Misperceived body weight in older people can affect their health and quality of life. We analysed the body image of older adults in Primary Health Care services in central Portugal, by considering participants’ weight, body size satisfaction and body appreciation. This epidemiological and cross-sectional study involved 150 participants (56% women) with an average age of 74.9 years who completed questionnaires on body size and body appreciation. Forty-nine percent of participants were affected by overweight and 29% by obesity. The majority was not satisfied with their body size (71.2%), but had very high scores related to body appreciation. Around 40% of the participants with normal weight or overweight were satisfied with their body size. Multiple regression analysis revealed that both body size satisfaction and appreciation were negatively associated with obesity, but not with overweight. Older Portuguese adults are not able to assess if their weight is a risk to their health, but regardless of their perceived physical appearance, the elderly respect their body and are receptive to improving their health.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
Al-Busaidi, Z. Q. (2008). Qualitative research and its uses in health care. Sultan Qaboos University Medical Journal,8(1), 11–19.
Alves, D., Pinto, M., Alves, S., Mota, A., & Leirós, V. (2009). Cultura e imagem corporal. Motricidade,5(1), 1–20. https://doi.org/10.6063/motricidade.5(1).184.
Avalos, L., Tylka, T. L., & Wood-Barcalow, N. (2005). The Body Appreciation Scale: Development and psychometric evaluation. Body Image,2(3), 285–297. https://doi.org/10.1016/j.bodyim.2005.06.002.
Baldaia, A. (2013). A atratividade física e o seu contributo para o envelhecimento bem-sucedido. Actas de Gerontologia,1(1), 1–8.
Bhanji, S., Khuwaja, A. K., Siddiqui, F., Azam, I., & Kazmi, K. (2011). Underestimation of weight and its associated factors among overweight and obese adults in Pakistan: A cross sectional study. BMC Public Health,11, 363. https://doi.org/10.1186/1471-2458-11-363.
Brandão, M. P., Martins, L., Philp, I., & Cardoso, M. F. (2017). Reliability and validity of the EASYCare-2010 Standard to assess elderly people in Portuguese Primary Health Care. Atención Primaria,49(10), 576–585. https://doi.org/10.1016/j.aprim.2016.11.016.
Brandão, M. P. M., Martins, L., Szewczyczak, M., Talarska, D., Philp, I., & Cardoso, M. F. (2018). Threats to health and well-being perceived by older people in Poland and Portugal. Acta Médica Portuguesa,31(7–8), 409–415. https://doi.org/10.20344/amp.9613.
Brandão, M. P., Pimentel, F. L., Silva, C. C., & Cardoso, M. F. (2008). Risk factors for cardiovascular disease in a Portuguese university population. Revista Portuguesa de Cardiologia,27(1), 7–25.
Bulik, C. M., Wade, T. D., Heath, A. C., Martin, N. G., Stunkard, A. J., & Eaves, L. J. (2001). Relating body mass index to figural stimuli: population-based normative data for Caucasians. International Journal of Obesity,25(10), 1517–1524. https://doi.org/10.1038/sj.ijo.0801742.
Buote, V. M., Wilson, A. E., Strahan, E. J., Gazzola, S. B., & Papps, F. (2011). Setting the bar: divergent sociocultural norms for women’s and men’s ideal appearance in real-world contexts. Body Image,8(4), 322–334. https://doi.org/10.1016/j.bodyim.2011.06.002.
Cash, T. F., & Szymanski, M. L. (1995). The development and validation of the Body-Image Ideals Questionnaire. Journal of Personality Assessment,64(3), 466–477. https://doi.org/10.1207/s15327752jpa6403_6.
Cho, B. Y., Seo, D. C., Lin, H. C., Lohrmann, D. K., & Chomistek, A. K. (2018). BMI and central obesity with falls among community-dwelling older adults. American Journal of Preventive Medicine,54(4), e59–e66. https://doi.org/10.1016/j.amepre.2017.12.020.
Choi, J., Bender, M. S., Arai, S., & Fukuoka, Y. (2015). Factors associated with underestimation of weight status among Caucasian, Latino, Filipino, and Korean Americans—DiLH Survey. Ethnicity and Disease,25(2), 200–207.
Coady, S. A., Johnson, N. J., Hakes, J. K., & Sorlie, P. D. (2014). Individual education, area income, and mortality and recurrence of myocardial infarction in a Medicare cohort: The National Longitudinal Mortality Study. BMC Public Health,14, 705. https://doi.org/10.1186/2F1471-2458-14-705.
Costa, C., Ramos, E., Barros, H., Torres, A. R., Severo, M., & Lopes, C. (2007). Propriedades psicométricas do Eating Disorders Inventory em adolescentes Portugueses [Psychometric properties of the Eating Disorders Inventory among Portuguese adolescents]. Acta Médica Portuguesa,20(6), 511–524.
