Differential Association Between Actual and Perceived Obesity Between African Americans and Whites in the United States

   Background and aims: Although actual and perceived obesity are associated, some research has shown that this association may differ across racial and ethnic groups. Accordingly, this cross-sectional study tested racial differences regarding the association between actual and perceived obesity among American adults. Methods: The Health Information National Trends Survey (HINTS ۵- Cycle ۳) is a representative survey of American adults conducted in ۲۰۱۹. A total number of ۳۷۳۱ adults entered our analysis, including ۳۰۵۴ (۸۱.۹%) non-Hispanic Whites and ۶۷۷ (۱۸.۱%) African Americans (AAs). The independent variable was actual obesity, which was defined as a body mass index of ۳۰ or greater. The outcome was perceived as obesity. In addition, age, gender, marital status, education, and income were considered as control variables (confounders), and the race was the focal effect modifier. Finally, logistic regressions without and with interaction terms were utilized to analyze the data. Results: Overall, actual and perceived obesity were associated, with obese individuals having higher odds of seeing themselves as obese (odds ratio [OR] = ۲۵.۸۲, ۹۵% CI = ۱۸.۵۸-۳۵.۸۹, P < ۰.۰۰۱). Furthermore, race showed a statistical interaction with actual on perceived obesity (OR = ۰.۲۷, ۹۵% CI = ۰.۱۴-۰.۵۵, P < ۰.۰۰۱), indicating a weaker link between the two for AAs compared to non-Hispanic Whites. Race-stratified models also confirmed the same pattern with the actual and perceived obesity, showing a weaker association for AAs (OR = ۱۵.۶۱, ۹۵% CI = ۹.۵۳-۲۵.۵۹, P < ۰.۰۰۱) in comparison with non-Hispanic Whites (OR = ۴۶.۲۳, ۹۵% CI = ۲۷.۰۱-۷۰۹.۱۴, P < ۰.۰۰۱). Conclusion: AAs compared to non-Hispanic Whites differed in the effect of their actual obesity on their perceived obesity. This may explain the looser association of obesity and depression in AAs as compared to Whites.

Keywords:

population groups , Obesity , Body Mass Index , perceived weight