, 1.09-1.30; boys: AOR, 1.16; 95% CI, 1.08-1.26).

CONCLUSIONS

Underestimating body shape can provoke UEB among Korean adolescents. The need for appropriate school health interventional programs to prevent underestimating body shape is emphasized to avoid UEB.

Weight changes and the incidence of depressive symptom in the middle-aged and older adults: findings from the Chinese nationwide cohort study

BACKGROUND

Previous studies, predominantly in Western individuals, have reported weight gain or weight loss are related to the increased depressive symptoms at all ages, but no study of depressive symptoms has examined its relation to actual (not just self-reported) weight changes in the middle-aged and older adults. Evidence of the relationship in older Asian individuals remains sparse. The study aimed to examine the relationship between weight changes and incidence of depressive symptoms in a nationally representative sample of community-dwelling older Asians.

METHOD

Data were obtained from the China Health and Retirement Longitudinal Study (CHARLS), which included 17,284 adults aged 45 years. Participants were followed every two years using a face-to-face, computer-aided personal interview (CAPI) and structured questionnaire. We excluded participants with no follow-up data. The numbers of individuals who completed both the baseline and follow-up surveys were 3118 for the short-term (two years from 2011-2013) and the long-term (four years from 2011-2015). Additionally, to associate weight change with subsequent depressive symptoms, we also included 2472 participants without depressive symptom in 2013 and observed the incidence of depressive symptom in 2015 (subsequent term from 2013-2015). Finally, weight changes were classified as loss > -3%, stable-3-3%, gain3-6%, gain6-9%, and gain > 9%. Multivariable-adjusted cox regression in the study were used to assess the hazard ratios (HRs) of each weight change category.

RESULTS

The incidence of depressive symptoms was 20.72% in the 2011-2013, 27.04% in the 2011-2015, and 23.02% in 2013-2015. Weight loss > 3% for all intervals was associated with higher depressive symptoms than stable weight during the 2011-2013 [1.305(1.031,1.651)] among the total populations. When stratified by sex, the results in males and females were different from those in the total population [females:1.389(0.997, 1.935); males:1.263(0.902, 1.767)]. Weight loss > 3% for intervals was associated with higher depressive symptoms than stable weight during the 2013-2015[1.643(1.140, 2.368)] among the males and its effect was also stronger for the total in 2011-2013. Moreover, there was no significant association between weight gain and incident depressive symptom, and no significant interaction effect in terms of the sex*weight changes.

CONCLUSION

Our findings could inform health promotion interventions to body-weight management aimed at improving the health of the middle-aged and older adults, particularly in the total people with short-term weight loss and males with subsequent term weight loss.

The Interaction Effects of Age and Body Size on Body Appreciation and Health- Related Behaviors

Whilst the associations among age, body size, body (dis)satisfaction, and weight management behavior have been well documented, there is little research on how the combination of age and body size is related to body appreciation and health-related behavioral intentions. The purpose of this study is to identify the associations of age, body size, and their interactions with body appreciation and health-related behavioral intentions among Korean women. A cross-sectional research design was adopted with a convenience sampling method. Using an online survey questionnaire, complete data on body appreciation, health-related behavioral intentions, body size, height, weight, and age were collected from 531 Korean adult women aged 20-77 years. Using average scores for each variable, a series of hierarchical regression analyses were performed to identify the relative contributions of predictor variables on each criterion variable. The significant interaction terms were further examined using the PROCESS macro in SPSS. Overall, older Korean women were found to be more likely to have a positive body image and lower levels of behavioral intentions towards striving for a healthy body than younger women. This study confirmed the relative contribution of subjective body size in explaining women's body-related perceptions and behaviors, as compared to their actual BMI.

The effects of acculturation and environment on lifestyle behaviors in Korean immigrants: the mediating role of acculturative stress and body image discrepancy

OBJECTIVES

Despite high rates of cardiometabolic diseases in Korean immigrants (KIs), little is known about cultural and environmental factors contributing to lifestyle behaviors. The purpose of this cross-sectional study was to examine the relationships among acculturation, environment, and lifestyle behaviors (dietary behavior, physical activity, and sedentary behavior) through culturally sensitive psychological mediators, body image discrepancy and acculturative stress in middle-aged KIs.

