Weight perception and risk of non-communicable diseases among women: A cross-sectional study in Ghana

Objective measures of overweight/obesity have shown consistent association with other key non-communicable diseases (NCDs) such as type II diabetes and hypertension, but there is a gap in knowledge about the role of how people's perceived weight in the aetiology of these diseases, especially in the African context. This study investigated the relationship between weight perception and NCD risk factors among women living in an urban setting in Ghana. A cross-sectional design was employed to recruit 378 female adults aged 18-65 years in the Accra Metropolis using convenience sampling method. Weight perception was assessed using the Feel-weight-status minus Actual-weight-status Index. Obesity was diagnosed using BMI based on the World Health Organization cut-offs. Elevated blood sugar level and pressure were assessed through a single random blood sugar test and multiple blood pressure readings, respectively. Regression models were used to determine associations between weight perception and NCD risk factors, while controlling for potential confounders. Approximately 80% of overweight participants and 90% of obese participants underestimated their weight. The proportion at risk of central obesity, elevated blood pressure, and elevated blood glucose level were 49.5%, 29.1%, and 6.6%, respectively. Age was associated with higher odds of elevated blood glucose levels (OR = 1.049, 95% CI: 1.026 - 1.073, p < 0.0001), elevated blood pressure (OR = 1.051, 95% CI: 1.031 - 1.072, p < 0.0001), and overweight/obesity (OR = 1.065, 95% CI: 1.042 - 0.089, p < 0.0001). Accurate weight perception was associated with lower odds of overweight/obesity (OR = 0.069, 95% CI: 0.038, 0.126, p < 0.0001), but was not significantly associated with elevated blood pressure and blood glucose levels. Accurate weight perception was negatively associated with obesity among the study participants. Public health education is needed to promote accurate weight perception among women as this may help to address objective measures of overweight/obesity and mitigate NCD risk in this sub-population.