Abstract
BackgroundIndividuals’ self-perceptions of weight often differ from objective measurements of body fat. This study aimed to 1) measure agreement between self-perceptions of weight and objective measurement of body fat by bioelectric impedance analysis (BIA) among Peruvian adults; and 2) quantify the association between body fat and a) baseline self-perceptions of weight and b) whether a participant underestimated their weight status.MethodsLongitudinal data from the CRONICAS Cohort Study of 3181 Peruvian adults aged 35-years and older were used. BIA measurements of body fat were categorized across four nominal descriptions: low weight, normal, overweight, and obese. Kappa statistics were estimated to compare BIA measurements with baseline self-perceptions of weight. To quantify the association between body fat over time with both baseline self-perceptions of weight and underestimation of weight status, random effects models, controlling for socioeconomic and demographic covariates, were employed.ResultsOf the 3181 participants, 1111 (34.9%) were overweight and 649 (20.4%) were obese at baseline. Agreement between self-perceived and BIA weight status was found among 43.1% of participants, while 49.9% underestimated and 6.9% overestimated their weight status. Weighted kappa statistics ranged from 0.20 to 0.31 across settings, suggesting poor agreement. Compared to perceiving oneself as normal, perceiving oneself as underweight, overweight, or obese was associated with − 4.1 (p < 0.001), + 5.2 (p < 0.001), and + 8.1 (p < 0.001) body fat percentage points, respectively. Underestimating one’s weight status was associated with having 2.4 (p < 0.001) body fat percentage points more than those not underestimating only after adjusting for demographic and socioeconomic covariates.ConclusionsHalf of study participants were overweight or obese. There was poor agreement between self-perceptions of weight with BIA measurements of body fat, indicating that individuals often believe they weigh less than they actually do. Underestimating one’s weight status was associated with having more body fat percentage points, but was only statistically significant after adjusting for demographic and socioeconomic characteristics. Further research should be conducted to investigate how self-perceptions of weight can support clinical and public health interventions to curb the obesity epidemic.
Highlights
Individuals’ self-perceptions of weight often differ from objective measurements of body fat
Cohort Study included Peruvian adults living in four regions that varied in urbanicity and altitude: highly urbanized Lima, urban and rural Puno, and semi-urban Tumbes [16]
The prevalence of being overweight or obese was lower among participants who were 65-years-old or older
Summary
Individuals’ self-perceptions of weight often differ from objective measurements of body fat. Poor self-perception of weight is associated with psychological stress [3], body image issues [4], and risk factors for poor health including poor diet, smoking, and alcohol consumption [5]. Through these mechanisms, self-perception of weight likely influences an individual’s health, and, in particular, objective measurement of his or her weight. Self-perception of weight may influence lifestyle factors that can result in changes in body fat over time. Exploring how self-perceptions of weight relate to reality may help frame the way clinicians and public health leaders think about interventions to curb obesity
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