The Impact of Weight Status Perception on Perceived Risk for Diabetes and Diabetes Screening.

Abstract

Self-perceived weight status refers to how an individual assesses his or her own body weight and size. Misperception of weight status can occur in either direction, with underperception of weight status being more prevalent. Underperception of weight status is closely associated with BMI category, with those who are categorized as obese having a higher prevalence ratio (PR) of misperceiving their weight status of 5.31 (95% CI, 3.41-8.25) compared to those who have a healthy weight, even after adjusting for other covariates. Males, those identifying as Native Hawaiian or Other Pacific Islander and those who have ever served in the US Military are more likely to underperceive their weight status, even after adjusting for BMI category, whereas those in older age groups are less likely to underperceive their weight status compared to younger adults. Weight status underperception is associated with diabetes risk perception. Individuals who overperceive their weight status are more likely to perceive themselves to be at risk for diabetes (PR 1.42, 95% CI 1.14-1.76), whereas those who underperceive their weight status are less likely to do so (PR 0.76, 95% CI 0.60-0.97) compared to those with accurate weight status perception. Other factors associated with diabetes risk perception include being diagnosed at risk (PR 1.97, 95% CI 1.58-2.45), having a family history of diabetes (PR 1.77, 95% CI 1.39-2.24), and BMI category, with obese individuals being more likely to perceive themselves to be at risk compared to those who have a healthy weight (PR 2.07, 95% CI 1.46-2.93). Higher diabetes risk perception is associated with greater receipt of diabetes screening in the past three years (PR 1.31, 95% CI 1.05-1.62) even after adjusting for age and other potential confounders. The findings have important implications for correcting weight status perception and enhancing awareness of diabetes risk, with the goal of motivating those at risk to engage in lifestyle change efforts targeted at reducing their risk for diabetes.