Body Image 9 (2012) 184–188

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Body Image
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Brief research report

Weight status misperception among Mexican young adults

Flavia Cristina Drumond Andrade a,∗ , Marcela Raffaelli a , Margarita Teran-Garcia a , Jilber A. Jerman a ,
Celia Aradillas Garcia b , Up Amigos 2009 Study Group1
a
University of Illinois at Urbana-Champaign, Champaign, IL, USA
b
Universidad Autónoma de San Luis Potosí, Mexico

a r t i c l e i n f o a b s t r a c t

Article history: Individuals who misperceive their body size are at risk for eating disorders, unhealthy weight control
Received 12 April 2011 practices, and obesity-related diseases. This study assessed the prevalence and demographic, behav-
Received in revised form 21 October 2011 ioral, and psychosocial correlates of agreement between perceived (self-reported) and actual (measured)
Accepted 21 October 2011
body mass index categories in a sample of Mexican college applicants aged 18–20 years (N = 3622; 52%
female). Under two thirds (63.1%) accurately reported their weight status categories. Reporting accu-
Keywords:
racy was lower among overweight and obese participants. In multivariate analyses, overestimating was
Body weight status misperception
associated with female gender, younger age, lower level of parent education, and more hours of daily TV
Body mass index
Young adults
viewing; underestimating was associated with male gender and older age. In within-gender analyses,
Mexico overestimating was associated with hours of TV among men and underestimating was positively associ-
ated with depressive symptoms among women. This study adds to a growing international literature on
body weight status misperception among adolescents and young adults.
© 2011 Elsevier Ltd. All rights reserved.

Introduction
Body weight misperception, a discrepancy between actual and
perceived body weight, puts both normal and overweight indi-
viduals at risk. Among normal weight individuals, perceiving
oneself as overweight is associated with eating disorders and
unhealthy weight control practices (Cachelin, Monreal, & Juarez,
2006; Liechty, 2010). In contrast, overweight and obese individu-
als who underestimate their size are unlikely to attempt weight
control or seek medical attention and are at risk of obesity-related
diseases (Brener, Eaton, Lowry, & McManus, 2004). Given these
health risks, it is important to understand discrepancies between
perceived and actual weight status.
Adolescents and adults in the U.S. and Western European often
misperceive their body weight and size (e.g., Dorsey, Eberhardt,
& Ogden, 2009; Isomaa, Isomaa, Marttunen, Kaltiala-Heino,
& Bjorkqvist, 2011; Jáuregui-Lobera, Bolaños-Ríos, Santiago-
Fernandez, Garrido-Casals, & Sánchez, 2011; Liechty, 2010).
However, little work has been conducted in developing coun-
∗ Corresponding author at: University of Illinois at Urbana-Champaign, Depart-
ment of Kinesiology and Community Health, Champaign, IL, USA.
Tel.: +1 2173333675.
E-mail address: fandrade@illinois.edu (F.C.D. Andrade).
1
Study Group Members: Angela Wiley, Eduardo Medina, Esperanza de la Cruz,
Diana Patricia Portales Pérez, Carmen Rojas, Omar Sánchez Armáss, Sergio Rosales
Mendoza and Juan Manuel Vargas Morales.
tries like Mexico, where rates of obesity and related disorders
are rapidly increasing (Salazar-Martinez, Allen, Fernandez-Ortega,
Torres-Mejia, Galal, & Lazcano-Ponce, 2006; Toro et al., 2006). There
is evidence that young Mexican men are concerned about their
height, strength and overall physical condition, whereas young
women worry about their weight and specific body parts (Mejia-
Arauz, Sheets, Villasenor, & Tello, 2007). Mexican adolescents also
report pressure from friends and family to lose weight and describe
dieting, physical activity and vomiting to lose weight (Toro et al.,
2006). Building on this work, our first aim was to examine the
prevalence of body weight status misperception among Mexican
young adults.
Our second aim is to examine whether body weight status
misperception was associated with demographic, behavioral, and
psychosocial factors identified in prior research. Women tend
to overestimate their weight whereas men underestimate (Brug,
Wammes, Kremers, Giskes, & Oenema, 2006; Isomaa et al., 2011;
Jáuregui-Lobera et al., 2011; ter Bogt, van Dorsselaer, Monshouwer,
Verdurmen, Engels, & Vollebergh, 2006). Body weight mispercep-
tion also increases with age (Brug et al., 2006; Jáuregui-Lobera
et al., 2011) and is more common at lower levels of education and
income (Dorsey et al., 2009; Gregory, Blanck, Gillespie, Maynard,
& Serdula, 2008; Johnson-Taylor, Fisher, Hubbard, Starke-Reed, &
Eggers, 2008). Accordingly, we examined whether gender, age, and
socioeconomic status were associated with body weight misper-
ception.
Fewer studies have explored non-demographic correlates of
body weight misperception, so we drew on related literatures to