DESIGN

A cross-sectional study was conducted. KIs aged 30-65 years were recruited online and at Korean community centers and churches in the Northeastern US Participants completed validated measures of dietary behavior (the Nutrition Subscale of the Health Promoting Lifestyle Profile (HPLP) II), physical activity (the International Physical Activity Questionnaire (IPAQ) - short form), and sedentary behavior (the Sedentary Behavior Questionnaire). Acculturative stress was measured by the Acculturative Stress Index and body image discrepancy was measured by the Stunkard Figure Rating Scale. Acculturation was defined as a latent variable measured by Korean and American orientation (Vancouver Index of Acculturation), age of immigration to the US, length of residency in the US, and English proficiency. Data were analyzed with structural equation modeling (SEM).

RESULTS

The sample included 361 KIs (mean age = 41.77 ±10.28 years, 48.1% female, and 46.4% overweight or obese). In the SEM model, acculturation had significant indirect effects on dietary behavior, physical activity, and sedentary behavior through body image discrepancy. Acculturative stress mediated the relationship between acculturation and sedentary behavior. Greater environmental support for physical activity and better healthy food accessibility were related to higher levels of physical activity and healthier dietary behavior, respectively.

CONCLUSION

In our study, acculturation and environmental support for physical activity and healthy food simultaneously influenced KIs' lifestyle behaviors. Addressing an unhealthy body image and acculturative stress may be additional strategies for lifestyle intervention programs to prevent cardiometabolic diseases in KIs.

Is food environment associated with body mass index, overweight and obesity? A study with adults and elderly subjects from southern Brazil

•

Proximity to food establishments had few associations with body mass index.

•

Living near a street fair was associated with a higher body mass index.

•

Living near a convenience store was associated with a higher body mass index.

•

Living near a restaurant was associated with lower body mass index.

•

Living near a fruit shop was associated with lower body mass index.

The purpose of this article was to investigate the association of food environment variables with Body Mass Index (BMI), excess weight and obesity. This was a cross-sectional study determining the presence or absence of food establishments within a 100-m buffer zone from each sampled household. Individuals aged 18 years and older living in the urban area of Rio Grande, RS State, Brazil, in 2016, were considered eligible. A total of 1,139 individuals, with an average age of 46.5 years (SD 17.1), residing in the household for more than one year, were selected as a representative sample of the population. The mean BMI of study participants was 27.0 kg/m² (SD 4.8), and the prevalence of excess weight and obesity was 61.6% (95%CI: 58.9; 64.3) and 23.7% (95%CI: 21.3; 26.1), respectively. Living near a convenience store was associated with a higher BMI and a higher likelihood of being above normal weight and obese. In contrast, living near a restaurant was associated with a lower BMI and a lower likelihood of being above normal weight and obese. In addition, participants who lived close to fruit shops had lower BMI and a lower likelihood of being above normal weight. Concluding few associations were found between food environment and the health-related outcomes. Proximity to food establishments does not seem to significantly affect BMI, excess weight and obesity in the studied population.

Association of depression and obesity is mediated by weight perception

This study investigates whether the association between obesity and depression is mediated by the perception of body weight and verifies the combined effect of being obese and having a self-perception of being fat on depression in a population-based sample of 1238 individuals. Weight perception mediated the association between depression and obesity in 39.3 percent of participants. In stratified analysis, mediation occurred in the following groups: non-single, those with more schooling, non-alcohol abusers, non-smokers, and those who did not engage in physical activity. Being obese and having a self-perception of being fat produced a potentiating effect, significantly increasing the likelihood of depression.

Weight underestimation linked to anxiety and depression in a cross-sectional study of overweight individuals in a Sami and non-Sami Norwegian population: the SAMINOR Study

OBJECTIVES

Underestimation of overweight/obesity may prevent weight loss attempts, resulting in further weight gain and maintenance of overweight. Mental health benefits may nevertheless surpass negative consequences. Our main objective was to study the association between underestimation of overweight/obesity and symptoms of anxiety and depression in Sami and non-Sami populations.

DESIGN

Population-based cross-sectional study.

