Background: When obese people fail to properly
perceive their body size, it leads to lack of motivation for
adequate lifestyle modification needed for improvement of
weight and health status. This study investigated how
obese people perceive their body size, factors influencing
misperception, and their attempts at lifestyle modification.
Methods: A total of 1,296 subjects were enrolled since
March to June 2009 from two separate health promotion
centers belonging to different general hospitals located in
Incheon and Gyeonggi-do. The subjects were composed of
413 obese subjects (body mass index ≥ 25 kg/m2) and
277 centrally obese subjects (waist circumference ≥ 90
cm for men, 85 cm for women). The subjects’ perception
of their body size and their attempts at lifestyle
modification were investigated.
Results: In cases of proper body size perception,
54.7% of obese and 43.7% of centrally obese persons had
attempted a lifestyle modification. However, in cases of
misperception, only 6.5% of obese and 12.5% of centrally
obese persons had attempted lifestyle modification.
Among the obese group, those over 65 year-old (odds
ratio [OR] 5.22; 95% confidence interval [CI] 1.21-3.98)
and males (OR, 2.20; 95% CI, 1.56-17.46) tended to have
a misperception concerning their weight status compared
to those under 35 years and females. In contrast,
metabolic syndrome patients manifested low level of
misperception (OR, 0.57; 95% CI, 0.35-0.94). Among the
centrally obese group, there were no meaningful factors
related to misperception.
Conclusion: In obese population, misperception of
body size was strongly related to low proportion of
attempts at lifestyle modification. Factors such as ‘old
age’, ‘male’ and ‘no metabolic syndrome’ were related to
misperception of body size.

Keywords: Obesity, Central obesity, Perception, Metabolic
syndrome, Lifestyle modification