Perceived weight status and weight change among a U.S. adult sample

Examine bidirectional associations between weight perception and weight change over time among adults.

Data are from adult employees (N = 623) across 12 U.S. public high schools participating in a cluster-randomized multilevel weight gain prevention intervention. Data were collected at baseline, 12 months, and 24 months. Perceived weight status (very/somewhat underweight, just right, somewhat overweight, very overweight) were obtained via self-administered surveys. Weight (kg) was measured by trained staff. Change in weight was calculated as the difference between baseline weight and weight at each follow-up time point. Structural equation models were used to assess bidirectional associations of perceived weight status and change in weight over time. Models were adjusted for study condition, gender, age, race/ethnicity, education level, and previous time point.

The sample was 65% female with a mean age of 44.6 (SD = 11.3). Nearly two thirds of the sample consisted of people with overweight (38.8%) or obesity (27.3%). Structural equation models indicated that baseline weight predicted subsequent perceived weight status (β = 0.26; P < 0.001), whereas baseline perceived weight status did not predict subsequent change in weight, adjusting for previous time point and covariates.

Results do not support bidirectional causality between weight perception and weight change in an adult sample.