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American Journal of Epidemiology Advance Access originally published online on February 16, 2009
American Journal of Epidemiology 2009 169(7):857-866; doi:10.1093/aje/kwn412
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

The Relation Between Body Size Perception and Change in Body Mass Index Over 13 Years

The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Elizabeth Lynch, Kiang Liu, Gina S. Wei, Bonnie Spring, Catarina Kiefe and Philip Greenland

Correspondence to Dr. Elizabeth Lynch, Department of Preventive Medicine, Rush University, 1700 West Van Buren, Suite 470, Chicago, IL 60612 (e-mail: elizabeth_lynch{at}rush.edu).

Received for publication June 26, 2008. Accepted for publication December 11, 2008.

The authors assessed associations of body size perception and weight change over 13 years in black men and women and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) Study (1992–2005). The perceptions of self and ideal body size were measured by using the Stunkard 9-figure scale at the year 7 examination (1992–1993). Figures were classified into underweight, normal weight, overweight, and obese. Self-ideal discrepancy yielded 4 body size satisfaction categories. Body mass index (BMI) (measured at years 7, 10, 15, and 20) was the dependent variable in gender-specific adjusted multiple regression models stratified by year 7 BMI. Obese women who perceived themselves as obese lost 0.09 BMI units annually, while those who perceived themselves as normal weight gained 0.31 units annually (P = 0.0005); obese women who considered their body size much too large had less annual weight gain than did those who considered their body size a bit too large (0.21 vs. 0.38 BMI units; P = 0.009). Obese women with overweight ideal body size gained less weight annually than did those with normal weight ideal body size (0.12 vs. 0.27 BMI units; P = 0.04). Results for men showed fewer and weaker associations. When obese women perceive themselves as obese and feel that their body size is too large, they gain less weight over time.

body image; body mass index; health status disparities; obesity; psychology; weight gain

Abbreviations: BMI, body mass index; CARDIA, Coronary Artery Risk Development in Young Adults


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