Underestimation Of Weight Status Research Articles

Body Image Misperceptions Among Tunisian Adolescents.

Background Obesity is a globally recognized health concern with profound consequences for individual health, especially among adolescents. Tunisia, like many countries, is experiencing alarming rates of adolescent obesity. Understanding adolescents' perceptions of their weight status and the factors influencing these perceptions is pivotal for developing targeted interventions and policies to counteract the rising obesity trends. Objective To determine the accuracy of weight status perceptions among Tunisian adolescents compared to objective metrics and to identify sociodemographic characteristics associated with the inaccurate estimation of weight status. Methods A cross-sectional, school-based study was conducted among adolescents attending secondary schools in Sousse, Tunisia, during the 2017-2018 academic year. A total of 1399 students participated, with anthropometric measurements taken, and a pre-tested Arabic questionnaire administered to gather sociodemographic data and perceived weight status, assessed using the Figure Rating Scale (FRS). The accuracy of perceived weight status was determined by comparing the measured weight status with participants' self-reported perceptions. Results The study achieved an 86.68% response rate, with over half of the participants being female (60.5%), and the average age being 17 years. The majority of adolescents (41%) perceived themselves as having normal body weight, while 34.5% perceived themselves as underweight, 16.6% as overweight, and 7.9% as obese. However, based on BMI categories, 72.6% had a normal measured weight, 20.4% were overweight, and 6.9% were obese. A substantial proportion of participants (45.6%) underestimated their weight status, with a significant proportion being objectively overweight or obese (26%). Furthermore, we found a significant association between the perception of weight accuracy and both gender (p = 0.010) and the mother's educational level (p = 0.035). Conclusions The findings revealed a disparity between perceived and actual weight status among Tunisian adolescents, with a significant underestimation of weight status, particularly among those who are overweight or obese. The results highlighted the crucial need for interventions that address weight perception inaccuracies and promote healthy weight awareness and management among adolescents in Tunisia.

Cross-national time trends in adolescent body weight perception and the explanatory role of overweight/obesity prevalence

ABSTRACT Introduction Body weight perception (BWP) is associated with health behaviors. Current evidence points to an increase over time in both actual and perceived weight status among adolescents, however there is limited evidence on time trends in BWP in cross-national samples of adolescents. Therefore, the aims of this study were to examine time trends in BWP between 2002 and 2018 among adolescents from 41 countries and regions, including gender and country differences and to explore the role of changes over time in country-level overweight/obesity prevalence in these trends. Methods Data were used from five cycles (2002, 2006, 2010, 2014, 2018) of the repeated cross-sectional Health Behavior in School-Aged Children (HBSC) study (n = 746,121; mean±standard deviation age 13.7 ± 1.6 years, 51.0% girls). Multilevel logistic models estimated cross-national linear time trends in adolescent BWP (correct perception, underestimation, or overestimation), adjusted for gender, age, and family affluence. Next, we tested whether country-level changes over time overweight/obesity prevalence could explain these trends in BWP among adolescents. Results Correct weight perception increased over time among girls, while it decreased among boys. Underestimation of weight status increased, and overestimation of weight status decreased over time among both genders, with stronger trends for girls. Furthermore, country differences in trends in both BWP and overweight/obesity were found. Changes over time in country-level overweight/obesity prevalence could not explain these trends. Conclusion The linear increase over time in correct weight perception and the decrease in overestimation may have a positive effect on unhealthy weight reduction behaviors among adolescents. However, the increase in underestimation could signal a need for interventions to strengthen correct weight perception among adolescents. Several implications for policy and practice are discussed.

Perception of body size and body dissatisfaction in adults

Self-perception of body size seems to be not always in line with clinical definitions of normal weight, overweight and obesity according to Word Health Organization classification. The effect of self-perception of body size disturbances and body dissatisfaction may be the development of eating disorders, such as anorexia nervosa or binge eating disorder—a major risk factor of obesity development. Therefore, the study aimed to assess separately the perception of weight status and body size as well as body dissatisfaction in adults with normal weight, overweight and obesity. The study included 744 adults (452 women; 35.9 ± 12.4 years; 21 underweight, 326 normal weight, 221 overweight, 176 obese) referred to Metabolic Management Center and volunteers. Body size perception and body dissatisfaction were assessed based on Stunkards’ Figure Rating Scale (FRS). Additionally, participants’ were asked: ‘Do you think you are: underweight/normal weight/overweight/obese?’ to assess perception of weight status. Participants’ weight and height were measured to calculate body mass index (BMI) after completing the FRS. Individuals within the overweight BMI range have rated themselves as underweight (1.4%), normal weight (30.8%) and obese (2.8%). Also individuals within the obesity BMI range have rated themselves as normal weight (2.6%), and overweight (41.6%). Compatibility of self-assessment of weight status with BMI category according to the measured values was moderate—Kappa coefficient was 0.59 (95% CI: 0.54–0.64). Underestimation of weight status was significantly more common among men than women. There were statistically significant differences in the distribution of body dissatisfaction according to the weight in both women and men. Normal-weight subjects less often than overweight and obese were dissatisfied with their own body size. The degree of body dissatisfaction was greater among women than among men. Adults subjects frequently underestimate their own weight status and body size. Women with overweight and obesity more often than men are dissatisfied with their own body size.

