Objective Weight self-perceptions, or how a person perceives his/her weight status, may affect weight outcomes. We use nationally representative data from 1988-1994 and 1999-2008 to examine racial/ethnic disparities in weight self-perceptions and understand how disparities have changed over time. Design Using data from two time periods, 1988-1994 and 1999-2008, we calculated descriptive statistics, multivariate logistic regression models and predicted probabilities to examine trends in weight self-perceptions among Whites, Blacks, US-born Mexican Americans and Mexican immigrants to the USA. Setting National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and continuous NHANES (1999-2008). Subjects Adult NHANES participants aged 18 years and older (n 37 050). Results The likelihood of self-classifying as overweight declined between 1988-1994 and 1999-2008 among all US adults, despite significant increases in mean BMI and overweight prevalence. Trends in weight self-perceptions varied by gender and between racial/ethnic groups. Whites in both time periods were more likely than racial/ethnic minorities to perceive themselves as overweight. After adjustment for other factors, disparities in weight self-perceptions between Whites and Blacks of both genders grew between survey periods (P<0·05), but differences between overweight White women and Mexican immigrants decreased (P<0·05). Conclusions Weight self-perceptions have changed during the obesity epidemic in the USA, but changes have not been consistent across racial/ethnic groups. Secular declines in the likelihood of self-classifying as overweight, particularly among Blacks, are troubling because weight self-perceptions may affect weight-loss efforts and obesity outcomes. © 2014 The Authors.

Race/ethnicity psychosocial factors health disparities Obesity

Continental Population Groups ancestry group human middle aged Overweight Ethnic Groups ethnic group obesity Logistic Models United States Humans psychology male female Socioeconomic Factors Multivariate Analysis socioeconomics self concept prevalence nutrition adult body weight Nutrition Surveys statistical model body mass Body Mass Index