SETTING

The SAMINOR 2 Clinical Study with participants from 10 municipalities in Northern Norway enrolled between 2012 and 2014.

PARTICIPANTS

The study included 3266 adults of multiethnic rural origin with overweight/obesity (body mass index (BMI) ≥25 kg/m²) whereof 1384 underestimated their weight (42%).

PRIMARY AND SECONDARY OUTCOME MEASURES

Primary outcome measure was symptoms of anxiety and depression and secondary outcome measures were BMI and the demographic variables: sex, age, education and marital status.

RESULTS

A higher proportion of Sami men compared with non-Sami men were obese, and reported more symptoms of anxiety and depression. More men than women, and a higher proportion of Sami women compared with non-Sami women, underestimated their weight. Multivariable-adjusted analyses showed that women were less likely to underestimate their weight compared with men (OR 0.43, 95% CI 0.33 to 0.55 in Sami and OR 0.33, 95% CI 0.26 to 0.42 in non-Sami), higher BMI was protective against weight underestimation (OR 0.72, 95% CI 0.69 to 0.75 in Sami and OR 0.63, 95% CI 0.60 to 0.67 in non-Sami), slightly higher odds of weight underestimation were observed with increasing age in both ethnic groups (OR 1.03, 95% CI 1.01 to 1.05 in Sami and OR 1.02, 95% CI 1.00 to 1.03 in non-Sami), while higher education lowered the odds in non-Sami (OR 0.69, 95% CI 0.55 to 0.87). Weight underestimation was protectively associated with anxiety and depression in Sami men (OR 0.48, 95% CI 0.27 to 0.84) and in non-Sami women (OR 0.44, 95% CI 0.25 to 0.78) adjusted for age, BMI, education and marital status.

CONCLUSIONS

Independent of ethnicity, more men than women underestimated their weight. Underestimation of weight was protectively associated with anxiety and depression in Sami men and non-Sami women.

Does perceived overweight increase risk of depressive symptoms and suicidality beyond objective weight status? A systematic review and meta-analysis

Obesity is associated with a significant disease burden, but whether recognising as opposed to failing to recognise personal overweight is beneficial or detrimental to mental health is unclear. Here we examine the associations between perceived overweight and depressive symptoms and suicidality. A systematic search of three electronic databases yielded 10,398 unique records, from which 32 studies (110 observations) were eligible for inclusion. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated for each outcome using random effects meta-analyses and potential publication bias was examined. Perceived overweight was associated with an increased risk of depressive symptoms (OR: 1.42, CI: 1.31, 1.54 p <.0001, N >128,585) and suicidality (OR: 1.41, CI: 1.28, 1.56, p <.0001, N = 133,576) in both cross-sectional and longitudinal studies. The association between perceived overweight and poorer mental health was observed irrespective of study origin, participant age (children vs. adults), gender, and whether or not a person was objectively overweight. The pooled statistical relationship between objective weight status and poorer mental health was attenuated to non-significance when perceived overweight was accounted for, suggesting that the detrimental effect of overweight on mental health is largely dependent on whether or not a person identifies as overweight.

Weight control behaviors according to body weight status and accuracy of weight perceptions among Korean women: a nationwide population-based survey

This study aimed to identify associations among self-perceived weight status, accuracy of weight perceptions, and weight control behaviors, including both healthy and unhealthy behaviors, in a large, nationally representative sample from an East Asian country. Data were collected from the 2016 Korean Study of Women's Health Related Issues, a population-based, nationwide survey. Accurate weight perceptions were investigated by comparing body mass index (BMI) categories, based on self-reported height and weight, and weight perceptions. Weight control behaviors over the previous 12 months were additionally surveyed. Odds ratios (ORs) and 95% confidence intervals (CIs) are presented as an index of associations. Among normal weight, overweight, and obese women, 12.8%, 44.3%, and 17.4% under-assessed their weight; 17.9% of normal weight women over-assessed their weight. Both weight status according to BMI category and weight perceptions were strongly associated with having tried to lose weight. Exercise and diet (ate less) were the most commonly applied weight control behaviors. Misperception of weight was related to more unhealthy weight control behaviors and less healthy behaviors: Women who under-assessed their weight showed a lower tendency to engage in dieting (OR = 0.57, 95% CI = 0.43-0.75) and a greater tendency to fast/skip meals (OR = 1.47, 95% CI = 1.07-1.99). Meanwhile, normal weight or overweight women who over-assessed their weight were more likely to have engaged in fasting/skipping meals or using diet pills (OR = 5.72, 95% CI = 2.45-13.56 for fasting/skipping meal in overweight women; OR = 1.62, 95% CI = 1.15-2.29 and OR = 3.16, 95% CI = 1.15-8.23 for using diet pills in normal and overweight women). Inaccuracy of weight perceptions in any direction (over/under) were related to more unhealthy weight control behaviors and less healthy weight control behaviors, especially in normal and overweight women.

