The association between misperceptions around weight status and quality of life in adults in Australia.
BACKGROUND
Limited evidence supports a possible association between a person's perception of their weight status and their quality of life (QoL). This study evaluates whether misperception around weight status is associated with QoL and the impact of gender on this association.


METHODS
A cross-sectional survey of Australian adults (n = 1,905 analysed) collected self-reported height and weight (used to estimate BMI), gender and QoL (described using the AQoL-8D). Participants reported whether they perceived their weight status to be 'underweight', 'healthy weight', 'overweight' or 'obese'. Misperception around weight status was categorised based on perceived weight status and self-reported BMI. Ordinary least squares regression was used to test associations between self-reported overall, physical and psychosocial QoL, misperception of weight status, and gender, across different BMI categories, after controlling for income, education, relationship status and health conditions.


RESULTS
Compared to accurate perception, underestimation of weight status was associated with higher overall QoL for obese males and females and for overweight males. Overestimation of weight status was associated with higher overall QoL for underweight females and lower overall QoL for healthy weight males and females. The same pattern was seen for psychosocial QoL. Physical QoL was less sensitive to misperception than psychosocial QoL.


CONCLUSIONS
Self-reported misperception around weight status is associated with overall, psychosocial and to a lesser extent physical QoL in Australian adults, although its role depends on BMI category and gender. Generally misperception in the direction of "healthy weight" is associated with higher QoL and overestimation of weight status by those who are of healthy weight is associated with lower QoL. Findings should be confirmed in datasets that contain measured as opposed to self-report height and weight.
School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia.
Christopher
C
Heard
Menzies Health Institute Queensland, Griffith University, Queensland, Australia.
Paul A
PA
Scuffham
Institute for Choice, Business School, University of South Australia, Adelaide, South Australia, Australia.
Julie
J
Ratcliffe
School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, Australia. Jennifer.whitty@uea.ac.uk.|Menzies Health Institute Queensland, Griffith University, Queensland, Australia. Jennifer.whitty@uea.ac.uk.|Health Economics Group, Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich Research Park, Norwich, UK, NR4 7JT. Jennifer.whitty@uea.ac.uk.
Jennifer A
JA
Whitty
D000328:Adult; D001315:Australia; D015992:Body Mass Index; D001835:Body Weight; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009765:Obesity / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D057566:Self Report; D013851:Thinness; D055815:Young Adult
Obesity; Perceived weight; Predictors of quality-of-life; Public health