Contributions of weight perceptions to weight loss attempts: Differences by body mass index and gender

Abstract

Previous studies have consistently observed that women are more likely to perceive themselves as overweight compared to men. Similarly, women are more likely than men to report trying to lose weight. Less is known about the impact that self-perceived weight has on weight loss behaviors of adults and whether this association differs by gender. We conducted a cross-sectional analysis among an employee sample (n = 899) to determine the association of self-perceived weight on evidence-based weight loss behaviors across genders, accounting for body mass index (BMI) and demographic characteristics. Women were more likely than men to consider themselves to be overweight across each BMI category, and were more likely to report attempting to lose weight. However, perceiving oneself to be overweight was a strong correlate for weight loss attempts across both genders. The effect of targeting accuracy of self-perceived weight status in weight loss interventions deserves research attention.

Introduction

The health risks associated with being overweight and obese are well-established (Wyatt, Winters, & Dubbert, 2006), and include type 2 diabetes, heart disease, stroke, high blood pressure, high cholesterol, sleep disorders and certain types of cancer (Calle, Rodriguez, Walker-Thurmond, & Thun, 2003; Lucove, Huston, & Evenson, 2007). Prevalence estimates of overweight and obesity among US adults have increased steadily over recent decades, with an estimated 66% overweight or obese (Ogden et al., 2006). This trend is expected to continue, even in view of the call for public health attention to this important risk factor (US Department of Health and Human Services & Office of Disease Prevention and Health Promotion, 2000).

Evidence supports that this increase in rates of overweight and obesity has been accompanied by decreased perceptions of overweight/obese status among persons who are overweight and obese. Johnson-Taylor and colleagues observed substantial decreases in the percentage of overweight (body mass index (BMI) 25.0–29.9 kg/m²) persons who perceived themselves to be overweight between the 1988–1994 (57% of men, 84% of women) and 1999–2004 (51% of men, 78% of women) study periods of the National Health and Nutrition Surveys (Johnson-Taylor, Fisher, Hubbard, Starke-Reed, & Eggers, 2008). Previous studies have consistently observed that women are more likely to perceive themselves as overweight compared to men (Bish et al., 2006; Chang & Christakis, 2003; Paeratakul, Lovejoy, Ryan, & Bray, 2002; Schieman, Pudrovska, & Eccles, 2007; Wardle & Johnson, 2002). Similarly, women are more likely than men to report trying to lose weight (Bish et al., 2005; Chang & Christakis, 2003; Kruger, Galuska, Serdula, & Jones, 2004). Less is known about the impact that self-perceived weight has on weight loss behaviors of adults and whether this association differs by gender. Further research is needed to determine the utility of targeting accuracy of self-perceived weight as a motivator for weight loss among women and men in behavioral interventions.

The purpose of this study was to examine the association of weight perception and participation in evidence-based weight loss practices in a particular population, employees of six hospitals that are participating in an intervention promoting weight control through lifestyle changes. We also explore if these associations differ according to body mass index and gender.