Abstract
Background
To understand, prevent, and manage weight-related health issues, researchers and clinicians rely on the ability to identify those at risk. Prevention and management strategies may also rely on accurate self-perception of weight and body composition in the general population.
Methods
We analyzed data from The Tomorrow Project® (n=7,436), a prospective cohort study enrolling adults aged 35–69 years, in Alberta, Canada. Weight perception accuracy was defined based on body mass index (BMI), waist circumference (WC), and a combined (BMI and WC) risk profile.
Results
The majority of participants correctly perceived themselves as overweight. Women were more accurate than men in identifying themselves as overweight. In terms of inaccuracy, more normal-weight women than men perceived themselves to be overweight, while more overweight men than women perceived themselves as about the right weight. When using the combined risk profile, all men with normal weight (BMI) but higher risk WC perceived their weight as about right whereas just under half of men who were overweight (BMI) but lower risk WC perceived their weight as about right. For women, a much higher proportion recognized their weight status as overweight when only BMI was elevated compared to when only WC indicated higher risk.
Discussion
Adults in our sample showed reasonable accuracy in weight perception. Gender differences reveal that women were more accurate than men in identifying themselves as overweight. Incongruence between weight status indicators was noted, indicating the importance of using both BMI and waist circumference as health status measures.
Keywords: Weight perception, body mass index, waist circumference, obesity
Résumé
Contexte
Pour comprendre, prévenir et gérer les problèmes de santé liés au poids, les chercheurs et les cliniciens doivent pouvoir identifier les personnes à risque. Les stratégies de prévention et de gestion peuvent aussi faire appel à l’autoperception correcte du poids et de la composition corporelle dans la population générale.
Méthode
Nous avons analysé les données du projet The Tomorrow Project® (n=7 436), une étude prospective de cohortes d’adultes de 35 à 69 ans menée en Alberta, au Canada. Nous avons défini l’exactitude de la perception du poids d’après l’indice de masse corporelle (IMC), le périmètre ombilical (PO) et le profil de risque combiné (IMC et PO).
Résultats
La majorité des participants se percevaient correctement comme ayant une surcharge pondérale. Les femmes étaient plus précises que les hommes à cet égard. Pour ce qui est de l’imprécision, davantage de femmes que d’hommes de poids normal se percevaient comme faisant de l’embonpoint, et davantage d’hommes que de femmes ayant un excès de poids se percevaient comme ayant un poids normal. Avec l’utilisation du profil de risque combiné, tous les hommes de poids normal (IMC) mais dont le PO constituait un risque plus élevé se percevaient comme ayant un poids normal, tandis qu’un peu moins de la moitié des hommes ayant une surcharge pondérale (IMC) mais dont le PO constituait un moindre risque considéraient avoir un poids normal. Chez les femmes, une proportion beaucoup plus grande reconnaissait faire de l’embonpoint lorsque seul l’IMC était élevé, comparativement aux femmes dont seul le PO constituait un risque plus élevé.
Discussion
Les adultes de notre échantillon avaient une perception raisonnablement exacte de leur poids. Les différences entre les sexes montrent que les femmes s’identifiaient plus correctement que les hommes comme ayant une surcharge pondérale. Nous avons cerné une incompatibilité entre les indicateurs de statut pondéral, ce qui dénote l’importance d’utiliser à la fois l’IMC et le périmètre ombilical comme mesures de l’état de santé.
Motsclés: perception du poids, indice de masse corporelle, périmètre ombilical, obésité
Footnotes
Conflict of Interest: None to declare.
References
- 1.Lau D, Douketis J, Morrison K, Hramiak I, Sharma A, Ur E. 2006 Canadian clinical practice guidelines on the management and prevention of obesity in adults and children. CMAJ. 2007;176(8):1–13. doi: 10.1503/cmaj.061409. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Stein J. Fact sheet: Major causes of death in Canada, 1993–1995. Chron Dis Can. 1997;18:91–92. [PubMed] [Google Scholar]
- 3.McLaren L, Beck CA, Patten SB, Fick GH, Adair CE. The relationship between body mass index and mental health: A population-based study of the effects of the definition of mental health. Soc Psychiatry Psychiatr Epidemiol. 2008;43:63–71. doi: 10.1007/s00127-007-0269-x. [DOI] [PubMed] [Google Scholar]
- 4.Wardle J, Johnson F. Weight and dieting: Examining levels of weight concern in British adults. Int J Obes. 2002;26:1144–49. doi: 10.1038/sj.ijo.0802046. [DOI] [PubMed] [Google Scholar]
- 5.Strauss RS. Self-reported weight status and dieting in a cross-sectional sample of young adolescents. Arch Pediatr Adolesc Med. 1999;153:741–47. doi: 10.1001/archpedi.153.7.741. [DOI] [PubMed] [Google Scholar]
