Abstract
BackgroundFew studies have examined the association between weight perception and socioeconomic status (SES) in sub-Saharan Africa, and none made this association based on education, occupation and income simultaneously.MethodsBased on a population-based survey (n = 1255) in the Seychelles, weight and height were measured and self-perception of one's own body weight, education, occupation, and income were assessed by a questionnaire. Individuals were considered to have appropriate weight perception when their self-perceived weight matched their actual body weight.ResultsThe prevalence of overweight and obesity was 35% and 28%, respectively. Multivariate analysis among overweight/obese persons showed that appropriate weight perception was directly associated with actual weight, education, occupation and income, and that it was more frequent among women than among men. In a model using all three SES indicators together, only education (OR = 2.5; 95% CI: 1.3-4.8) and occupation (OR = 2.3; 95% CI: 1.2-4.5) were independently associated with appropriate perception of being overweight. The OR reached 6.9 [95% CI: 3.4-14.1] when comparing the highest vs. lowest categories of SES based on a score including all SES indicators and 6.1 [95% CI: 3.0-12.1] for a score based on education and occupation.ConclusionsAppropriately perceiving one's weight as too high was associated with different SES indicators, female sex and being actually overweight. These findings suggest means and targets for clinical and population-based interventions for weight control. Further studies should examine whether these differences in weight perception underlie differences in cognitive skills, healthy weight norms, or body size ideals.
Highlights
Few studies have examined the association between weight perception and socioeconomic status (SES) in sub-Saharan Africa, and none made this association based on education, occupation and income simultaneously
We examined the association between one’s own weight perception and SES indicators in individuals randomly selected from the population in a rapidly developing country in sub-Saharan Africa, and whether this association differed based on education, occupation, and income
The proportions of persons in the highest SES category were 25% based on education, 17% based on occupation, 10% based on income, 32% based on any of the three indicators and only 5% based on all three indicators
Summary
Few studies have examined the association between weight perception and socioeconomic status (SES) in sub-Saharan Africa, and none made this association based on education, occupation and income simultaneously. While the relationship between weight perception and SES has been assessed in several Western countries [1,2,3,5,9], few such studies have been conducted in sub-Saharan Africa [10,12,13,14]. The existing literature in both Western countries and Africa indicates that appropriate perception of one’s own weight is more frequent in high than low SES individuals [1,2,3,5,9,14]. The situation in the Seychelles, a middle-income country, provides an interesting case study as the association between obesity and SES is direct in men, but inverse in women [17]. Obesity tends to be more prevalent among both men and women of low SES in developed countries [18]
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