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.

A systematic review of the relationship between weight status perceptions and weight loss attempts, strategies, behaviours and outcomes

It is commonly assumed that a person identifying that they are 'overweight' is an important prerequisite to successful weight management. However, there has been no systematic evaluation of evidence supporting this proposition. The aim of the present research was to systematically review evidence on the relationship between perceived overweight and (i) weight loss attempts, (ii) weight control strategies (healthy and unhealthy), (iii) weight-related behaviours (physical activity and eating habits), (iv) disordered eating and (v) weight change. We synthesized evidence from 78 eligible studies and evaluated evidence linking perceived overweight with outcome variables separately according to the gender, age and objective weight status of study participants. Results indicated that perceived overweight was associated with an increased likelihood of attempting weight loss and with healthy and unhealthy weight control strategies in some participant groups. However, perceived overweight was not reliably associated with physical activity or healthy eating and was associated with greater disordered eating in some groups. Rather than being associated with improved weight management, there was consistent evidence that perceived overweight was predictive of increased weight gain over time. Individuals who perceive their weight status as overweight are more likely to report attempting weight loss but over time gain more weight.

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.

Nutritional status, weight perception and weight control practices among office employees in Sokoto, Nigeria

INTRODUCTION

Overweight and obesity have become the fifth leading risk for global deaths. Office employees have been identified as a high risk group due to the sedentary nature of their work, and accurate weight perception is believed to be critical to acceptance of weight control interventions. This study was conducted to assess the nutritional status, weight perception and weight control practices of office employees in Sokoto, Nigeria.

METHODS

A cross sectional study was conducted among 285 randomly selected office employees in private establishments in Sokoto, Nigeria, in February and March 2013. Anthropometry was done for the participants in addition to questionnaire administration.

RESULTS

The mean age of the participants was 33.08 ± 7.23 years, they were predominantly males (56.5%) and married (57.5%). None was underweight, 111 (38.9%) had normal weight, 105 (36.8%) were overweight and 69 (24.2%) were obese. Among the participants with normal weight, overweight and obesity, 71.2%, 35.2% and 58.0% respectively accurately perceived their weight; while 28.8%, 50.5% and 30.4% respectively underestimated their weight. There was poor agreement between actual and perceived weight (k statistics = 0.341, p < 0.001). Only 67 (23.5%) of the 285 participants were engaged in weight control practices.

CONCLUSION

This study showed high prevalence of overweight and obesity, weight misperceptions, and poor uptake of weight control practices among office employees in Sokoto, Nigeria. These findings underscore the need for a holistic approach to obesity control interventions that encompasses both body image perception and nutritional assessment.

Association between body size, weight change and depression: systematic review and meta-analysis

BackgroundThe association between body size, weight change and depression has not been systematically summarised, especially for individuals who are underweight.AimsTo conduct a systematic review and a meta-analysis to examine the association between indices of body size, weight change and depression.MethodA total of 183 studies were selected. Fully adjusted hazard ratios (HRs) or odds ratios (ORs) were extracted. A total of 76 studies contributed to data synthesis with a random-effect model, and subgroup analyses were conducted to evaluate the effect of potential moderators.ResultsIn cohort studies, underweight at baseline increased the risk of subsequent depression (OR = 1.16, 95% CI 1.08-1.24). Overweight (BMI 25-29.9 kg/m²) showed no statistically significant relationship with depression overall; however, the subgroup analyses found different results according to gender (men: OR = 0.84, 95% CI 0.72-0.97, women: OR = 1.16, 95% CI 1.07-1.25). In cross-sectional designs, obesity with BMI >40 kg/m² showed a greater pooled odds ratio than obesity with BMI >30 kg/m²ConclusionsBoth underweight and obesity increase the risk of depression. The association between overweight and depression differs by gender.

