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Underestimation of body mass index through the self-perception of the body image in subjects with overweight and obesity

Abstract:

Introduction: Currently, obesity is considered a pandemic worldwide, which is determined by the body mass index (BMI), however in many patients there may be intrapersonal factors such as the alteration of perception in the personal image and body dissatisfaction, reason why the present study was motivated to evaluate the underestimation of the BMI perceived by the patients with overweight and obesity. Materials and methods: An analytical and cross-sectional study was carried out in 364 adults between 18 and 64 years old, overweight and obese from Ricaurte, Azuay-Ecuador, during 2015. The self-perception of the BMI was determined by a validated visual scale. The variables were expressed in absolute frequencies and percentages. A logistic regression model was used to determine the underestimation of the BMI according to self-perception. The results of the statistical tests were considered significant when the value of p<0.05. Results: 17.6% of overweight or obese subjects underestimate their BMI by self-perception. 78% reported body dissatisfaction, which was more frequent in the obese (90.9%) compared to overweight (67.5%). The variables that were associated with underestimation were: obesity, where subjects with obesity were 1.91 times more likely to underestimate their BMI by self-perception compared with overweight subjects (OR=1.91, IC95%: 1.04-3.48, p=0.035), the educational status of illiterate/primary (OR=1.86, IC95%: 1.01-5.89, p=0.045), body dissatisfaction (OR=2.45, IC95%: 1.01-5.89, p=0.046) and recreational physical activity ≥90 minutes/week as a protective factor (OR=0.21, IC95%:0.04-0.32, p=0.039). Conclusions: Subjects with overweight and obesity tend to underestimate their body mass index by self-perception, and have body dissatisfaction, which are more frequent in obese patients, and multiple factors are associated with this altered self-perception. Therefore it is suggested to increase the educational intervention aimed at communities with low educational level, as well as encourage the realization of recreational activities that allow to establish awareness of weight alteration, adequate body self-perception and healthy lifestyles in overweight and obese subjects.