Measured and Perceived Body Weight Status of Women in the Peruvian Amazon.

Background and objectives: The prevalence of obesity among adults has reached epidemic proportions in Latin America, placing large demands on health care systems. Research suggests cultural differences in body weight perceptions may be a barrier during the implementation of weight-loss strategies. The aim of this study was to examine the prevalence of weight misperception in Peruvian women and evaluate contributing factors. Materials and Methods: A total of 236 women were recruited in San Martín, northern Peru. Participants’ socio-demographic characteristics and attitudes towards their weight and health were collected. Self-perception of weight status was assessed with a 10-point scale and compared with measured body mass index (BMI). Multiple logistic regression analysis was conducted to identify factors associated with underestimation of weight status. Results: A total of 65.2% of women were classified as overweight/obese by BMI, but only 15.2% perceived themselves so. A total of 70.4% of women underestimated their weight status and no incidence of overestimation was reported. Overweight and obese women were more likely to underestimate their weight status than normal weight women (OR (Odds Ratio): 34.24, 95% CI (Confidence Interval): 11.55–101.45; OR: 42.06, 95% CI: 11.17–158.32, respectively). Women who underestimated weight status felt more comfortable with their weight (59.3% vs. 20.6, p < 0.001) and agreed a large stomach is a sign of good health (40.7% vs. 5.9%, p < 0.001) versus those who correctly estimated. Conclusions: Underestimation of weigh status was highly prevalent and associated with unhealthy beliefs. Future public health programs must be culturally sensitive and tailored to specific groups within the population.

Food Insecurity Associated With Underestimation of Weight Status in Children With a Healthy Weight

ObjectiveAccurate parental weight perception of one's child is an important step in addressing healthy behaviors, but its associations with socioeconomic status (SES) and household food insecurity (HFI) are unclear. We aimed to assess the association of parental weight perception with HFI. MethodsThis was a secondary data analysis of a cross-sectional study of 284 children ages 2 to 8 years whose parents completed surveys about weight perception, SES, and HFI. Height and weight were measured to determine the children's body mass index scores and were self-reported by parents. We performed chi-square tests to compare HFI and accuracy of parental weight perception and used logistic regression to assess accuracy, adjusting for significant covariates and stratifying by child weight category. ResultsApproximately two thirds of children had healthy weight, 18% had overweight, and 15% had obesity. About one third of parents inaccurately identified their child's weight category, almost always underestimating weight status. Twenty-eight percent of the families were food insecure. HFI was not associated with parental weight perception in bivariate analysis. When stratified by weight status, food insecure families with children at healthy weight had 0.16 times the odds of accurately perceiving their children's weight status. There was no association between HFI and accuracy of weight perception in children with overweight or obesity. ConclusionsFood insecurity was associated with a decrease in the accuracy of parental weight perceptions in children with healthy weight. Pediatricians should clearly communicate about weight status, as families with HFI may adopt unhealthy eating behaviors under the incorrect assumption that their child is underweight.

A secondary analysis examining the concordance of self-perception of weight and actual measurement of body fat percentage: The CRONICAS Cohort Study

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.

Estimation of weight status and weight-loss efforts in Korean adults with non-obesity considering metabolic syndrome.