1740-1445/$ – see front matter © 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.bodyim.2011.10.006
 F.C.D. Andrade et al. / Body Image 9 (2012) 184–188
identify specific variables. Higher levels of depressive symptoms
were associated with misperceiving oneself as overweight among
female students in Finland (Isomaa et al., 2011). Social norms and
media messages have also been shown to contribute to body image
ideals and self-perceptions by influencing what individuals view
as desirable or normal body sizes (Swami et al., 2010). Our study
extends this research by examining whether psychological and
behavioral factors are associated with body weight status misper-
ception in Mexico.
Method
Participants and Procedures
Data were from a collaborative study conducted by the Uni-
versidad Autónoma de San Luis Potosí (UASLP) and the University
of Illinois at Urbana-Champaign. The study involves annual cross-
sectional data collection from UASLP applicants who are screened
at the UASLP clinic and complete self-report measures (in Span-
ish) previously adapted for use in Mexico. The study was approved
by Institutional Review Boards at both collaborating institutions
and participants provided written consent to have data used for
research purposes. No remuneration was provided.
The current analysis uses 2009 data from 3622 respondents aged
18–20 with complete data on actual and perceived body mass index
(BMI) categories. The analytic sample comprised 1886 women and
1736 men.
Measures
Actual and perceived BMI categories. Body weight and height
were measured without shoes and with light clothing by trained
examiners. Weight was measured to the nearest 0.1 kg using a
calibrated scale (Torino, Tecno Lógica, Mexicana, Mexico). Height
was measured using a fixed stadiometer and recorded to the near-
est 0.5 cm. BMI was calculated as kg/m2 and used to categorize
actual BMI: underweight (BMI ≤ 18.5), normal (BMI 18.5–24.9),
overweight (BMI 25.0–29.9) and obese (BMI ≥ 30) (Kuczmarski
et al., 2002). Participants reported whether they perceived being
“severely underweight,” “underweight,” “normal,” “overweight,”
“obese” or “do not know” (the latter were excluded). Given low
frequencies, the first two categories were merged. Individuals were
classified as “accurate” if their actual and perceived BMI categories
matched, as “overestimating” if perceived BMI was higher than
actual BMI, and as “underestimating” if perceived BMI was lighter
than actual BMI.
Demographics. Respondents reported their gender (0 = male,
1 = female); age was derived from self-reported birth date and date
of data collection. Highest level of education completed by either
parent was coded as: less than middle school, middle, high, tech-
nical school and bachelor’s degree or higher. Monthly household
income (thousands of Mexican pesos) categories were: less than
$10, $10–$15, $15–$20, $20–$25, $25 or higher. Average household
income in Mexico was $12,460 Mexican pesos in 2009 (adjusted to
2010 prices).
Depressive symptoms. Respondents completed the Center
for Epidemiological Studies Depression Scale (CESD-10; Kohout,
Berkman, Evans, & Cornoni-Huntley, 1993), indicating how often
they experienced 10 depressive symptoms during the past week.
Possible scores range from 0 to 30; a score of 10 or more is con-
sidered a positive screen for depression (Andresen, Malmgren,
Carter, & Patrick, 1994). The CESD-10 has established psychome-
tric properties (Andresen et al., 1994; Kohout et al., 1993) and has
been validated for use in Mexico (Bojorquez Chapela & Salgado de
185
Snyder, 2009). In the current sample, ˛ was .76, comparable to the ˛
of .74 reported by Bojorquez Chapela and Salgado de Snyder (2009).
TV viewing and internet use. Two items assessing time watch-
ing TV on weekdays and weekends were combined and daily TV
viewing categorized as: less than 1 h, 1–2, 2–3, and more than 3 h.
Internet use was coded as “less than daily use” vs. “daily use.”
Statistical Analysis
Analyses and multiple imputation procedures were conducted
using STATA 12.0 SE for Windows (StataCorp, College Station, TX,
USA). Missing data were most common for the household income
variable (n = 477), followed by TV viewing (n = 147) and parental
education (n = 116). Missing-value patterns were analyzed and
chained equations were used to impute missing data. Dichoto-
mous variables were estimated using logistic regression (logit) and
ordered variables were estimated using ordered logistic regression
(ologit). Age and gender were included as independent variables in
multiple imputations.
Descriptive statistics were calculated. Agreement between
actual and perceived BMI categories by gender was contrasted
using Chi-square tests (2 ). Multinomial regression analyses were
used to assess whether discrepancies between actual and perceived
BMI categories were associated with selected demographic, behav-
ioral, and psychosocial variables. Given that prior literature has
reported gender differences in associations between body misper-
ceptions and these factors, analyses were conducted separately by
gender.
Results
Parental education ranged from less than middle school (10%) to
bachelor’s degree or higher (42%). Almost half of respondents had
monthly household incomes of less than $10,000 Mexican pesos
(48%). About one-fourth presented depression symptoms (23%).
The mode for daily TV watching was 2–3 h (30%); 46% reported
daily internet use.
Agreement between Actual and Perceived BMI Categories
Table 1 displays detailed breakdowns of actual vs. perceived
BMI categories overall and by gender. Based on actual BMI, few
respondents were underweight (7.4%), most were of normal weight
(62.0%), and almost a third were overweight (21.0%) or obese (9.6%).
Perceived BMI had a different distribution: 15.9% reported being
underweight, 65.0% normal weight, 18.1% overweight and only 1.1%
obese.
In the overall sample, there was 63.1% agreement between
actual and perceived BMI. Overestimating was rare (5.3%); underes-
timating was more common (31.6%). The majority of underweight
individuals (64.9%) perceived themselves accurately. Most individ-
uals with normal BMI (79.1%) perceived themselves accurately;
16.8% underestimated and 4.1% overestimated. Among overweight
respondents, 39.8% perceived themselves accurately, but over half
described themselves as being of normal weight (57.7%). Among
individuals who were obese, only 9.5% accurately perceived their
weight status; most described themselves as overweight (75.1%).
Agreement between actual and perceived BMI differed by gen-
der (2 = 121.02, df 2, p < .001, Cramer’s V = .18). More women
correctly described their body size (69.5%) than men (56.2%). Fur-
thermore, men were more likely than women to underestimate
(40.2% vs. 23.7%, respectively) and less likely to overestimate (3.6%
vs. 6.8%). Among men, 33.6% were overweight or obese, but only
16.9% perceived themselves in those categories. Among women,
27.8% were overweight or obese and 21.2% perceived themselves
186 F.C.D. Andrade et al. / Body Image 9 (2012) 184–188