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

With society's increasing interest in weight control and body weight, we investigated the association between psychological factors and body image misperception in different age groups of adult Korean women with a normal weight. On a total of 4,600 women from the Korea National Health and Nutrition Examination Survey 2007-2009, a self-report questionnaire was used to assess body weight perception and 3 psychological factors: self-rated health status, stress recognition, and depressed mood. Through logistic regression analysis, a poor self-rated health status (P = 0.001) and a higher recognition of stress (P = 0.001) were significantly associated with body image misperception and this significance remained after controlling for several sociodemographic (Model 1: adjusted odds ratio [aOR], 1.62; 95% confidence interval [CI], 1.31-2.00), health behavior and psychological factors (Model 2: aOR, 1.59; 95% CI, 1.29-1.96; Model 3: aOR, 1.36; 95% CI, 1.01-1.84). Especially, highly stressed middle-aged (50-64 yr) women were more likely to have body image misperception (Model 2: aOR, 2.85; 95% CI, 1.30-6.26). However, the correlation between depressed mood and self-reported body weight was inconsistent between different age groups. In conclusion, self-rated health status and a high recognition rate of severe stress were related to body weight misperception which could suggest tailored intervention to adult women especially women in younger age or low self-rated health status or a high recognition rate of severe stress.

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.

Interaction Effect between Weight Perception and Comorbidities on Weight Control Behavior in Overweight and Obese Adults: Is There a Sex Difference?

We investigated the interaction effect between body weight perception and chronic disease comorbidities on body weight control behavior in overweight/obese Korean adults. We analyzed data from 9,138 overweight/obese adults ≥20 yr of age from a nationally representative cross-sectional survey. Multiple logistic regression using an interaction model was performed to estimate the effect of chronic disease comorbidities on weight control behavior regarding weight perception. Adjusted odds ratios for weight control behavior tended to increase significantly with an increasing number of comorbidities in men regardless of weight perception (P<0.05 for trend), suggesting no interaction. Unlike women who perceived their weight accurately, women who under-perceived their weight did not show significant improvements in weight control behavior even with an increasing number of comorbidities. Thus, a significant interaction between weight perception and comorbidities was found only in women (P=0.031 for interaction). The effect of the relationship between accurate weight perception and chronic disease comorbidities on weight control behavior varied by sex. Improving awareness of body image is particularly necessary for overweight and obese women to prevent complications.

The combined effect of subjective body image and body mass index (distorted body weight perception) on suicidal ideation

Objectives:

Mental health disorders and suicide are an important and growing public health concern in Korea. Evidence has shown that both globally and in Korea, obesity is associated with an increased risk of developing some psychiatric disorders. Therefore, we examined the association between distorted body weight perception (BWP) and suicidal ideation.

Methods:

Data were obtained from the 2007-2012 Korea National Health and Nutritional Evaluation Survey (KNHANES), an annual cross-sectional nationwide survey that included 14 276 men and 19 428 women. Multiple logistic regression analyses were conducted to investigate the associations between nine BWP categories, which combined body image (BI) and body mass index (BMI) categories, and suicidal ideation. Moreover, the fitness of our models was verified using the Akaike information criterion.

Results:

Consistent with previous studies, suicidal ideation was associated with marital status, household income, education level, and perceived health status in both genders. Only women were significantly more likely to have distorted BWP; there was no relationship among men. In category B1 (low BMI and normal BI), women (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.48 to 3.42) were more likely to express suicidal ideation than women in category B2 (normal BMI and normal BI) were. Women in overweight BWP category C2 (normal BMI and fat BI) also had an increased OR for suicidal ideation (OR, 2.25; 95% CI, 1.48 to 3.42). Those in normal BWP categories were not likely to have suicidal ideation. Among women in the underweight BWP categories, only the OR for those in category A2 (normal BMI and thin BI) was significant (OR, 1.34; 95% CI, 1.13 to 1.59).

