Academic journal article Hong Kong Journal of Psychiatry

Accuracy of Body Weight Perception and Figure Satisfaction in Young Adults with Psychotic Disorders in Hong Kong

Academic journal article Hong Kong Journal of Psychiatry

Accuracy of Body Weight Perception and Figure Satisfaction in Young Adults with Psychotic Disorders in Hong Kong

Article excerpt


Body image refers to a person's perceptions, attitudes, and experiences about his / her body. Weight perception is an important part of this concept. Body weight perceptions are not in agreement with actual weight all the time. One study found that 12% of Taiwanese men and 57% of Taiwanese women overestimated their body shape. (1) Weight control behaviours are motivated by perceived weight rather than actual body mass index (BMI). (2) It has been shown that dissatisfaction with one's body weight is an important predictor for engagement in various weight loss activities. (1) This is also true for patients with schizophrenia. (3) Whether accurate or not, people who perceive themselves as overweight wish to, or even try to, lose weight. A discrepancy between the actual and perceived body weight can lead to harmful unnecessary weight reduction if a person perceives that he is overweight but is actually not. On the other hand, if a person is not aware that he is overweight, he is unlikely to get involved in a weight reduction programme.

Attitudes towards body size and preferences for a particular level of fatness are mediated by local social and cultural factors. (4) Under the influence of 21st century culture, where thinness equals beauty, negative views towards fatness have been magnified. Studies of body weight perceptions among adolescents in Hong Kong have found poor agreement between BMI and perceived weight in adolescents, particularly in females who frequently overestimated their weight. (2) The weight perception in obese schizophrenic patients has been found to be fairly accurate in overseas studies (3) but there is little local data concerning the weight perception of patients with psychotic disorders. A group of schizophrenic patients were found to be significantly more likely to underestimate their weight than normal controls (46% versus 18%). (5) It would be interesting to compare the body weight perceptions of individuals with psychotic disorders with those of normal controls in Hong Kong.

This study aimed to examine (1) the body figure and weight satisfaction and the accuracy of body weight perception in cohorts with psychotic disorders and those without psychotic disorders in Hong Kong; and (2) the relationship between perceived and actual body weight and weight change behaviour.



The patient group was recruited at the Early Assessment Service for Young People with Psychosis (EASY) outpatient clinic of a psychiatric hospital serving a population of about one million in Hong Kong. Inclusion criteria were as follows: patients had a primary diagnosis falling into the schizophrenia spectrum disorder category as per the criteria of the International Classification of Disease--10th Revision (ICD-10) classification of mental and behavioural disorders; were able to give informed consent; and had adequate command and understanding of Chinese. Patients who were intellectually subnormal or were diagnosed with eating disorders were excluded.

The controls were recruited from a local secondary school and were matched for age and educational level with the patient group. Inclusion criteria required that they were able to give informed consent and to communicate in written Chinese. Those who had histories of being diagnosed with schizophrenia spectrum disorders and eating disorders under the ICD-10, and those with a score higher than or equal to 2 on the Chinese version of the SCOFF questionnaire, which is a highly sensitive screening tool for eating disorders, (6) were excluded.

The study was performed during 3 visits in 3 consecutive weeks to the clinic. Subjects who fulfilled the study selection criteria and were able to give consent were enrolled. Those who did not attend the clinic were interviewed when they came back for follow-up on another day. The diagnoses of the patient group were confirmed clinically by interviewing the patient and caregivers and reviewing the case notes. …

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