This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on http://publichealth.jmir.org, as well as this copyright and license information must be included.
The increase in the prevalence of overweight and obesity in low- and medium-income countries has a negative impact on overall health. Correct perception of one’s body weight is a step in seeking healthy help toward weight reduction in overweight and obese individuals.
This study was carried out to assess the body weight misperception and dissatisfaction among overweight and obese adults in an urban African setting.
This study was part of a larger cross-sectional study that was designed to plan an intervention for overweight and obese adults in an urban African setting. For this study, we randomly selected only overweight and obese adults (≥18 years old) who consented to participate in the study from 15 enumeration areas in Alimosho Local Government Area of Lagos State, Nigeria. We followed the World Health Organization guidelines for conducting community surveys in recruiting overweight and obese participants. We assessed body weight perception and dissatisfaction through their responses to the following: “How do you describe your weight?” and “I feel bad about myself because of my weight.” Data for this study were collected between November 2012 and March 2013.
We recruited 567 participants, of whom more than half (n=304, 53.6%) misperceived their weight as either underweight or normal weight, and 61.2% (n=186) of whom were women. The strength of agreement between the actual body mass index and weight perception was very poor (κ=.032, SE .015,
More than half of the participants misperceived their body weight as either underweight or normal weight, and the majority of them were women. More men were not happy with their body weight, and participants in the young adult age group were more dissatisfied with their body weight.
Weight perception is a concept of how an individual perceives his or her weight appropriateness. Self-perceived weight has been documented to have positive associations with effective weight control and weight loss behaviors in adults [
Weight misperception has been a public health concern, since it can result in large numbers of overweight and obese individuals failing to understand the need for weight control or losing weight [
Little is known about weight misperception among overweight and obese individuals in the urban setting of sub-Saharan Africa. Ethnic and racial differences in body weight perception have been reported in the literature. Non-Hispanic blacks and Mexican Americans who are overweight or obese have been found to view themselves as underweight and incorrectly perceived themselves to be at the recommended weight [
This was part of a cross-sectional study carried out at Alimosho Local Government Area of Lagos State, Nigeria. Alimosho Local Government Area has a population of over 1,277,714 (2006 National Population Census) [
We administered the WHO STEPS Questionnaire to each of the participants [
We assessed body weight perception and dissatisfaction mainly through 2 questions in the baseline survey using the protocol of Wang et al [
We obtained permission and ethical clearance from the University of the Western Cape Research Ethics Committee (12/9/15) and Lagos State University Health Research and Ethics Committee (LREC/10/06/261).
We recorded frequencies and percentages for categorical variables. For ease of analysis, we recoded the sociodemographic variables age (young adults, middle-aged adults, and older adults), educational status (primary school completed, secondary education completed, tertiary education completed, and postgraduate education), employment (employed, unemployed, and pensioner), and marital status (married and single). We assessed the relationship between independent (sociodemographic) variables and weight perception and weight dissatisfaction using chi-square analysis, and subjected only the variables that showed a significant relationship to logistic regression. We assessed the predictors of the relationship between independent (sociodemographic) variables and weight perception and weight dissatisfaction using logistic regression. Kappa statistics were used to determine the strength of agreement between weight perception and actual body weight (BMI). We set the level of significance at .05. We analyzed the data using IBM SPSS version 23 (IBM Corporation).
We administered the body weight perception questionnaires to a total of 567 overweight and obese Nigerians. Of these, 193 (34.04%) were men and 374 (65.96%) were women. The strength of the agreement between BMI and weight perception was very poor among our participants (κ=.032, SE .015,
We carried out a binomial logistic regression to determine which of the sociodemographic variables predicted weight perception. Our model contained sex, age, marital status, employment status, and educational status as predictors. We observed that the full model containing all sociodemographic predictors was statistically significant (χ29,n=567=25.60,
Body mass index (BMI) status of the study population.
BMI category | Men |
Women |
Total |
Overweight | 142 (73.6) | 165 (44.1) | 307 (54.1) |
Obese | 51 (26.4) | 209 (55.9) | 260 (45.9) |
Total | 193 (34.0) | 374 (66.0) | 567 (100) |
Weight misperception by overweight and obese Nigerians.
