Weight perceptions in older adults: findings from the English Longitudinal Study of Ageing.

Objectives: To explore weight perceptions in a large, nationally representative sample of older adults, and the extent to which they differ according to age and perceived health status.

Setting: England.

Participants: 5240 men and women (≥50 years old) participating in the English Longitudinal Study of Ageing (2016/2017).

Main Outcome Measures: Weight perception was self-reported as too heavy, too light or about right.

Results: The majority of older adults endorsed a weight perception that matched their (objectively measured) body mass index (BMI) classification. However, 1 in 10 (9.9%) older adults classified by BMI as normal weight (18.5-24.9 kg/m) felt too light, with women at the upper end of the older age spectrum (OR=1.04, 95% CI 1.01 to 1.09), and men (OR=3.70, 95% CI 1.88 to 7.28) and women (OR=2.61, 95% CI 1.27 to 5.35) in poorer health more likely to do so. Almost half (44.8%) of older adults classified as overweight (25-29.9 kg/m) and 1 in 10 (10.3%) classified as obese (≥30 kg/m) felt about the right weight, with this observed more frequently among men and women at the upper end of the older age spectrum (OR range 1.04-1.06).

Conclusion: Older adults' perceptions of their own weight generally correspond with traditional BMI cut-offs for normal weight, overweight and obesity. However, a substantial minority 'underestimate' their weight status, with those at the upper end of the age spectrum and those in poorer health more likely to do so.