Conclusions:

Distorted BWP should be considered an important factor in the prevention of suicide and for the improvement of mental health among Korean adults, especially Korean women with distorted BWPs.

Body mass index and depressive symptoms in middle aged and older adults

Background

The relationship between weight problems and depression has been the focus of many studies; however, results from these studies vary. The purpose of this study is to describe the association between depression and BMI using data from a national sample of middle aged and older Koreans and to examine whether gender moderates the relationship between depression and weight.

Methods

We used data from the Korean Longitudinal Study of Aging (KLoSA). Of the 7,920 respondents that participated in KLoSA in 2010, 7,672 adults aged between 50 and 102 years were included in the final analysis. The relationship between depression and obesity status was examined in both the full sample and in sub-samples stratified by gender. The observed U-shaped association between obesity status and CES-D score was tested by regressing CES-D score on linear and quadratic terms of BMI scores.

Results

The distribution of CES-D scores by respondents’ obesity status (i.e., underweight, normal weight, overweight, obese and severely obese) showed a U-shaped association. Specifically, the highest CES-D scores were found in underweight individuals; this was followed by the severely obese and obese groups in the full sample and in gender-specific subsamples. The lowest CES-D scores were found in the overweight group when considering the entire population and males alone and in the normal weight group for females. This U-shaped association between CES-D and obesity status was confirmed by a model in which CES-D scores were regressed on BMI scores and other covariates.

Conclusions

This study found a U-shaped association between BMI and levels of depressive symptoms among adults in Korea overall and also within each gender. Specifically, the highest level of depressive symptoms was found among the underweight, followed by the severely obese and then the obese. Slightly different patterns between male and female adults were found regarding the weight status associated with the fewest depressive symptoms.

Nurses' misperceptions of weight status associated with their body weight, demographics and health status

OBJECTIVE

To assess the agreement between self-perceived weight status and BMI status, calculated from self-reported height and weight, in nurses and to evaluate the relationship between weight status misperceptions and personal body weight, demographics and health status.

DESIGN

Cross-sectional questionnaire survey.

SETTING

A large university in London, UK.

SUBJECTS

Four hundred and fifty-six student nurses and 588 qualified nurses attending university were surveyed; 355 student nurses and 409 qualified nurses completed questionnaires representing a response rate of 78 % and 70 %, respectively.

RESULTS

The respondents were mainly female (90·0 %), 66·5 % were white and their mean age was 31 years. Sixty-eight per cent of qualified nurses and 77 % of student nurses correctly perceived their weight status. In logistic regression, (mixed) black ethnicity (OR = 2·53, 95 % CI 1·01, 6·32), overweight by BMI (OR = 3·10, 95 % CI 1·31, 7·33) and ≥3 family histories of obesity co-morbidities (OR = 2·51, 95 % CI 1·04, 6·08) were significantly associated with misperceptions in the sample of student nurses, whereas overweight by BMI (OR = 5·32, 95 % CI 2·66, 10·67) was the only significant variable in the sample of qualified nurses.

CONCLUSIONS

A substantial proportion of nurses misclassified their weight status. Nurses' misperception of weight status was related to their own BMI status, ethnic background and obesity-related family histories. Being aware of this may help nurses not only promote their own healthy weight, but also fulfil their public health role to practise weight management successfully with both patients and the public. While limitations of the sample mean that the study findings cannot be generalized, they do provide grounds for future larger-scale research.

Body mass index and weight loss in overweight and obese korean women: the mediating role of body weight perception

PURPOSE

This study were to assess the relationships among BMI, body weight perception, and efforts to lose weight in a public sample of Korean women who are overweight and obese and to examine the mediating role of body weight perception on the relationship between BMI and weight loss efforts.

METHODS

This cross-sectional study used data from the 2008 Korea National Health and Nutrition Examination Survey. The sample was 1,739 Korean women 20 years old or older with body mass index (BMI) ≥ 23 kg/m(2). Bivariate relationships among variables of interests were assessed. Three separate regressions were used to test the mediating role of body weight perception on the relationship between BMI and weight loss efforts.

RESULTS

BMI and body weight perception were significant correlates of weight loss efforts. BMI was significantly associated with weight perception, but a large proportion of women underestimated their weight. Weight perception partially mediated the relationship between BMI and weight loss efforts in Korean women.

