Misperceptions of Weight Status in Military Men and Women.

Objective: Military members may be in a unique position to misperceive their weight status because of the expectations of military service-specific body composition standards and sex-specific ideals of body image. Two-thirds of military service members are overweight or obese, costing the Department of Defense over $1 billion/year. This study assessed accuracy of perceived weight status.

Materials And Methods: A cross-sectional, descriptive study of active duty service members (n = 295). Participants were predominantly white (57%), Army (91%), male (71%), with a mean age of 30.1 ± 8.6 years. Thirty-six percent were normal body mass index (BMI) (22.7 ± 1.6 kg/m) and 64% were overweight/obese BMI (29.3 ± 3.3 kg/m). Subject BMI (m/kg) was dichotomized as normal (18.5-24.9 kg/m) or overweight (≥25 kg/m); BMI status was contrasted to perceived weight. The study was approved by the Institutional Review Boards at Madigan and Brook Army Medical Centers. Inferential statistics between groups compared differences between accurate and inaccurate weight status perception. Binary logistic regression was performed to identify if significant independent variables contributed to predicting weight status accuracy. Data were analyzed using SPSS Predictive Analytic Software version 21 with statistical significance set at p < 0.05.

Results: A higher education is associated with a 2.6 higher odds of accurately perceiving weight status. Trying to lose weight is associated with a 0.31 lower odds of accurate perception of weight status. Normal BMI: no men and 29% of women perceived they were overweight; 81% of normal weight women with inaccurate weight perceptions were attempting weight loss (p = 0.005). Overweight BMI: 66% of men and 63% of women were not dieting and 42% of men and 6% of women perceived being at the right weight (p < 0.001). Accurate weight perceivers: The majority of overweight/obese females (94%) and males (85%) with an accurate weight perception were trying to lose weight, compared to 30% of those who had inaccurate weight perceptions (p = 0.002 and p < 0.001, respectively).

Conclusions: Weight misperception may result in underestimation of personal health risk associated with weight gain and may lead to undesirable weight-related outcomes. Aspects of the military culture, such as weight and body composition standards, as well as an emphasis on physical fitness, may influence weight perception in military members differently than that observed in civilian populations, and may influence military men and women differently. Incongruence between actual and perceived weight status and lifestyle behaviors reveals a need for tailored interventions and inclusion of public health campaigns.