Levels and Associations of Weight Misperception with Healthy Lifestyle among Adults in Saudi Arabia

Introduction: Obesity affects more than one-quarter of adults in Saudi Arabia and is on the rise. A significant proportion of overweight and obese individuals misperceive their weight, and this misperception can affect their likelihood to exercise, consume healthy foods, or change unhealthy dietary habits. This study examines the prevalence of weight misperceptions in a national sample of Saudi adults and explores weight misperception association with sociodemographic factors, behavioral factors, and health status. Methods: This study was a nationwide cross-sectional survey conducted via phone interviews. A proportional quota sampling technique was used to obtain equal distributions of participants, stratified by age and gender, across the 13 regions of Saudi Arabia. Weight and height were self-reported, and obesity was determined as a BMI >= 30. Participants were asked to describe their current weight as ideal, underweight, overweight, or obese. Misclassification was then compared across groups according to a range of sociodemographic factors, behavioral risk factors, and health indicators. Results: Of the 6,239 participants contacted, 4,709 (75.5%) responded and completed the interview. Of them, 50.1% were female, and the mean age was 36.4 (SD +/- 13.55) years. The majority (70.1%) of participants indicated having weighed themselves within the past 30 days. The prevalence of weight misperception in general was 42.0%, and in obese participants, it was 67.6%. In addition, a significant association was observed between weight misperception and obesity, age-group, educational level, diagnosed chronic condition, self-rated health, and sedentary lifestyle. There was no significant association between weight misperception and gender, physical activity, or a nutritional knowledge. Conclusions: Weight misperception could be used as an indicator of a poor health routine that may lead to negative health outcomes.