- 6.Kaltiala-Heino R, Kautiainen S, Virtanen SM, Rimpela A, Rimpela M. Has the adolescents’ weight concern increased over 20 years? Eur J Public Health. 2003;13:4–10. doi: 10.1093/eurpub/13.1.4. [DOI] [PubMed] [Google Scholar]
- 7.Blokstra A, Burns CM, Seidell JC. Perception of weight status and dieting behaviour in Dutch men and women. Int J Obes. 1999;23:7–18. doi: 10.1038/sj.ijo.0800803. [DOI] [PubMed] [Google Scholar]
- 8.Villaneva E. BMC Public Health. 2002. The validity of self-reported weight in US adults: A population based cross-sectional study. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9.Paeratakul S, White MA, Williamson DA, Ryan DH, Bray GA. Sex, race/ethnicity, socioeconomic status, and BMI in relation to self-perception of overweight. Obes Res. 2002;10(5):345–50. doi: 10.1038/oby.2002.48. [DOI] [PubMed] [Google Scholar]
- 10.Whisenhunt BL, Williamson DA. Perceived weight status in normal weight and overweight women. Eat Behav. 2002;3:229–38. doi: 10.1016/S1471-0153(02)00067-3. [DOI] [PubMed] [Google Scholar]
- 11.Mack KA, Anderson L, Galuska D, Zablotsky D, Holtzman D, Ahluwalia I. Health and sociodemographic factors associated with body weight and weight objectives for women: Behavioural risk factor surveillance system. J Wom Health. 2004;13(9):1019–32. doi: 10.1089/jwh.2004.13.1019. [DOI] [PubMed] [Google Scholar]
- 12.Befort CA, Greiner KA, Hall S, Pulvers KM, Nollen NL, Charbonneau A, et al. Weight-related perceptions among patients and physicians: How well do physicians judge patients’ motivation to lose weight? J Gen Intern Med. 2006;21:1086–90. doi: 10.1111/j.1525-1497.2006.00567.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 13.Lean MEJ, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. Br Med J. 1995;311:158–61. doi: 10.1136/bmj.311.6998.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 14.Zhu S, Wang Z, Heshka S, Heo M, Faith MS, Heymsfield SB. Waist circumference and obesity-associated risk factors among whites in the third National Health and Nutrition Examination Survey: Clinical action thresholds. Am J Clin Nutr. 2002;76:743–49. doi: 10.1093/ajcn/76.4.743. [DOI] [PubMed] [Google Scholar]
- 15.Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79:279–84. doi: 10.1093/ajcn/79.3.379. [DOI] [PubMed] [Google Scholar]
- 16.Murray S. CMAJ. 2006. Is waist-to-hip ratio a better marker of cardiovascular risk than body mass index? [DOI] [PMC free article] [PubMed] [Google Scholar]
- 17.Pischon T, Boeing H, Hoffmann K, Bergmann M, Schulze MB, Overvad K, et al. General and abdominal adiposity and risk of death in Europe. NEJM. 2008;359:2105–20. doi: 10.1056/NEJMoa0801891. [DOI] [PubMed] [Google Scholar]
- 18.Bryant H, Robson PJ, Ullman R, Friedenreich C, Dawe U. Population-based cohort development in Alberta, Canada: A feasibility study. CDIC. 2006;27(2):55–63. [PubMed] [Google Scholar]
- 19.Robson P L, Siou G, Ullman R, Bryant HE. Sociodemographic, health and lifestyle characteristics reported by discrete groups of adult dietary supplement users in Alberta, Canada: Findings from The Tomorrow Project. Public Health Nutr. 2008;11(12):1238–47. doi: 10.1017/S136898000800219X. [DOI] [PubMed] [Google Scholar]
- 20.Health Canada. Canadian Guidelines for Body Weight Classification in Adults. 2003. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 21.Collett D. Modelling Binary Data. London, UK: Chapman & Hall; 1991. [Google Scholar]
- 22.Leemis LM, Trivedi KS. A comparison of approximate interval estimators for the Bernoulli Parameter. Am Statistician. 1996;50(1):63–68. [Google Scholar]
- 23.Blaak E. Curr Opin Clin Nutr Metab Care. 2001. Gender differences in fat metabolism. [DOI] [PubMed] [Google Scholar]
- 24.Chang VW, Christakis NA. Self-perception of weight appropriateness in the United States. Am J Prev Med. 2003;24(4):332–39. doi: 10.1016/S0749-3797(03)00020-5. [DOI] [PubMed] [Google Scholar]
- 25.Bigaard J, Tjonneland A, Thomsen BL, Overvad K, Heitmann BL, Sorensen TI. Waist circumference, BMI, smoking, and mortality in middle-aged men and women. Obes Res. 2003;11(7):895–903. doi: 10.1038/oby.2003.123. [DOI] [PubMed] [Google Scholar]
- 26.Hojgaard B, Gyrd-Hansen D, Olsen KR, Sogaard J, Sorensen T. Plos ONE. 2008. Waist circumference and body mass index as predictors of health care costs. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 27.Zhang C, Rexrode KM, van Dam RM, Li TY, Hu FB. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: Sixteen years of follow-up in US women. Circ. 2008;117:1658–67. doi: 10.1161/CIRCULATIONAHA.107.739714. [DOI] [PubMed] [Google Scholar]
- 28.Orpana HM, Berthelot JM, Kaplan MS, Feeny DH, McFarland B, Ross NA. BMI and mortality: Results from a national longitudinal study of Canadian adults. Obes. 2009;1:214–18. doi: 10.1038/oby.2009.191. [DOI] [PubMed] [Google Scholar]
- 29.Flegal KM, Graubard BI, Williamson DF, Gail MH. Excess deaths associated with underweight, overweight, and obesity. JAMA. 2005;293:1861–67. doi: 10.1001/jama.293.15.1861. [DOI] [PubMed] [Google Scholar]
- 30.Sharma AM, Kushner RF. Int J Obes. 2009. A proposed clinical staging system for obesity; pp. 1–7. [DOI] [PubMed] [Google Scholar]