title: Underestimation of weight and its associated factors in overweight and obese university students from 21 low, middle and emerging economy countries.
abstract: BACKGROUND
  Awareness of overweight status is an important factor of weight control and may have more impact on one's decision to lose weight than objective weight status. The purpose of this study was to assess the prevalence of underestimation of overweight/obesity and its associated factors among university students from 21 low, middle and emerging economy countries.
  
  
  METHODS
  In a cross-sectional survey the total sample included 15,068 undergraduate university students (mean age 20.8, SD=2.8, age range of 16-30 years) from 21 countries. Anthropometric measurements and self-administrated questionnaire were applied to collected data.
  
  
  RESULTS
  The prevalence of weight underestimation (being normal or underweight) for overweight or obese university students was 33.3% (41% in men and 25.1% in women), among overweight students, 39% felt they had normal weight or were under weight, and among obese students 67% did not rate themselves as obese or very overweight. In multivariate logistic regression analysis, being male, poor subjective health status, lack of overweight health risk awareness, lack of importance to lose weight, not trying and not dieting to lose weight, and regular breakfast was associated with underestimation of weight in overweight and obese university students.
  
  
  CONCLUSIONS
  The study found a high prevalence of underestimation of overweight/obesity among university students. Several factors identified can be utilized in health promotion programmes including diet and weight management behaviours to focus on inaccurate weight perceptions on the design of weight control, in particular for men.
authors.affiliation: ASEAN Institute for Health Development, Madidol University, Salaya, Phutthamonthon, Nakhonpathom 73170, Thailand; Department of Psychology, University of Limpopo, Turfloop Campus, Sovenga 0727, South Africa; HIV/AIDS/STIs and TB (HAST), Human Sciences Research Council, Private Bag X41, Pretoria 0001, South Africa. Electronic address: karl.pel@mahidol.ac.th.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
authors.affiliation: ASEAN Institute for Health Development, Madidol University, Salaya, Phutthamonthon, Nakhonpathom 73170, Thailand; Department of Research Innovation and Development, University of Limpopo, Turfloop Campus, Sovenga 0727, South Africa. Electronic address: supaprom@yahoo.com.
authors.forename: Supa
authors.initials: S
authors.lastname: Pengpid
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D057210:Delayed Diagnosis; D003906:Developing Countries; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology; D050177:Overweight / Q000175:diagnosis* / Q000453:epidemiology; D063766:Pediatric Obesity / Q000175:diagnosis* / Q000453:epidemiology; D015995:Prevalence; D012306:Risk; D057566:Self Report; D012737:Sex Factors; D013334:Students; D014495:Universities; D055815:Young Adult
keywords: Body weight misperception; Obese; Overweight; Young adults