De Lorenzo, A., Gratteri, S., Gualtieri, P., Cammarano, A., Bertucci, P., & Di Renzo, L. (2019). Why primary obesity is a disease? Journal of Translational Medicine,17(1), 169. https://doi.org/10.1186/s12967-019-1919-y.
de Morais, C., Oliveira, B., Afonso, C., Lumbers, M., Raats, M., & de Almeida, M. D. V. (2013). Nutritional risk of European elderly. European Journal of Clinical Nutrition,67(11), 1215–1219. https://doi.org/10.1038/ejcn.2013.175.
Eden, K., & Randle-Phillips, C. (2017). Exploration of body perception and body dissatisfaction in young adults with intellectual disability. Research in Developmental Disabilities,71, 88–97. https://doi.org/10.1016/j.ridd.2017.09.011.
Grogan, S. (2006). Body image and health: Contemporary perspectives. Journal of Health Psychology,11(4), 523–530. https://doi.org/10.1177/2F1359105306065013.
Haynes, A., Kersbergen, I., Sutin, A., Daly, M., & Robinson, E. (2018). A systematic review of the relationship between weight status perceptions and weight loss attempts, strategies, behaviours and outcomes. Obesity Reviews,19(3), 347–363. https://doi.org/10.1111/obr.12634.
Hernan, A. L., Versace, V. L., Laatikainen, T., Vartiainen, E., Janus, E. D., & Dunbar, J. A. (2014). Association of weight misperception with weight loss in a diabetes prevention program. BMC Public Health,14, 93. https://doi.org/10.1186/1471-2458-14-93.
Holland, G., & Tiggemann, M. (2016). A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image,17, 100–110. https://doi.org/10.1016/j.bodyim.2016.02.008.
Hosmer, D. W., Jr., Lemeshow, S., & Sturdivant, R. X. (2013). Applied logistic regression (3rd ed.). Hoboken: Wiley. ISBN 978-0-470-58247-3.
Jankowski, G. S., Diedrichs, P. C., Williamson, H., Christopher, G., & Harcourt, D. (2016). Looking age-appropriate while growing old gracefully: A qualitative study of ageing and body image among older adults. Journal of Health Psychology,21(4), 550–561. https://doi.org/10.1177/2F1359105314531468.
Jayawardena, R., Punchihewa, P., Ranathunga, I., Lokunarangoda, N., Pathirana, A. K., & Santharaj, W. S. (2016). Body weight perception among Sri Lankan cardiac patients. BMC Obesity,3, 32. https://doi.org/10.1186/s40608-016-0113-5.
Leal, S. A. (2009). Estado de saúde auto-percebido, índice de massa corporal e percepção da imagem corporal em utentes dos cuidados de saúde primários (Master’s thesis). Lisboa: Universidade de Lisboa.
Loureiro, M. H. V. S. (2008). Validação do “Mini-Nutritional Assessment” em idosos (Master’s thesis). Coimbra: Universidade de Coimbra.
Marques, A., Peralta, M., Naia, A., Loureiro, N., & de Matos, M. G. (2018). Prevalence of adult overweight and obesity in 20 European countries, 2014. European Journal of Public Health,28(2), 295–300. https://doi.org/10.1093/eurpub/ckx143.
McGowan, B. M. (2016). A practical guide to engaging individuals with obesity. Obesity Facts,9(3), 182–192. https://doi.org/10.1159/000445193.
Ministério da Saúde. (2017). Programa nacional para a promoção da alimentação saudável. Direção Geral de Saúde, Ed. Lisboa, Portugal. Retrieved December 23, 2017. https://www.alimentacaosaudavel.dgs.pt/activeapp/wp-content/files_mf/1507564169PNPAS_DGS2017.pdf.
Ministério da Saúde. (2018). Retrato da Saúde Lisboa, Portugal. Retrieved January 11, 2018. https://www.sns.gov.pt/wp-content/uploads/2018/04/RETRATO-DA-SAUDE_2018_compressed.pdf.
Mintem, G. C., Horta, B. L., Domingues, M. R., & Gigante, D. P. (2015). Body size dissatisfaction among young adults from the 1982 Pelotas birth cohort. European Journal of Clinical Nutrition,69(1), 55–61. https://doi.org/10.1038/ejcn.2014.146.
Neto, F. (2011). Avaliação psicométrica da Escala de Apreciação Corporal. In A. S. Ferreira, A. Verhaeghe, Silva, L. S. Almeira, R. Lima, & S. Fraga (Eds.), Actas do VIII Congresso Iberoamericano de Avaliação/evaluación Psicológica e XV Conferência Internacional Avaliação Psicológica: Formas e contextos. Lisbon: Faculdade de Psicologia. ISBN 978-989-20-2702-9.
