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Self-Perception of Weight and Its Association With Weight-Related Behaviors in Young, Reproductive-Aged Women

Rahman, Mahbubur MBBS, PhD; Berenson, Abbey B. MD, MMS

doi: 10.1097/AOG.0b013e3181fdfc47
Original Research

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.


Almost one fourth of overweight women consider their weight normal and one sixth of normal-weight women consider themselves overweight.

From the Department of Obstetrics and Gynecology and the Center for Interdisciplinary Research in Women's Health, Galveston, Texas.

Corresponding author: Mahbubur Rahman, MBBS, PhD, MPH, Center for Interdisciplinary Research in Women's Health, Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston TX 77555-0587; e-mail:

Supported by a K24 grant awarded to A.B.B. (K24HD043659).

The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2010 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.