Nearly two in five adults in a Cameroonian town misjudge their own body weight, and among those who actually carry excess weight, more than four in five underestimate it, according to a cross-sectional study published in Archives of Public Health. The researchers found such poor agreement between what people think they weigh and what the scales and measuring tape show that they argue public health strategies in Cameroon must explicitly address weight awareness if obesity prevention is to succeed.
The study was a secondary analysis of cross-sectional data collected in 2016 from 1,139 adults living in Buea, a semi-urban town in Cameroon. Rather than relying on self-reported height and weight, which can distort estimates, the researchers ascertained objective weight status through measured body mass index, calculated from directly measured height and weight. Self-perceived body weight status was captured separately with a questionnaire. Agreement between the two approaches was evaluated with the kappa statistic, and Poisson regression models were fitted to identify sociodemographic and behavioural factors predicting misperception.
The headline result is a kappa statistic of just 0.13, which the authors characterise as poor agreement between objective and perceived weight status. In practical terms, knowing what a participant believes about their own weight tells clinicians and researchers very little about what their measured BMI actually shows. Any misperception, meaning any mismatch between perceived and measured status in either direction, affected 43.0 percent of the total sample, with a 95 percent confidence interval of 40.1 to 45.9 percent.
The direction of that mismatch was strikingly lopsided. Among participants whose measured BMI placed them in the overweight or obesity categories, 82.8 percent underestimated their weight, with a 95 percent confidence interval of 79.2 to 85.9 percent. In other words, the vast majority of people carrying excess weight in this sample did not recognise it. The reverse error was far less common: among individuals with a normal BMI, only 4.9 percent overestimated their weight, with a confidence interval of 3.4 to 7.0 percent.
The study also identified who was most likely to misjudge their weight. Any misperception was higher among participants aged 45 to 54 years and those aged 55 years or older, among women, among married individuals, and among those who reported consuming high amounts of alcohol. These patterns suggest that weight awareness in this population varies systematically across demographic and lifestyle groups rather than being randomly distributed.
The two error types had partly distinct drivers. Overestimation, believing oneself heavier than measured BMI indicates, was more prevalent among those aged 55 years or older and among married persons. Underestimation, the far more frequent error, was more common among smokers and among participants who reported good-to-excellent health status. That last association is notable, because it hints that feeling healthy may blunt recognition of a weight problem that measured BMI confirms.
The authors frame these findings against rising trends in the prevalence of overweight and obesity in Cameroon, where limited evidence had previously existed on the magnitude and determinants of weight misperception. Body weight misperception, they note in the study’s objective, can adversely affect obesity prevention and control efforts, since people who do not perceive themselves as carrying excess weight are unlikely to see a reason to change. The study was designed to examine the prevalence and drivers of misperception, underestimation and overestimation among adults in Cameroon precisely because of that gap.
The conclusions drawn by the team are direct: agreement between self-perceived and measured body weight was poor, approximately two in five adults misclassified their weight status, and four in five people underestimated their body weight. They call for public health strategies to improve awareness of weight status and to address the related drivers of misperception in order to optimise health outcomes in Cameroon.
Several limitations shape how these results should be read. The data come from a single semi-urban town and were collected in 2016, so the figures describe that population at that time rather than the whole of Cameroon today. The cross-sectional design captures associations between characteristics and misperception but cannot establish why those associations exist or whether changing them would reduce misclassification. As a secondary analysis, the study also depended on the variables the original survey collected.
Even with those caveats, the scale of underestimation carries a clear message for obesity prevention. The authors argue that correcting that perception gap, alongside addressing its demographic and behavioural drivers, is a necessary part of improving weight-related health in Cameroon.
Subject of Research: Body weight misperception and its determinants among adults in Cameroon
Article Title: Poor agreement between measured and perceived body weight status, and determinants of misclassification among adults in Cameroon: a cross-sectional study
Article References: Rajesh, P., Saad, C., Ngwasiri, C. A., & Aminde, L. N. (2026). Poor agreement between measured and perceived body weight status, and determinants of misclassification among adults in Cameroon: a cross-sectional study. Archives of Public Health. https://doi.org/10.1186/s13690-026-02103-x
Image Credits: AI Generated
DOI: 10.1186/s13690-026-02103-x
Keywords: body weight misperception, obesity, overweight, Cameroon, body mass index, cross-sectional study, weight underestimation, public health, Buea, kappa agreement, Poisson regression, health awareness
News Source: Ophelia Keating. (October 30, 2026). Four in Five Adults with Excess Weight in Cameroon Misjudge Their Body Size. Scienmag.
