Self-perception of unhealthy weight among Mexican women on the US-Mexico border

BACKGROUND: Overweight (body mass index [BMI]≥25 kg/m2 ) and obesity (BMI ≥30kg/m2 ) contribute to morbidity in women of reproductive age. On the US-Mexico border, the prevalence of unhealthy weight is high, but self-perception of weight status is unknown. Mexico's 2006 National Survey of Health and Nutrition (ENSANUT) provided an opportunity to measure self-perception of weight and associated factors.METHODS: Non-pregnant women 20-49 years of age from 80 Mexican border municipalities (N=876) were sampled. Women were classified by clinical measurement of BMI and self-reported weight status (underweight, normal, overweight, obese); we compared these two measures to identify weight misperception. Age, education, parity and a previous diagnosis of hypertension, high-triglycerides, high-cholesterol, and/or obesity were examined in multivariable analyses using weight status misperception as the dependent variable. RESULTS: Most women were overweight (28.9%) or obese (45.5%); 37.9% of overweight and 92.1% of obese women incorrectly reported their weight classification. Among all women with unhealthy weight (overweight/obese), women >35 years misreported their weight status more frequently than younger women (OR:1.6; CI:1.1-2.3) and women with less education misreported more often than with more education (OR:2.3; CI:1.4--4.0). Women diagnosed with hypertension misperceived their weight status more often than those without a diagnosis (OR:1.9; CI:1.1-3.4). CONCLUSION: Older, less educated, and hypertensive women were most likely to misperceive their weight. These women may be difficult to enroll in healthy weight programs, and interventions developed for these populations will need to account for limited self-awareness of obesity.