Distorted self-perceived weight status and underestimation of weight status in diabetes mellitus type 2 patients

Abstract

Objectives: Diabetes mellitus type 2 (DM 2) patients' self-perception of their weight status is very critical in diabetes care. We sought to investigate perception of weight status in a sample of 200 DM 2 patients attending an outpatient clinic at a Teaching Hospital and compared it with their BMI-measured weight status, with a focus on underestimation of their weight status. Factors associated with underestimation of weight status in this sample were also explored.

Methods: Using a cross-sectional design, anthropometric and clinical variables were assessed using appropriate tools. Questionnaires were used to collect socio-demographic data and self-perception of weight status. Self-perceived weight status was compared to BMI-measured weight status by cross-tabulation, Kappa statistics of agreement and χ2 for trend analysis. Both univariate and multiple logistic regression analysis were conducted to identify factors associated with underestimation of weight status.

Results: The prevalence of general overweight/obesity and abdominal obesity was 32.0% (n = 64) and 58.0% (n = 116) respectively. Generally, 58.0% (n = 116) of the participants had a distorted weight perceived weight status in which 77.6% (n = 90) underestimated their weight status. Factors associated with underestimation of weight status were being overweight/obese (AOR = 22.9, 95% CI = 8.30-63.07, p<0.001), not married (AOR = 3.7, 95% CI = 1.50-9.17, p = 0.005) and never tried to lose weight (AOR = 6.9, 95% CI = 2.35-19.97, p<0.001). Participants aged over 40 years and those being hyperglycaemic were not significantly associated to underestimation of weight status.

Conclusion: We found a substantial discordance between BMI-measured and self-perceived weight status. Factors that were associated with underestimation of weight status were being; overweight/obese, not married and never tried to lose weight. Diabetes patients should be provided with information about weight guidelines.

Figure 1. BMI-measured weight status compared to self-perceived weight status.

Comparison between BMI-measured weight status with perception of underweight (A); perception of normal weight (B); perception of overweight/obese (C) and perception status (D). UND =  Underweight, NOR = Normal weight, OVER/OB =  Overweight/obesity. Data was presented as proportion and analyzed using chi-square for trend.