To examine whether metabolic syndrome (MetS) is related to estimation of weight status and weight-loss efforts in Korean adults with non-obesity. In 4345 men and 6387 women in non-obese Koreans (age 49.2 ± 16.7years, BMI < 25kg/m2) participating in the 2011-2013 Korean National Health and Nutrition Examination Survey, the presence/absence of MetS using the harmonized criteria, and weight perception and weight-loss efforts using questionnaires were assessed. Estimation of weight status was determined as underestimation, correct estimation, and overestimation based on differences between perceived weight categories and BMI-based categories. 15.7% in men and 12.6% in women with BMI < 25kg/m2 had the MetS. After adjusting for sociodemographic factors, health-related behaviors, treatment of cardiovascular diseases and cardiovascular risk factors, and BMI-based categories, correct estimation and overestimation of weight status in men [odds ratio (95% CI), 1.58 (1.29-1.92); 2.82 (1.48-5.38)], and women [1.53 (1.26-1.86); 1.59 (1.09-2.31)] were positively associated with the presence of MetS compared to those with underestimation of weight status. After adjusting for weight estimation, sociodemographic factors, health-related behaviors, and treatment of cardiovascular diseases and cardiovascular risk factors, weight-loss efforts were positively associated with the presence of MetS [1.66 (1.33-2.08) in men, 1.31 (1.07-1.61) in women] in all subjects, and number of MetS components [1.28 (1.02-1.62) per 1 more component] in those with MetS. In non-obese individuals, correct estimation and overestimation of weight status may be more likely to identify individuals with MetS and concurrent MetS may increase weight-loss efforts regardless of weight estimation. Level III, evidence obtained from a case-control observational study.

Visual body size norms and the under-detection of overweight and obesity.

SummaryObjectivesThe weight status of men with overweight and obesity tends to be visually underestimated, but visual recognition of female overweight and obesity has not been formally examined. The aims of the present studies were to test whether people can accurately recognize both male and female overweight and obesity and to examine a visual norm‐based explanation for why weight status is underestimated.MethodsThe present studies examine whether both male and female overweight and obesity are visually underestimated (Study 1), whether body size norms predict when underestimation of weight status occurs (Study 2) and whether visual exposure to heavier body weights adjusts visual body size norms and results in underestimation of weight status (Study 3).ResultsThe weight status of men and women with overweight and obesity was consistently visually underestimated (Study 1). Body size norms predicted underestimation of weight status (Study 2) and in part explained why visual exposure to heavier body weights caused underestimation of overweight (Study 3).ConclusionsThe under‐detection of overweight and obesity may have been in part caused by exposure to larger body sizes resulting in an upwards shift in the range of body sizes that are perceived as being visually ‘normal’.

Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory.

SummaryAlthough overweight and obesity are widespread across most of the developed world, a considerable body of research has now accumulated, which suggests that adiposity often goes undetected. A substantial proportion of individuals with overweight or obesity do not identify they are overweight, and large numbers of parents of children with overweight or obesity fail to identify their child as being overweight. Lay people and medical practitioners are also now poor at identifying overweight and obesity in others. A visual normalization theory of the under‐detection of overweight and obesity is proposed. This theory is based on the notion that weight status is judged relative to visual body size norms. Because larger body sizes are now common, this has caused a recalibration to the range of body sizes that are perceived as being ‘normal’ and increased the visual threshold for what constitutes ‘overweight’. Evidence is reviewed that indicates this process has played a significant role in the under‐detection of overweight and obesity. The public health relevance of the under‐detection of overweight and obesity is also discussed.

Overweight or about right? A norm comparison explanation of perceived weight status.

SummaryObjectivesBody‐weight norms may explain why personal evaluations of weight status are often inaccurate. Here, we tested a ‘norm comparison’ explanation of weight status perceptions, whereby personal evaluations of weight status are biased by perceived body‐weight norms.MethodsStudy 1 examined whether perceptions of how one's own body weight compares to an average person predict personal evaluations of weight status. Study 2 examined whether manipulating perceptions of how one's own body weight compares to an average person influences whether or not a person identifies their own weight status as being overweight.ResultsIn Study 1, if participants rated their body weight as being similar to the body weight of an average person, they were less likely to identify their weight status as being overweight. In Study 2, participants that were led to believe that their body weight was heavier than the average person were more likely to perceive their own weight status as being overweight.ConclusionsPersonal perceptions of weight status are likely to be shaped by a ‘norm comparison’ process. As overweight becomes more normal, underestimation of weight status amongst individuals with overweight and obesity will be more common.