Oldham, M., & Robinson, E. (2016). Visual weight status misperceptions of men: Why overweight can look like a healthy weight. Journal of Health Psychology,21(8), 1768–1777. https://doi.org/10.1177/2F1359105314566257.
Park, S., Lee, S., Hwang, J., & Kwon, J. W. (2017). The impact of weight misperception on health-related quality of life in Korean adults (KNHANES 2007–2014): A community-based cross-sectional study. British Medical Journal Open,7(6), e016098. https://doi.org/10.1136/bmjopen-2017-016098.
Pordata. (2019). Base de Dados Portugal Contemporâneo—Fundação Francisco Manuel dos Santos, População residente com 15 a 64 anos e 65 e mais anos: por nível de escolaridade completo mais elevado—Portugal. Retrieved 25 January 2019. https://www.pordata.pt/Portugal/População+residente+com+15+a+64+anos+e+65+e+mais+anos+por+nível+de+escolaridade+completo+mais+elevado-332.
Robinson, E., & Oldham, M. (2016). Weight status misperceptions among UK adults: The use of self-reported vs measured BMI. BMC Obesity,3, 21. https://doi.org/10.1186/s40608-016-0102-8.
Sánchez, C. M., Dijkstra, S. C., & Visser, M. (2015). Self-perception of body weight status in older Dutch adults. Journal of Nutrition, Health & Aging,19(6), 612–618. https://doi.org/10.1007/s12603-015-0486-z.
Sardinha, L. B., Santos, D. A., Silva, A. M., Coelho-e-Silva, M. J., Raimundo, A. M., Moreira, H., et al. (2012). Prevalence of overweight, obesity, and abdominal obesity in a representative sample of Portuguese adults. PLoS ONE,7(10), e47883. https://doi.org/10.1371/journal.pone.0047883.
Singh, D. K. A., Manaf, Z. A., Yusoff, N. A. M., Muhammad, N. A., Phan, M. F., & Shahar, S. (2014). Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions. Clinical Interventions in Aging,9, 1415–1423. https://doi.org/10.2147/CIA.S64997.
Siparsky, P. N., Kirkendall, D. T., & Garrett, W. E., Jr. (2014). Muscle changes in aging: Understanding sarcopenia. Sports Health,6(1), 36–40. https://doi.org/10.1177/2F1941738113502296.
Stronks, K., & Mackenbach, J. P. (2006). Evaluating the effect of policies and interventions to address inequalities in health: Lessons from a Dutch programme. European Journal of Public Health,16(4), 346–353. https://doi.org/10.1093/eurpub/cki157.
Stunkard, A. J., Sørensen, T., & Schulsinger, F. (1983). Use of the Danish Adoption Register for the study of obesity and thinness. Research Publications - Association for Research in Nervous and Mental Disease,60, 115–120.
Tiggemann, M., & McCourt, A. (2013). Body appreciation in adult women: Relationships with age and body satisfaction. Body Image,10(4), 624–627. https://doi.org/10.1016/j.bodyim.2013.07.003.
Tulle, E. (2008). The ageing body and the ontology of ageing: Athletic competence in later life. Body & Society,14(3), 1–19. https://doi.org/10.1177/2F1357034X08093570.
Vaquinhas, I. (2012). Quando a gordura começou a deixar de ser formosura… Os caminhos de um novo paradigma estético nos finais do século XIX—inícios do século XX [When plumpness stopped being fairness…: the construction of a new aesthetical body ideal at the end of the 19th century–beginning of the 20th century]. In Revista de história das ideias (Vol. 33, pp. 241–259). Coimbra, Portugal: Imprensa da Universidade de Coimbra. https://doi.org/10.14195/2183-8925_33_11.
von Lengerke, T., Mielck, A., & Group, K. S. (2012). Body weight dissatisfaction by socioeconomic status among obese, preobese and normal weight women and men: Results of the cross-sectional KORA Augsburg S4 population survey. BMC Public Health,12, 342. https://doi.org/10.1186/1471-2458-12-342.
WHO. (1995). Physical status: The use and interpretation of anthropometry. Report of a World Health Organization (WHO) Expert Committee. Technical Report Series No. 854. Geneva, Switzerland. Retrieved 25 June 2018. http://www.who.int/childgrowth/publications/physical_status/en/.
Conflict of Interest
The authors declare that there is no conflict of interest.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Brandão, M.P., Fonseca Cardoso, M. Misperception of Healthy Weight: Associations Among Weight, Body Size Satisfaction and Body Appreciation in Older Adults. J Primary Prevent 41, 1–14 (2020) doi:10.1007/s10935-019-00573-0
- Body size
- Primary health care