Response | Men |
Women |
Total |
Underweight | 6 (42.9) | 8 (57.1) | 14 (100) |
Normal weight | 112 (38.6) | 178 (61.4) | 290 (100) |
A little overweight | 53 (27.3) | 141 (72.7) | 194 (100) |
Very overweight | 22 (31.9) | 47 (68.1) | 69 (100) |
Total | 193 | 374 | 567 |
Relationship between body weight misperception and demographic variables.
Sociodemographic characteristics | B | SE | Wald | Odds ratio | 95% CI | |||
Male (reference) | ||||||||
Female | 0.490 | 0.186 | 6.962 | 1 | .008a | 1.633 | 1.134-2.350 | |
Young adult (reference) | ||||||||
Middle-aged adult | –0.667 | 0.191 | 12.219 | 1 | .001a | 0.513 | 0.353-0.746 | |
Older adult | –0.467 | 0.353 | 1.750 | 1 | .19 | 0.627 | 0.314-1.252 | |
Primary school completed (reference) | ||||||||
Secondary school completed | –0.277 | .366 | 0.573 | 1 | .45 | 0.758 | 0.370-1.553 | |
Tertiary education completed | –0.125 | .357 | 0.123 | 1 | .73 | 0.882 | 0.439-1.776 | |
Postgraduate education | 0.023 | .369 | 0.004 | 1 | .95 | 1.023 | 0.497-2.107 | |
Employed (reference) | ||||||||
Unemployed | –0.937 | .446 | 4.409 | 1 | .04a | 0.392 | 0.164-0.940 | |
Pensioner | –0.877 | .841 | 1.086 | 1 | .30 | 0.416 | 0.080-2.164 | |
Single (reference) | ||||||||
Married | –.147 | .254 | 0.335 | 1 | .56 | .863 | 0.525-1.420 | |
Constant | 0.124 | 0.397 | 0.097 | 1 | 0.76 | 1.132 |
aSignificant at
We performed logistic regression to assess the impact of sociodemographic variables on weight dissatisfaction among the overweight and obese adult Nigerians in our study population. The model contained sex, age, highest educational level, employment status, and marital status as independent variables, with weight dissatisfaction as the dependent variable. The model explained between 4.7% (Cox and Snell
Weight dissatisfaction among the overweight and obese Nigerian adult study population.
Description | Men |
Women |
Total |
Dissatisfied | 70 (30.0) | 163 (70.0) | 233 (42.9) |
Satisfied | 123 (37.9) | 211 (65.1) | 324 (57.1) |
Total | 193 (34.0) | 374 (66.0) | 567 (100) |
This study sought to determine the prevalence of weight misperception and dissatisfaction among Nigerian overweight and obese adults, as well as those factors that would predict weight perception and dissatisfaction. The outcome of this study shows that more than half of our participants perceived their BMI as either underweight or normal, and the majority of them were women, although we found no difference between male and female weight perception. The level of agreement between BMI and weight perception was actually very poor, which accounts for why more than half perceived their weight to be underweight or normal. Of the participants, 41.1% displayed dissatisfaction toward their body weight (BMI).
Weight reduction success depends on a few factors, among which are weight control practice and behavior acquired by the individual. Recognition and appreciation of one’s body weight once it is compromising health is an important factor in reducing excess weight. This can be achieved through accurate body weight perception. Weight control behaviors and practices have been shown to be caused by body weight perception [
Weight misperception was reported among overweight and obese Sri Lankan adults in a study in which more than two-thirds of overweight and one-third of obese Sri Lankan adults misperceived their weight to be normal or underweight [
The predictors of weight misperception were sex (female), young adult age, and being employed. This is contrary to the finding of Jayawardena et al [
The extent of body weight satisfaction or dissatisfaction hinges on self-assessment of one’s body, the knowledge of which is personal and cannot be assessed or determined by someone else [
This study has shown that the majority of participants misperceived their body weight (BMI) and less than half of the participants were dissatisfied with their body weight. These results should be interpreted and generalized with caution because we obtained the responses subjectively. Another limitation is that the 2 questions that assessed weight perception and dissatisfaction were not validated and their reliability was not determined. However, the strength of this study lies in the fact that it was conducted on only overweight and obese adults of both sexes. We recommend, therefore, that further studies should be carried out using a validated measure to assess weight misperception and dissatisfaction. We also recommend that various weight reduction steps and attempts being made by overweight and obese individuals should be assessed.
body mass index
Sri Lankan Diabetes Cardiovascular Study
World Health Organization
No financial support was received for the research or the authorship of this paper.
None declared.