The association between misperceptions around weight status and quality of life in adults in Australia

BackgroundLimited evidence supports a possible association between a person’s perception of their weight status and their quality of life (QoL). This study evaluates whether misperception around weight status is associated with QoL and the impact of gender on this association.MethodsA cross-sectional survey of Australian adults (n = 1,905 analysed) collected self-reported height and weight (used to estimate BMI), gender and QoL (described using the AQoL-8D). Participants reported whether they perceived their weight status to be ‘underweight’, ‘healthy weight’, ‘overweight’ or ‘obese’. Misperception around weight status was categorised based on perceived weight status and self-reported BMI. Ordinary least squares regression was used to test associations between self-reported overall, physical and psychosocial QoL, misperception of weight status, and gender, across different BMI categories, after controlling for income, education, relationship status and health conditions.ResultsCompared to accurate perception, underestimation of weight status was associated with higher overall QoL for obese males and females and for overweight males. Overestimation of weight status was associated with higher overall QoL for underweight females and lower overall QoL for healthy weight males and females. The same pattern was seen for psychosocial QoL. Physical QoL was less sensitive to misperception than psychosocial QoL.ConclusionsSelf-reported misperception around weight status is associated with overall, psychosocial and to a lesser extent physical QoL in Australian adults, although its role depends on BMI category and gender. Generally misperception in the direction of “healthy weight” is associated with higher QoL and overestimation of weight status by those who are of healthy weight is associated with lower QoL. Findings should be confirmed in datasets that contain measured as opposed to self-report height and weight.

Perceptions of overweight in a Caribbean population: the role of health professionals.

The prevalence of obesity and its complications is particularly high in the Caribbean. Underestimation of weight status could explain the failure by subjects concerned to adopt behaviours complying with medical recommendations. Little research is available on the role of health professionals in overweight perception. To examine relationships between overweight underestimation and lack of communication on overweight diagnosis by health professionals in a multicultural Caribbean population. A cross-sectional study, lead in 2014 on a sample representative of the population of Saint-Martin (395 subjects, 25-74 years). Overweight perception was assessed on Likert scale. Corpulence was assessed from measured waist circumference (WC). Individuals with excess abdominal adiposity (WC ≥ 80cm for women, ≥ 94cm for men) but stating they did not feel overweight were considered to underestimate their weight status. Patient-reported lack of communication on their diagnosis by health professionals was likewise explored. Respondents' first language defined cultural community. Multivariate analysis used logistic regression. Among individuals presenting excessive WC, 4 out of 10 did not perceive themselves as overweight. Six out of 10 said they had never been told about their weight by a health professional, whether or not they had their weight and waist measured by their referring physician in the preceding year. Independently from WC, overweight underestimation was associated with lack of communication on overweight diagnosis for both sexes. For women, overweight underestimation was associated with belonging to the Creole community. Greater care is required when giving a diagnosis of overweight, particularly in social-cultural contexts where weight norms differ.

Visual weight status misperceptions of men: Why overweight can look like a healthy weight

Overweight men often underestimate their weight status. Here, we examine whether underestimation occurs when visually judging the weight status of men and whether exposure to heavier body weights may be a cause of visual underestimation of male weight status. Participants systematically underestimated the weight status of overweight and obese men (Study 1) and participants reporting more frequent exposure to heavy male body weights were most likely to underestimate (Study 2). Experimental exposure to different body weights influenced underestimation of weight status (Study 3). Frequent exposure to heavier body weights may cause visual underestimation of the weight status of overweight men.

Tendency toward Weight Loss among Iranian Adolescent Girls: Study on Perceived Weight, Ideal Body Mass Index and Attitude toward Eating Disorders

Background Adolescents’ perception of their weight is a strong factor in shaping dietary habits and weight control and management. Among non-overweight and overweight adolescents, both overestimation and underestimation of weight status are associated with harmful effects. This study aimed to examine the relationship between perceived weight and attitude toward eating disorders among adolescent girls living in Karaj, Iran. Materials and Methods Involving a two-stage random sampling, this cross-sectional study was conducted on a total of 537 high school girls 14-18 years of age living in Karaj. The Eating Attitudes Test (EAT-26) was employed to screen for attitude toward eating disorders. Also, anthropometric measurements (weight and height), perceived and the ideal weights of the participants were assessed. Results The average age of girls participating in the study was 16.12±1.20. According to the results, 70% of girls had normal body mass index. It was found that the ideal weight of 55% of the girls in the normal body mass index group fell under the lower than normal boundary. Moreover, the prevalence of eating disorders was estimated to be 23.6%. The attitude toward eating disorder was significantly correlated with body mass index of participants and their self-concept (P<0.05). Conclusion The results showed that girl’s adolescent with normal BMI have tendency to the lower weight. Their opinion about ideal weight fall them to the underweight group. Concerns about lean and bony body require desirable planning and weight management for adolescent girls.

