Self-perception of Weight and Its Association with Weight-related Behaviors in Young, Reproductive-aged Women

Objectives: To examine weight misperceptions and their predictors and association with weight-related behaviors among low-income, multiethnic, reproductive-age women.

Methods: We assessed perceptions of body weight and weight-related behaviors of women aged 18 to 25 attending one of five publicly funded reproductive clinics in Texas between August 2008 and March 2010. Data were collected through self-administered questionnaires and chart review. Overweight and normal-weight women were divided into four categories based on self-perception of their body weight: overweight misperceivers, overweight actual perceivers, normal-weight misperceivers, and normal-weight actual perceivers. Multivariable logistic regression analyses were performed to examine the predictors of misperception and the association with weight-related behaviors.

Results: Twenty-three percent (267/1,162) of overweight and 16% (170/1,062) of normal-weight women were misperceivers. Overweight African-American women were more likely to consider themselves normal weight (28% compared with 15%; odds ratio [OR], 2.84; 95% confidence interval [CI], 1.79-4.50), whereas normal-weight African-American women were less likely than whites to consider themselves overweight (7% compared with 16%; OR 0.40; 95% CI 0.22-0.74). Overweight women who had at least some college education (14% compared with 29%; OR 0.53; 95% CI 0.32-0.86) and used the Internet (18% compared with 28%; OR 0.47; 95% CI 0.31-0.70) were less likely to misperceive their body weight. Normal-weight misperceivers were more likely to report healthy and unhealthy weight-reduction behaviors compared with normal-weight actual perceivers, after adjusting for age, race, ethnicity, and body mass index. Opposite scenarios were observed for overweight misperceivers.

Conclusion: Weight misperception is common among both overweight and normal-weight women of reproductive age. Clinicians should provide patient-specific counseling related to healthy weight management goals that take each patient's perceptions into consideration.