Abstract
BACKGROUND
Understanding the reasons for overweight and obesity is critical to addressing the obesity epidemic. Often the decision to lose weight is based as much on one’s self-perception of being overweight as on inherent health benefits.
OBJECTIVE
Examine the relationships between self-reported health and demographic factors and measured health risk status and the misperception of actual weight status.
DESIGN
Cross-sectional study of factors associated with self-perceived overweight status in participants who self-selected to participate in stroke risk factor screenings. Participants were asked, “Are you overweight?” before their body mass index (BMI) was determined from measured weight and self-reported height. Demographics including, sex, race, education, and location; and health status variables including level of exercise and history of high blood pressure and cholesterol were collected.
RESULTS
Mean BMI for the group was 30 kg/m2. Most women (53.1%) perceived themselves to be overweight, whereas most men (59.6%) perceived themselves not to be overweight. Factors related to misperception of weight status varied by actual BMI category. Among individuals with normal BMI, sedentary individuals had 63% higher odds of misperceiving themselves as overweight. Sedentary individuals with obese BMI were at 55% reduced odds of misperceiving themselves as normal weight.
CONCLUSIONS
Active obese and overweight individuals may be more likely to incorrectly perceive themselves as normal weight, and thus misperceive their risk for stroke. Thus, it is not enough to only counsel individuals to be active. Physicians and other health professionals need to counsel their clients to both be active and to attain and maintain a healthy weight.
Similar content being viewed by others
References
Kurth T, Moore SC, Gaziano JM, et al. Healthy lifestyle and the risk of stroke in women. Arch Intern Med. 2006;166:1403–9.
Ogden CL, Carroll MD, Curtin L, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295(13):1549–55.
Muennig P, Lubetkin E, Jia H, Franks P. Gender and the burden of disease attributable to obesity. Am J Public Health. 2006;96(9):1662–8.
Howard G, Prineas , Moy C, et al. Racial and geographic differences in awareness, treatment, and control of hypertension: the REasons for geographic and racial differences in stroke study. Stroke. 2006;37(5):1171–8.
Elmer PJ, Obarzanek E, Vollmer WM, et al. Effects of comprehensive lifestyle modification on diet, weight, physical fitness, and blood pressure control: 18-month results of a randomized trial. Ann Intern Med. 2006;144(7):485–95.
Kumanyika SK, Charleston JB. Lose weight and win: a church-based weight loss program for blood pressure control among black women. Patient Educ Couns. 1992;19(1):19–32.
Stevens VJ, Obarzanek E, Cook N R, et al. Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, phase II. Ann Intern Med. 2001;134(1):1–11.
Whelton PK, Kumanyika SK, Cook N R, et al. Efficacy of nonpharmacologic interventions in adults with high-normal blood pressure: results from phase 1 of the Trials of Hypertension Prevention. Trials of Hypertension Prevention Collaborative Research Group. Am J Clin Nutr. 1997;65(2 Suppl):652S–660S.
Chang VW, Christakis NA. Extent and determinants of discrepancy between self-evaluations of weight status and clinical standards. J Gen Intern Med. 2001;16(8):538–43.
Chang VW, Christakis NA. Self-perception of weight appropriateness in the United States. Am J Prev Med. 2003;24(4):332–9.
Howard G, Anderson R, Johnson NJ, Sorlie P, Russell G, Howard VJ. Evaluation of social status as a contributing factor to the stroke belt of the United States. Stroke. 1997;28:936–40.
McCreary D R, Sadava SW. Gender differences in relationships among perceived attractiveness, life satisfaction, and health in adults as a function of body mass index and perceived weight. Psychol Men Masc. 2001;2(2):108–16.
Expert Panel on the Identification, Evaluation, and Treatment of Overweight in Adults. Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: executive summary. Am J Clin Nutr. 1998;68(4):899–917.
Rodin J. Cultural and psychosocial determinants of weight concerns. Ann Intern Med. 1993;119(7 Pt 2):643–5.
Williamson DF. Descriptive epidemiology of body weight and weight change in U.S. adults. Ann Intern Med. 1993;119(7 Pt 2):646–9.
Rowland ML. Reporting bias in height and weight data. Stat Bull Metrop Insur Co. 1989;70(2):2–11.
Rowland ML. Self-reported weight and height. Am J Clin Nutr. 1990;52(6):1125–33.
Poehlman ET, Goran MI, Gardner AW, et al. Determinants of decline in resting metabolic rate in aging females. Am J Physiol. 1993;264(3 Pt 1):E450–5.
Kumanyika SK. The association between obesity and hypertension in blacks. Clin Cardiol. 1989;12(suppl 4):IV72–7.
Befort CA, Greiner KA, Hall S, et al. Weight-related perceptions among patients and physicians: how well do physicians judge patients’ motivation to lose weight? J Gen Intern Med. 2006;21(10):1086–90.
Acknowledgments
Support for this study was provided by an Office of Minority Health, Department of Health and Human Services Award # 93.004; as well as by the University of North Carolina Greensboro Office of Undergraduate Research. Pandora Simrel, BS, provided data entry and cleaning. Gaurav Dave MPH, Huaibo Xin, and Gail Lutz MS provided feedback and encouragement.
Conflict of Interest
None disclosed.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Miller, E.C., Schulz, M.R., Bibeau, D.L. et al. Factors Associated with Misperception of Weight in the Stroke Belt. J GEN INTERN MED 23, 323–328 (2008). https://doi.org/10.1007/s11606-007-0499-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11606-007-0499-3