Fatores associados à subestimação materna do peso da criança: um estudo de base populacional

Objetivo Investigar os fatores associados à subestimação materna do peso de crianças menores de cinco anos de Goiânia, Goiás. Métodos Estudo transversal, de base populacional, domiciliar, com 673 crianças menores de cinco anos de idade. A percepção materna do peso da criança foi obtida pela pergunta: "Atualmente, o que a senhora (mãe) acha do peso do seu filho?", e o estado nutricional da criança foi avaliado pelo índice de massa corporal por idade. Regressão múltipla de Poisson foi realizada a um nível de significância de 5%. Para a análise de concordância, foi utilizado o teste Kappa. Resultados Das crianças estudadas, 1,6% estavam magras, 87,7% eutróficas e 10,7% com excesso de peso. A maioria das mães (66,0%) identificou corretamente o peso de seus filhos; 5,2% superestimaram, e 28,8% subestimaram. Mães de crianças com excesso de peso, idade superior a 24 meses, apresentaram maior prevalência de subestimação, enquanto as mães com excesso de peso e maior escolaridade apresentaram menor subestimação do peso das crianças. A concordância entre a opinião materna sobre o peso da criança e o real estado nutricional da criança foi de 0,12 (p&lt;0,001). CONCLUSÃO Existe uma distorção na percepção materna do peso de crianças menores de cinco anos. A subestimação materna do peso da criança apresentou associação direta com idade e estado nutricional da criança e associação inversa com escolaridade e estado nutricional materno. Sugere-se atenção no atendimento a essas mães com o objetivo de evitar o ganho de peso excessivo nessa idade e prejuízos na saúde da criança.

Accuracy of Weight Perceptions in a Nationally Representative Cohort of US 8th Grade Adolescents

ObjectiveTo describe the accuracy of weight perceptions in a nationally representative sample of US 8th graders, its relationship with weight control intentions (WCI), and the relationship of weight misperceptions and WCI with diet and activity behaviors. MethodsData analyzed came from the 8th grade wave (2006–2007) of the Early Childhood Longitudinal Study–Kindergarten Class, a nationally representative sample. Body mass index was calculated from height and weight measurements for 7800 8th graders (mean age 14.3 years). Measured weight status was categorized into underweight, normal weight, overweight, and obese using the US Centers for Disease Control and Prevention's age- and sex-specific growth charts. Self-reported weight status was compared with measured weight status to classify adolescents into accurate perceivers, overestimators, and underestimators. Multivariate logistic and negative binomial regression models were estimated for binary and count data outcome variables, respectively. ResultsOverall, 42.1% of adolescents misperceived their weight status: 35.3% underestimated and 6.8% overestimated their weight status. Among overweight or obese adolescents, 68.4% misperceived their weight status; 35% of underweight adolescents overestimated their weight status. Among normal-weight adolescents, 8.5% overestimated and 18.5% underestimated their weight. Compared to accurate perception, both overestimation and underestimation of weight status were associated with greater likelihood of inappropriate WCI, but only underestimation was associated with unhealthy diet and activity behaviors. ConclusionsWeight misperception was a common problem among US adolescents from all weight categories and was associated with inappropriate WCI. Future research should examine how adolescents' weight perceptions are formed and whether reducing misperceptions may improve behaviors.

Misperception of weight status and associated factors among undergraduate students

We compared participants' self-perception of their weight with the World Health Organisation (WHO) definition for BMI categories among undergraduate university students undertaking health related academic programmes in Ghana. Also, we investigated factors associated to the underestimation of weight status in this sample. This cross-sectional study was conducted among a sample of 368 undergraduate students. Anthropometric measurements of weight and height were measured with appropriate tools and computed into Body Mass Index (BMI) categorised based on WHO classifications. Waist and hip circumferences were also measured appropriately. Participants' self-perception of weight status was assessed by the question: How do you perceive your weight? (a) Underweight, (b) normal weight, (c) overweight, and (d) obese. The BMI-measured weight status was compared to the self-perceived weight status by cross-tabulation, Kappa statistics of agreement and χ(2) for trend analysis. Factors associated with misperception of weight status was measured using univariate and multivariable analysis. Thirteen percent (n=48) of the participants were overweight/obesity (BMI) and 31.5% had central obesity. Overall, 20.6% of the participants misperceived their weight status in which 78.9% of them underestimated it. Among overweight/obese participants, 41.7% self-perceived themselves accurately. Whereas 10.6% of normal weight participants underestimated their weight status, over half (58.3%) of overweight/obese participants did so. Factors that were associated with underestimation of weight status were having overweight/obesity (BMI) and central obesity. Underestimation of weight status was frequent. Health professionals and related government agencies should develop intervention programmes to empower young people to have accurate weight status perception.

