Self-perceived body image and its influence on weight management among adults in South Africa

Background. Misperception of body image is common, and may prevent individuals from undertaking healthy corrective measures. Objectives. To investigate how misperception of body image and weight among adults may influence efforts to improve health and illnesses associated with metabolic syndrome (MetS). Methods. A cross-sectional study involving 1 889 adults aged ≥20 years was conducted. Participants were required to complete a questionnaire and to estimate their weight prior to anthropometric measurements (weight, height, waist and hip circumferences). The Stunkard figure rating scale (FRS) was used for participants to select silhouettes that they believed closely resembled their body types. Biochemical parameters were measured for all participants. Results. Obesity (51.2% v. 15.9%) and MetS (49.9% v. 25.5%) were more prevalent in women than men. Most participants with overweight/ obesity underestimated their body size, and over 75% reported no intention to lose weight. Only 13% reported efforts to lose weight. The FRS results showed poor body size recognition, particularly in men with obesity. Logistic regression analyses adjusted for age, sex and MetS parameters showed that waist circumference significantly predicted weight management efforts (odds ratio 5.7, 95% confidence interval 3.8 - 8.4, p<0.0001). Conclusions. Incorporating visual body shape guides in obesity management settings can help to bridge this perception gap and promote healthier behaviours.