Discrepancies between actual weight, weight perception and weight loss intention amongst persons with NAFLD

• Published in: Journal of internal medicine Vol. 289; no. 6; pp. 840 - 850
• Main Authors: Nguyen, V. H., Yeo, Y. H., Zou, B., Le, M. H., Henry, L., Cheung, R. C., Nguyen, M. H.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.06.2021
• Subjects: Body Image; Body Mass Index; Body weight; Body weight loss; diet; Ethnicity; exercise; Fatty liver; Female; Humans; Intention; Male; Minority & ethnic groups; Non-alcoholic Fatty Liver Disease; Nutrition; Nutrition Surveys; Obesity - therapy; Overweight; Overweight - therapy; Perception; Race; race/ethnicity; Sociodemographic Factors; United States - epidemiology; Weight Loss; United States; body weight; weight loss; exercise; fatty liver; diet; race/ethnicity
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1111/joim.13203

Background Currently, weight loss remains the main management strategy for NAFLD, but the weight loss intention and methods remain poorly characterized. Methods We analysed data about the perception of weight status, intention and methods to lose weight amongst 3,822 persons with NAFLD (United States Fatty Liver Index ≥ 30) from the National Health and Nutrition Examination Survey, 2001‐2014. Results Only 53.9% of people with NAFLD intended to lose weight, 91.8% with perception of overweight and 8.2% with normal weight perception. Persons with perception of overweight or overweight/obese status were four times more likely to try to lose weight (adjusted odds ratios 3.9 and 4.2, respectively, both P < 0.0001). Younger age, women, higher educational level, Hispanic and blacks (versus whites) were significant independent factors associated with weight loss intention. Notably, ≤10% attended weight loss programme. Metabolic equivalent of task hours per week was significantly higher in whites who exercised to lose weight (vs. no exercise, P = 0.003) but not in other racial/ethnic groups. Interestingly, calorie intake was similar between those who dieted versus not (2056 vs. 1970 kcal/day, P = 0.11). About 30% reported ≥ 10‐lb weight loss, with 50% higher odds of success for men but there was no difference by race/ethnicity. Conclusion Overweight or obese perception was a key driver in weight loss activities but was inconsistent with actual weight status and varied by race/ethnicity and other sociodemographic factors. Weight loss programme is under‐utilized and should take in account of weight perception training and culturally appropriate approach.