Maternal Underestimation of Child's Weight Status and Health Behaviors as Risk Factors for Overweight in Children

To evaluate children's risk of being overweight associated with maternal underestimation of weight status and health behaviors. One hundred forty mother-child dyads were included. Children whose weight status was underestimated by their mothers were at greater risks of being overweight compared to those whose weigh status was correctly perceived (adjusted OR 2.31, 95% CI 1.11-4.81). Less television viewing time was associated with a 63% reduced risk of being overweight (adjusted OR .37, 95% CI .17-.83). Maternal underestimation of weight status was common among overweight and normal-weight children, and it was associated with an increased children's risk of being overweight.

Large proportions of overweight and obese children, as well as their parents, underestimate children's weight status across Europe. The ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project.

To investigate the magnitude and country-specific differences in underestimation of children's weight status by children and their parents in Europe and to further explore its associations with family characteristics and sociodemographic factors. Children's weight and height were objectively measured. Parental anthropometric and sociodemographic data were self-reported. Children and their parents were asked to comment on children's weight status based on five-point Likert-type scales, ranging from 'I am much too thin' to 'I am much too fat' (children) and 'My child's weight is way too little' to 'My child's weight is way too much' (parents). These data were combined with children's actual weight status, in order to assess underestimation of children's weight status by children themselves and by their parents, respectively. Chi-square tests and multilevel logistic regression analyses were conducted to examine the aims of the current study. Eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) project. A school-based survey among 6113 children aged 10-12 years and their parents. In the total sample, 42·9 % of overweight/obese children and 27·6 % of parents of overweight/obese children underestimated their and their children's weight status, respectively. A higher likelihood for this underestimation of weight status by children and their parents was observed in Eastern and Southern compared with Central/Northern countries. Overweight or obese parents (OR=1·81; 95 % CI 1·39, 2·35 and OR=1·78, 95 % CI 1·22, 2·60), parents of boys (OR=1·32; 95 % CI 1·05, 1·67) and children from overweight/obese (OR=1·60; 95 % CI 1·29, 1·98 and OR=1·76; 95 % CI 1·29, 2·41) or unemployed parents (OR=1·53; 95 % CI 1·22, 1·92) were more likely to underestimate children's weight status. Children of overweight or obese parents, those from Eastern and Southern Europe, boys, younger children and children with unemployed parents were more likely to underestimate their actual weight status. Overweight or obese parents and parents of boys were more likely to underestimate the actual weight status of their children. In obesity prevention such underestimation may be a barrier for behavioural change.

Distorted self-perceived weight status and underestimation of weight status in diabetes mellitus type 2 patients.

ObjectivesDiabetes mellitus type 2 (DM 2) patients' self-perception of their weight status is very critical in diabetes care. We sought to investigate perception of weight status in a sample of 200 DM 2 patients attending an outpatient clinic at a Teaching Hospital and compared it with their BMI-measured weight status, with a focus on underestimation of their weight status. Factors associated with underestimation of weight status in this sample were also explored.MethodsUsing a cross-sectional design, anthropometric and clinical variables were assessed using appropriate tools. Questionnaires were used to collect socio-demographic data and self-perception of weight status. Self-perceived weight status was compared to BMI-measured weight status by cross-tabulation, Kappa statistics of agreement and χ2 for trend analysis. Both univariate and multiple logistic regression analysis were conducted to identify factors associated with underestimation of weight status.ResultsThe prevalence of general overweight/obesity and abdominal obesity was 32.0% (n = 64) and 58.0% (n = 116) respectively. Generally, 58.0% (n = 116) of the participants had a distorted weight perceived weight status in which 77.6% (n = 90) underestimated their weight status. Factors associated with underestimation of weight status were being overweight/obese (AOR = 22.9, 95% CI = 8.30–63.07, p<0.001), not married (AOR = 3.7, 95% CI = 1.50–9.17, p = 0.005) and never tried to lose weight (AOR = 6.9, 95% CI = 2.35–19.97, p<0.001). Participants aged over 40 years and those being hyperglycaemic were not significantly associated to underestimation of weight status.ConclusionWe found a substantial discordance between BMI-measured and self-perceived weight status. Factors that were associated with underestimation of weight status were being; overweight/obese, not married and never tried to lose weight. Diabetes patients should be provided with information about weight guidelines.