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Eating Disorders and Behaviors / Obesity and Health Practices · Journal article
South African Medical Journal · September 7, 2026
Early or partial results. Treat as a signal, not a conclusion.
This cross-sectional survey of 1,889 South African adults documents high rates of body image misperception, particularly among obese individuals, and shows that most overweight/obese participants underestimate body size and report no intention to lose weight. Waist circumference was significantly associated with weight management efforts (OR 5.7, 95% CI 3.8–8.4), but the study design does not establish causation or test any intervention.
Cross-sectional survey study. 1,889 adults aged ≥20 years in South Africa. No restrictions by health status reported.. n = 1,889. South Africa (specific sites or regions not stated in abstract)..
Obesity prevalence 51.2% in women vs 15.9% in men Metabolic syndrome prevalence 49.9% in women vs 25.5% in men Over 75% of overweight/obese participants reported no intention to lose weight
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
Clinicians should recognize that body image misperception is common in obese populations and may impede self-initiated weight loss efforts. The suggestion to use visual body shape guides in clinical practice is based on observational association, not a tested intervention, and requires validation before adoption.
Cross-sectional observational study with associations only; no intervention tested, no comparator group, and findings are descriptive of perception gaps rather than causal mechanisms or treatment effects.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognize that body image misperception is common in obese populations and may impede self-initiated weight loss efforts. The suggestion to use visual body shape guides in clinical practice is based on observational association, not a tested intervention, and requires validation before adoption.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Background. Misperception of body image is common, and may prevent individuals from undertaking healthy corrective measures. Objectives. To investigate how misperception of body image and weight among adults may influence efforts to improve health and illnesses associated with metabolic syndrome (MetS). Methods. A cross-sectional study involving 1 889 adults aged ≥20 years was conducted. Participants were required to complete a questionnaire and to estimate their weight prior to anthropometric measurements (weight, height, waist and hip circumferences). The Stunkard figure rating scale (FRS) was used for participants to select silhouettes that they believed closely resembled their body types. Biochemical parameters were measured for all participants. Results. Obesity (51.2% v. 15.9%) and MetS (49.9% v. 25.5%) were more prevalent in women than men. Most participants with overweight/ obesity underestimated their body size, and over 75% reported no intention to lose weight. Only 13% reported efforts to lose weight. The FRS results showed poor body size recognition, particularly in men with obesity. Logistic regression analyses adjusted for age, sex and MetS parameters showed that waist circumference significantly predicted weight management efforts (odds ratio 5.7, 95% confidence interval 3.8 - 8.4, p<0.0001). Conclusions. Incorporating visual body shape guides in obesity management settings can help to bridge this perception gap and promote healthier behaviours.
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