South Asian immigrant perspectives on overweight, obesity, and the relationship between weight and health

Background: South Asians may be more likely than other U.S. populations to underestimate their weight status and weight-related health risks due to the lower Body Mass Index (BMI) cut-offs recommended by the World Health Organization (WHO) for overweight/obesity among Asian populations. Objective: To describe among a U.S. South Asian population actual as compared with perceived weight status, perceptions of ideal weight and perceived impact of weight on health. Methods: South Asian adults in Chicago, IL were interviewed in English, Hindi, and Urdu. Participants were asked: (1) what do you think about your weight, (2) what do you think your ideal weight range should be, and (3) do you think that your weight affects your health; if yes, how? Participants' weight and height were measured. Based on WHO recommendations, overweight was defined as BMI 23-27.4kg/m2 and obese as BMI >27.5kg/m2. Results: Participants (N=75) were 51% male, mean age 46, 60% recent immigrants. Eighty-six percent (66/75) of participants were overweight/obese. Sixty-four percent of overweight (14/22) and 18% of obese participants (5/28) perceived their weight to be normal. Seventy percent of participants indicated ideal weights corresponding to BMI >23kg/m2. Seventy-three percent (19/26) of overweight and 26% (9/34) of obese participants felt their weight did not affect their health. Many participants cited weight-related physical problems, but few connected overweight with development of chronic diseases. Conclusion: South Asians in the U.S. underestimate their weight status and the impact of overweight on risk for chronic diseases. Weight loss interventions among South Asians should reform these misperceptions.