Perceptions of overweight in a Caribbean population: the role of health professionals

Background. The prevalence of obesity and its complications is particularly high in the Caribbean. Underestimation of weight status could explain the failure by subjects concerned to adopt behaviours complying with medical recommendations. Little research is available on the role of health professionals in overweight perception. Objective. To examine relationships between overweight underestimation and lack of communication on overweight diagnosis by health professionals in a multicultural Caribbean population. Methods. A cross-sectional study, lead in 2014 on a sample representative of the population of Saint-Martin (395 subjects, 25-74 years). Overweight perception was assessed on Likert scale. Corpulence was assessed from measured waist circumference (WC). Individuals with excess abdominal adiposity (WC >= 80 cm for women, >= 94 cm for men) but stating they did not feel overweight were considered to underestimate their weight status. Patient-reported lack of communication on their diagnosis by health professionals was likewise explored. Respondents' first language defined cultural community. Multivariate analysis used logistic regression. Results. Among individuals presenting excessive WC, 4 out of 10 did not perceive themselves as overweight. Six out of 10 said they had never been told about their weight by a health professional, whether or not they had their weight and waist measured by their referring physician in the preceding year. Independently from WC, overweight underestimation was associated with lack of communication on overweight diagnosis for both sexes. For women, overweight underestimation was associated with belonging to the Creole community. Conclusion. Greater care is required when giving a diagnosis of overweight, particularly in socialcultural contexts where weight norms differ.