CONCLUSION

In light of the high prevalence of overweight or obesity and the many health consequences associated with obesity, Korean women should be aware of a healthy body weight and try to achieve that weight. Nursing interventions should consider body weight perception to effectively motivate overweight and obese Korean women to lose weight, as necessary.

Gender differences in the associations among body mass index, weight loss, exercise, and drinking among college students

OBJECTIVE

To explore gender differences regarding weight management behaviors of college drinkers.

PARTICIPANTS

Nationally representative sample of college students from the fall 2008 American College Health Association's National College Health Assessment II (N = 26,062 students).

METHODS

Structural equation modeling was used to examine potential gender differences in associations among exercise, weight loss behaviors, and alcohol use.

RESULTS

Critical ratio tests revealed that associations between exercise and weight loss behaviors were more strongly correlated among females as compared with males. For females, there was a small negative association between exercise and drinking behaviors; in contrast, for males, there was a positive relationship between exercise and alcohol use. Weight loss behaviors were positively associated with drinking for both female and male students; however, the association was significantly stronger for females.

CONCLUSIONS

This investigation furthers previous research on drunkorexia and also sheds additional light on the gender-based differences in weight management behaviors of drinkers.

The role of differences in individual and community attributes in perceived air quality

Most epidemiological studies on the adverse effects of air pollution on health have focused on scientific measurements of air quality provided by monitoring stations. However, many studies have indicated that self-reported health status, such as disease severity and depressive symptoms, are associated with perceived air pollution rather than measured air pollution. The main goal of this study was to investigate social factors that may affect perceived local air quality using a multilevel analysis among a Korean population. We used the Seoul Citizens Health Indicator Survey (SCHIS III) and five air pollutants. The total study population was 16,041. We considered individual-level and community-level variables that may affect perceived air quality, such as the percentage of college-educated individuals aged >20 years, satisfaction with public transportation, and the percentage of individuals below the poverty line. Measured air quality showed a negative or neutral relationship with perceived air quality. We found that the degree of perceived air pollution was associated with younger age (20-34 years; OR=1.40, 95% CI=1.18-1.65), married and divorced/separated/widowed people, a higher level of education (>17 years; OR=1.67, 95% CI=1.30-2.15), and lower household income. Communities that were more economically deprived were associated with poor perceived air quality. Differences in individual and community characteristics affected perceived air quality. Perception is a key factor influencing the public acceptance of environmental policy. This study may help policymakers understand the social distribution of environmental awareness.

Body weight perception among high school students and its influence on weight management behaviors in normal weight students: a cross-sectional study

AIM

This study investigates body weight perception and its influence on weight management behaviors in normal weight adolescents in Timis County, Romania. We hypothesized that misperception of overweight in normal weight adolescents would be positively associated with unhealthy weight control behaviors.

METHODS

From 2908 respondents participating in the survey we selected a total of 2093 normal weight high school students for the analysis. Outcome measures included self-reported height and weight measurements, overweight misperceptions and weight control behaviors. Weighted prevalence estimates and odds ratios were computed.

RESULTS

There were 22.64% of normal weight students who perceived themselves as overweight. Females (36.48%) were more likely to perceive themselves as overweight than males (8.15%) (P < 0.0001). After adjusting for age and gender, students who perceived themselves as overweight were more likely to exercise (OR = 2.85; 95% CI: 2.25-3.61), eat less food, fewer calories or low fat foods (OR = 3.54; 95% CI: 2.78-4.51), fast for 24 hours or more (OR = 1.79; 95% CI: 1.28-2.49), take diet pills, powders or tea (OR = 3.93; 95% CI: 2.62-5.89), vomit or take laxatives (OR = 1.96; 95% CI: 1.15-3.34) to lose weight or to keep from gaining weight, compared to students who did not perceive themselves as overweight.

CONCLUSION

A significant proportion of normal weight high school students misperceive themselves as overweight and are engaging in unhealthy weight management behaviors. These results should be considered when establishing prevention programs and educational components that address weight misperceptions and the harmful effects of unhealthy weight control methods should be performed even among normal weight adolescents.