Underestimation of body mass index through perceived body image as compared to self-reported body mass index in the European Union

An observational, cross-sectional study was conducted in a representative s ample of the European Union (7155 men and 8077 women) to calculate the unde restimation of body weight as assessed by body image among the overweight a nd obese population and identify the associated factors to this behavior. P articipants were older than 15 years and they were living in the 15 Europea n Union countries. Body mass index (BMI) was grouped into 4 categories using the cutpoints est ablished by the WHO, while perceived body image (PBI) was assessed using a nine-silhouettes drawing. The degree of underestimation between PBI as comp ared to BMI was identified in overweight and obesity categories of BMI. A m ultivariable logistic regression model for each gender was used to adjust f or potentially confounding variables. Men classified themselves worse than women, being more likely to underestimate their body weight (65.2% of men u nderestimated their weight vs 32.2% women), regardless of other socioeconom ic and attitudinal variables. The greatest degree of underestimation was ob served in Mediterranean individuals (68.7% of men and 37.9% of women undere stimated their weight). The subjects in the 'maintenance' stage of physical activity tended more often to wrongly select their actual image (71.8% for men and 38.7% for women).