Association between overweight/obesity perception, actual body weight and cardiometabolic risk among healthy Ghanaian adults

The global rise in obesity, particularly among black Africans in developing nations experiencing nutritional transitions, underscores the importance of exploring Overweight/Obesity Perception (OP) as a crucial factor in maintaining an optimal body weight. Incorrect body image perception may impede efforts to achieve the desired body weight, leading to adverse outcomes related to Cardiometabolic Diseases (CMD). This cross-sectional study investigated the interplay between overweight/obesity perception, actual body weight, and CMD risk in a cohort of healthy Ghanaian adults. A total of 302 apparently healthy adults, aged 25–60 years, with Dagomba ancestry, were recruited from three communities. Participants were screened based on age, ancestry, history of communicable and Non-Communicable Diseases (NCD), and use of antidiabetic, lipid-lowering, and antihypertensive drugs. Anthropometric assessments and blood sample collections for biochemical analysis were conducted. Body image perception was measured using the Stunkard Figure Rating Scale (SFRS). Data were analyzed using descriptive statistics, chi-square tests, correlation analysis, logistic regression, and multivariate analysis. Participants had a mean age of 38.28 ± 10.88, with 61.6% being women. While 47% accurately perceived their body weight, 53% had incorrect perceptions. Notably, 47.2% underestimated and 8.5% overestimated their weight status. Among overweight individuals, 33% underestimated and 9.4% overestimated their weight, whereas among the obese, 66.7% and 33.3% respectively had inaccurate perceptions. Gender, serum triglyceride levels, and waist circumference were significantly associated with weight perception. About 55% of overweight/obese participants and 62.1% with high waist circumference did not express a desire to lose weight. Multiple logistic regression revealed that both overweight (AOR = 6, 95% CI (1.8–20.2), p < 0.05) and obesity (AOR = 20.5, 95% CI (5–84.9), p < 0.05) significantly increased the odds of CMD. The findings underscore the association between overweight/obesity and an elevated risk of CMD. This emphasizes the imperative for public health interventions aimed at promoting an ideal body weight and highlighting the impact of overweight/obesity on CMD risk factors.