Abstract
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.
Highlights
Having rapidly increased over the past few decades, the worldwide prevalences of obesity and overweight in 2013 were reportedly 36.9% in men and 38.0% in women[1]
Another study reported that proportions of women who perceive themselves as overweight and are trying to lose weight are higher in women residing in Asian countries, compared to Western countries, in all body mass index (BMI) deciles, especially women in lower BMI deciles[11]
Discrepancies were discovered between actual weight status based on BMI and weight perceptions. 12.8% of normal weight women perceived that they were underweight, and 15.2% and 2.7% of them perceived that they were overweight and obese, respectively. 43.0% and 1.4% of overweight women perceived themselves as having the correct weight and being underweight; 2.4% of them perceived that they were obese. 17.0% and 0.4% of obese women perceived themselves as having the correct weight and being underweight, respectively. 22.8% of normal weight women had tried to lose weight during the last 12 months, which increased to 34.5% in overweight women and to 41.3% in obese women
Summary
Having rapidly increased over the past few decades, the worldwide prevalences of obesity and overweight in 2013 were reportedly 36.9% in men and 38.0% in women[1]. Negative effects of misperceived body weight status on weight control behaviors, have been reported People who perceived their weight status inaccurately were more likely to engage in extreme or unhealthy weight management practices, and this was more prominent in normal/underweight women who perceived themselves as overweight[8,13,14]. In Asian countries, where rapidly rising trends of obesity have been observed due to rapid urbanization followed by lifestyle changes including decreased physical activity and an increasingly energy-dense diet[17], the proportion of individuals who perceive themselves as overweight is reportedly much higher than that of individuals who are overweight[18], suggesting more distorted body weight perceptions. In this study, we aimed to investigate associations among self-perceived weight status, accuracy of weight perceptions based on BMI calculated from self-reported height and weight, and weight control behaviors, including both healthy and unhealthy behaviors, in a large, nationally representative sample from Korea
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