Self-perception of being overweight in Spanish adults

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Abstract
Objective: To describe the frequency, distribution and trend in misperceived overweight and obesity. Design: Three independent cross-sectional studies carried out in 1987, 1995 and 1997 over representative samples of Spanish adult population. Setting: Spanish adult population aged 20 y and over. Subjects and interventions: A total of 11 496 men and women aged 20 y and over with a body mass index (BMI) ≥25 kg/m2. Main outcome measures: Prevalence and time trend of misperceived overweight and obesity based on self-perceived weight and height. Results: Some 28.4% of the population did not perceive themselves to be overweight or obese in 1987 (26.9% in 1995/97). Overweight was more frequently misperceived among men, persons over 64 y of age, those residing in rural areas and those with an elementary educational level. The largest percentages of misperceived overweight were in the more moderate levels of BMI: 50% of men and 30% of women with a BMI of 25–26.9 kg/m2 in 1995/1997 did not perceive themselves to be overweight. Conclusions: Misperceived overweight and obesity is frequent in the adult population in Spain. Some social and cultural factors may explain its higher frequency in men, older individuals and those with elementary level of education. The fact that most of those who do not perceive themselves to be overweight are in the moderate levels of overweight should be taken into account when designing strategies for the prevention and control of overweight and obesity in the general population.