Weight underestimation linked to anxiety and depression in a cross-sectional study of overweight individuals in a Sami and non-Sami Norwegian population: the SAMINOR Study

Abstract

ObjectivesUnderestimation of overweight/obesity may prevent weight loss attempts, resulting in further weight gain and maintenance of overweight. Mental health benefits may nevertheless surpass negative consequences. Our main objective was to study the association between underestimation of overweight/obesity and symptoms of anxiety and depression in Sami and non-Sami populations.DesignPopulation-based cross-sectional study.SettingThe SAMINOR 2 Clinical Study with participants from 10 municipalities in Northern Norway enrolled between 2012 and 2014.ParticipantsThe study included 3266 adults of multiethnic rural origin with overweight/obesity (body mass index (BMI) ≥25 kg/m2) whereof 1384 underestimated their weight (42%).Primary and secondary outcome measuresPrimary outcome measure was symptoms of anxiety and depression and secondary outcome measures were BMI and the demographic variables: sex, age, education and marital status.ResultsA higher proportion of Sami men compared with non-Sami men were obese, and reported more symptoms of anxiety and depression. More men than women, and a higher proportion of Sami women compared with non-Sami women, underestimated their weight. Multivariable-adjusted analyses showed that women were less likely to underestimate their weight compared with men (OR 0.43, 95% CI 0.33 to 0.55 in Sami and OR 0.33, 95% CI 0.26 to 0.42 in non-Sami), higher BMI was protective against weight underestimation (OR 0.72, 95% CI 0.69 to 0.75 in Sami and OR 0.63, 95% CI 0.60 to 0.67 in non-Sami), slightly higher odds of weight underestimation were observed with increasing age in both ethnic groups (OR 1.03, 95% CI 1.01 to 1.05 in Sami and OR 1.02, 95% CI 1.00 to 1.03 in non-Sami), while higher education lowered the odds in non-Sami (OR 0.69, 95% CI 0.55 to 0.87). Weight underestimation was protectively associated with anxiety and depression in Sami men (OR 0.48, 95% CI 0.27 to 0.84) and in non-Sami women (OR 0.44, 95% CI 0.25 to 0.78) adjusted for age, BMI, education and marital status.ConclusionsIndependent of ethnicity, more men than women underestimated their weight. Underestimation of weight was protectively associated with anxiety and depression in Sami men and non-Sami women.

Cognitive insight is associated with perceived body weight in overweight and obese adults

“…Considering that this sample comprised only overweight and obese participants, this means the closer one is to a normal BMI, the more likely they are to think they are normalas weight increases the less likely participants are to think they are normal and/or weight gain becomes harder to deny. A Norwegian study of overweight individuals had similar resultsfinding that a higher BMI was protective against weight underestimation [15]. However, as our categories were limited to three groups (participants could only select whether they perceived themselves to be underweight, normal weight or overweight) this decreased our sensitivity to pick up whether individuals with very high BMIs were also underestimating their weightthese individuals, for instance, might think they are overweight when they are in fact obese.…”

“…A longitudinal study found that weight misperception among overweight/obese adolescents of white ethnicity in the USA may be protective against depression in adulthood [14]. Other cross-sectional studies have also found a protective effect of misperceived weight on mental health [15,16].…”

Disordered Eating amongst Adolescents

“…Being dissatisfied with one's body is known to associate with changes in affect, lower selfesteem, and social dysfunction [118]. Interestingly, weight underestimation has been associated with less symptoms of anxiety/depression in both adulthood [119] and preadulthood [120].…”

10. Symptovmh byöpmedimssturremidie jïh madtjelesvoetese jïjtse kråahpine

“…På norsk ble denne studien kalt «Underestimering av vekt knyttet til angst og depresjon blant samer og ikke-samer med overvekt: SAMINOR 2 -den kliniske undersøkelsen» (8). Så vidt vi vet er dette den første studien som har undersøkt oppfattelsen av egen kroppsstørrelse i samsvar med målt vekt i et fler-etnisk utvalg i Nord-Norge.…”

“…Konfidensintervall som strekker seg over verdien 1,0 er ikke statistisk signifikante, hvilket betyr at det ikke er noen forskjell i angst/depresjonsplager mellom de som underestimerer sin overvekt og de som ikke gjør det. Figuren er tidligere publisert i engelsk utgave i artikkelen: Kvaløy et al(8), http://dx.doi.org/10.1136/bmjopen-2019-031810, © Forfattere, lisensiert under CC BY-NC 4.0…”