Table 1
Agreement between actual and perceived BMI categories.

Perceived BMI categories, % Actual BMI categories, %

Underweight Normal Overweight Obese

Total (n = 3622) 15.9 65.0 18.1 1.1

BMI ≤ 18.5 64.9 34.3 0.8 0.0 7.4
BMI 18.5–24.9 16.8 79.1 4.0 0.1 62.0
BMI 25.0–29.9 2.0 57.7 39.8 0.5 21.0
BMI ≥ 30.0 2.3 13.0 75.1 9.5 9.6
Men (n = 1736) 18.3 64.8 15.9 1.0
BMI ≤ 18.5 67.4 31.6 1.1 0.0 5.5
BMI 18.5–24.9 22.6 74.7 2.4 0.3 60.9
BMI 25.0–29.9 2.8 68.8 27.6 0.8 22.9
BMI ≥ 30.0 2.2 16.1 75.3 6.5 10.7
Women (n = 1886) 13.6 65.2 20.0 1.2
BMI ≤ 18.5 63.6 35.8 0.6 0.0 9.2
BMI 18.5–24.9 11.6 83.0 5.4 0.0 63.0
BMI 25.0–29.9 1.1 45.6 53.0 0.3 19.3
BMI ≥ 30.0 2.5 9.4 75.0 13.1 8.5

Notes: Actual body mass index (BMI) categories from measured height and weight.
Row and column percentages add to 100% for each sex.

