Perception versus reality of body weight and its association with dietary habits and body satisfaction among tertiary students in Hohoe Municipality of Ghana

Body weight perception is a key determinant of individuals’ dietary habits, weight management practices, and body satisfaction. Misperception of body weight may contribute to unhealthy eating behaviours and adverse mental health outcomes. The World Health Organization (WHO) reports that millions of people worldwide experience eating disorders annually, with young women disproportionately affected. This study examined body weight perception among tertiary students (training college and university students) in the Hohoe Municipality of Ghana and explored its association with body mass index (BMI), dietary habits, and body satisfaction.

A cross-sectional study design was conducted in the Hohoe Municipality of Ghana among tertiary students’ participants. A multistage sampling method was used to sample 333 participants. Disproportionate sampling was used to select 111 participants from each of the three institutions and administered with structured questionnaires. Descriptive (frequencies and percentages) and inferential analysis (Gwet’s AC₁ coefficient for multiple raters and binary logistic regression) were performed on all variables of interest. Statistical significance was set at p < 0.05 or 95% Confidence Interval (CI).

Percent agreement between participants' perceived body weight and their BMI status was 60.0%, as 40.0% underestimated or overestimated their body weight. For 62.2% of the participants who ever dieted, 71.5% sought to lose/gain weight. Though 91.9% of the participants were happy with their bodily appearance and 95.5% claimed to have an attractive body, 57.1% were concerned about people’s opinions, and 69.9% wished to change certain parts of their bodies. There was moderate agreement between perceived body weight and BMI status [AC₁= 0.53, 95% CI: 0.46, 0.59]. Participants consuming vegetables 1–3 days per week, (adjusted odds ratio [AOR] = 0.51, 95% CI: 0.30, 0.87, p = 0.014) and having the intention to lose weight (AOR = 2.51, 95% CI: 1.42, 4.45, p = 0.002) were significant predictors of incorrect body weight perception.

A considerable proportion of participants either underestimated or overestimated their body weight when compared with their actual BMI status, with underestimation observed frequently among those who were overweight or obese. Despite this misperception, participants generally had suboptimal eating habits but positive body satisfaction. Additionally, consuming vegetables 1–3 days per week and intending to lose weight were significant predictors of incorrect body weight perception. These findings suggest that tertiary students may be underestimating or overestimating their body weight, which could have important consequences for their eating habits, body satisfaction, and overall health.