Influence of the body mass index on the perception and representation of subjects with overweight and obesity in Wallonia (Belgium): results from the EDUDORA2 study

Background Overweight and obesity are significant and growing public health concerns. In Belgium, the rates of overweight (Body Mass index (BMI) ≥ 25 kg/m2) and of obesity (BMI ≥ 30 kg/m2) amount 33% and 14%, respectively. While physiopathological processes subtending obesity are well documented, this is not the case for the representations and perceptions of subjects with overweight and obesity. One of the objectives of EDUDORA2 program intends to fill this gap by enabling concerned subjects to express their feeling and their experience. As the general practitioner (GP) greatly contributes to the treatment and the prevention of overweight and obesity, their view about weight management was also investigated. Methods A total of 4155 persons with overweight and obesity participated in an exploratory study conducted in Wallonia. Data were mainly collected by means of a web-based questionnaire. Interviews were also performed from a randomly selected sample of 201 GPs from Wallonia. Results A large majority (87.5%) of subjects were overweight (32.2%) or obese (obese class I 29.9%, class II 14.8%, class III 10.6%) and 94.5% of them deemed having a weight problem. This weight problem was very important for 46.3% of subjects and important for 42.4%. The perceived health was good or very good for the majority (respectively, 66.4% and 9.0%). The perceived health was found to deteriorate with the BMI (p < 0.0001). The number of psychological and physical problems reported by the subjects increased significantly with the BMI (p < 0.0001). The BMI also influenced the body image. In fact, obese subjects underestimated their body image; this underestimation was even more pronounced as their BMI was high. The percentage of poor diet perception (frustration, fatigue, weight gain, aggressiveness, inefficacy and impossibility) increased with the BMI. The weight loss targeted by the subjects increased with BMI. GPs reported that being aware of overweight and obesity as well as the knowledge of the risks related to obesity were both important in the weight management of the patients. Conclusions This study draws attention on the influence of the BMI over the perception and the representation of subjects. As a consequence, there is a need for a more adapted weight management. Key messages While physiopathological processes subtending obesity are well documented, this is not the case for the representations and perceptions of concerned subjects. This study intends to fill this gap. This study draws attention to the influence of the BMI on the perception and the representation of subjects. As a consequence, there is a need for a more adapted weight management.