as such. Overestimating was rare among normal weight men (2.6%)
and women (5.4%).
Inter-Variable Associations
Results of the multinomial regression analysis in the overall
sample (Table 2) indicated that overestimating was positively asso-
ciated with younger age, female gender and having parents who
completed middle school (vs. bachelor’s degree or more) and neg-
atively associated with watching TV for less than 1 h per day.
Underestimating was significantly associated with older age and
male gender.
Analyses were repeated by gender (results available upon
request). Among young men, watching TV for less than 1 h
(RRR = 0.28, p < .05) and 1–2 h (RRR = 0.43, p < .05) were negatively
associated with overestimating; older age (RRR = 1.28, p < .001) was
positively associated with underestimating. In contrast, among
women, younger age was negatively associated with overestimat-
ing (RRR = 0.68, p < .05), whereas depressive symptoms (RRR = 1.34,
p < .05) were positively associated with underestimating.
Discussion
The majority of the Mexican youth in our sample were accurate
in their self-perceptions, but nearly two fifths (37%) misperceived
their body weight status. Comparative data for other developing
countries are lacking; however, levels of misperception in our sam-
ple are higher than reported among Spanish (24%; Jáuregui-Lobera
et al., 2011) or Dutch (28%; Brug et al., 2006) high school students.
Two noteworthy gender differences were observed in our study.
First, young women had more accurate self-perceptions than their
male peers: 70% of women did not misperceive, compared with
56% of men. Second, as previously shown (Brug et al., 2006; Isomaa
et al., 2011; Jáuregui-Lobera et al., 2011; ter Bogt et al., 2006),
among young adults who misperceived their body weight status,
women were more likely than men to overestimate, and men were
more likely than women to underestimate, their weight status. This
is consistent with prior studies of body concerns among Mexican
adolescents (e.g., Mejia-Arauz et al., 2007; Toro et al., 2006).
The prevalence of overestimating among young women in our
sample (6.8%) is lower than reported in developed countries, where
rates of overestimating range from 13.9% (Spanish adolescents;
Jáuregui-Lobera et al., 2011) to 29% (U.S. 12–20 year olds; Liechty,
2010) to 37.6% (11–16 year old Dutch girls; ter Bogt et al., 2006).
One interpretation of the findings is that young Mexican women
may have internalized a standard of beauty that differs from the
exaggerated slimness fashionable in many Western countries, so
normal weight individuals may be less likely than U.S. and European
women to perceive themselves as overweight. Although published
studies from Mexico could not be located to evaluate this inter-
pretation, U.S. studies indicate that Latina young women endorse
larger body shape ideals for their ethnic group than do non-
Hispanic White women (Gordon, Castro, Sitnikov, & Holm-Denoma,
2010) and see a curvy body as attractive, despite recognizing it con-
flicts with the prevailing thin body ideal (Viladrich, Yeh, Bruning, &
Weiss, 2009). It is also possible that differences are due to sample
characteristics (e.g., our sample’s mean age was higher than the U.S.
and European studies cited above) or methodological differences,
given that there is no consensus on how to assess perceptions of
body weight status. We categorized perceived and measured BMI
into four categories (similar to Dorsey et al., 2009; Gregory et al.,
2008) but some studies have used fewer categories (2 in Brug et al.,
2006; 3 in ter Bogt et al., 2006) whereas others use more (e.g.,
5 in Jáuregui-Lobera et al., 2011). Future studies should explore
the extent to which cross-national differences are due to cultural
factors and/or reporting characteristics.
Turning to results for men, findings are consistent with
reports that Mexican adult men (Osuna-Ramírez, Hernández-
Prado, Campuzano, & Salmerón, 2006) and Mexican American
adolescent boys (Davis & Gergen, 1994) underestimate their weight
status more often than their female counterparts (see also Brug
et al., 2006; ter Bogt et al., 2006). Young men’s weight underes-
timation may reflect a tendency to equate large body size with
muscularity and strength, which have been identified as areas of
concern for young men in Latin America (e.g., Mejia-Arauz et al.,
2007; Mellor, McCabe, Ricciardelli, & Merino, 2008).
In addition to gender, several other demographic variables
were associated with body weight status misperceptions either
in the overall sample or within gender. In the overall sample,
younger age was associated with overestimating body weight
status, and older age with underestimating. This is consistent
with the notion that older individuals may consider weight gain
a normal aspect of aging (Brug et al., 2006). Analyses by gender
indicated differential findings such that among women younger
age was associated with overestimating and among men older age
was associated with underestimating. U.S. studies have shown that
body weight misperception is more common at lower levels of
education (Dorsey et al., 2009; Gregory et al., 2008; Johnson-Taylor
et al., 2008), and in the current study, respondents whose parents
had an middle level education were more likely to overestimate
 F.C.D. Andrade et al. / Body Image 9 (2012) 184–188 187

Table 2
Descriptive statistics and adjusted odds for overestimating and underestimating weight status among college applicants in Mexico.

Variables Overestimatinga Underestimatinga

% RRR 95% CI % RRR 95% CI

Age (mean) 18.4 0.8* [0.6,0.1.0] 18.6 1.1* [1.0,1.2]

Women 67.4 1.4* [1.0,2.0] 39.0 0.5** [0.4,0.6]
Parental educationb
Less than middle school 10.5 1.1 [0.6,1.9] 9.2 1.0 [0.8,1.3]
Middle school 24.2 1.6* [1.0,2.4] 17.0 1.0 [0.8,1.3]
High school 15.3 1.1 [0.7,1.8] 13.2 0.9 [0.7,1.2]
Technical school 13.7 1.0 [0.6,1.6] 17.4 1.2 [0.9,1.5]
Bachelor or more 36.3 1.0 43.2 1.0
Household Income (in 1000s)b
Less than $10 55.8 0.8 [0.4,1.6] 44.6 0.9 [0.7,1.2]
$10–$15 20.0 0.7 [0.4,1.5] 25.5 1.0 [0.8,1.4]
$15–$20 11.6 0.8 [0.4,1.7] 12.6 0.9 [0.6,1.3]
$20–$25 4.2 0.6 [0.2,1.5] 8.7 1.1 [0.8,1.6]
$25 or more 8.4 1.0 8.7 1.0
Depressed 25.3 1.1 [0.8,1.6] 23.4 1.1 [1.0,1.4]
Daily TV watchingb
Less than 1 h 11.0 0.6* [0.3,0.9] 16.9 0.8 [0.7,1.0]
1–2 h 29.0 0.8 [0.5,1.2] 27.9 0.8 [0.7,1.0]
2–3 h 26.8 0.7 [0.5,1.0] 28.3 0.8 [0.7,1.0]
>3 h 33.2 1.0 27.0 1.0
Daily internet use 38.4 0.9 [0.6,1.2] 48.7 1.00 [0.9,1.2]

Note. RRR = Relative Risk Ratio.

*
p < .05.
**
p < .001.
a
Agreement between actual and perceived BMI is the reference category.
b
Baseline categories: bachelor’s degree or higher (parental education), $25 or more (thousand, household income), >3 h (daily TV watching).

their weight status than those whose parents had a bachelor’s
degree or higher. In contrast to U.S. studies, household income was
not a significant predictor of misperception. Additional research is
needed to see if similar findings emerge in other Mexican samples.
Several of the psychosocial and behavioral variables were signif-
icantly associated with body weight misperception. In the overall
sample (and among men), overestimating was less evident among
those who watched fewer hours of TV each day. A recent multi-site
study reported that exposure to Western (but not local) media was
associated with a thinner ideal body (Swami et al., 2010). Although
we did not examine media source or content, it is plausible that
young men who watch TV are exposed to images that influence
their self-perception. Among young women, depressive symptoms
were associated with body weight underestimation but not over-
estimation; because prior studies have excluded underestimators
(e.g., Isomaa et al., 2011), additional work is needed to make sense
of this finding. These findings await replication in other samples.
The study had a number of strengths, including the large sample
size and consideration of both self-reported and measured weight
statuses. At the same time, limitations must be kept in mind when
considering the results. First, the cross-sectional design is compa-
rable to most prior studies but limits the ability to move beyond
describing associations to testing pathways of influence. Second,
although the sample was diverse in terms of parental education
and income, the respondents were college applicants in a single
Mexican state; thus, we cannot generalize the findings to other
populations. Third, the study used established measures of BMI and
depression, and a similar approach to identifying weight misper-
ception as used in recent studies, but several of the psychosocial
measures lacked precision (e.g., media use).
Despite these limitations, this work has implications for
research, theory, and practice. To our knowledge, this is the first
examination of body weight status misperceptions in a Mexican
young adult sample; thus, it contributes to the empirical literature.
Future research can build on this study to better understand dis-
crepancies between perceived and actual weight status in Mexico.
This work can ultimately contribute to the task of understanding
how young people in developing nations integrate messages from
a growing range of sources – including globalized media, goods,
and ideas – with cultural frames of reference (e.g., Larson, Wilson,
& Rickman, 2009). In terms of practice, the findings provide sug-
gestions for intervention development. Because Mexican young
women who misperceive their body weight are more likely to see
themselves as heavier, they may be at risk of eating disorders and
unhealthy weight loss practices. In contrast, Mexican young men
who misperceive their body weight tend to see themselves as less
heavy than they are, and thus may be at risk of obesity-related dis-
eases. These findings indicate the need to develop tailored health
interventions for young men and women.
Acknowledgements
Up Amigos acknowledges the contributions of research staff and
study participants. Funding was provided by grants from the UASLP
Hormones Laboratory at the School of Medicine, Clinical Biochem-
istry Laboratory at the Chemical Sciences School, and the University
Health Center under agreement support C09-PIFI-030606 (to C.
Aradillas-Garcia); the University of Illinois at Urbana-Champaign
Research Board (#09070) and Center on Health, Aging, and Dis-
ability (to F. Andrade); and the USDA National Institute of Food
and Agriculture, Hatch Projects # 600108-793000-793323 (to M.
Raffaelli) and # 600109-698000-698354 (to M. Terán-Garcia).
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