Obesity and Weight Misperception are Common in HIV Positive Patients
Methods: We surveyed 100 HIV+ patients, aged 21 to 60 for weight perception using a self-administered questionnaire with the Stunkard Figure rating scale. BMI categories were: underweight (BMI<18.5), normal (18.5 - 24.9), overweight (25- 29.9), obese (30 - 34.9) and morbidly obese (>=35). Patients were classified as underestimating weight if their BMI weight class was higher and overestimating weight if their BMI weight class was lower than Stunkard weight class. Concordance between actual and perceived weight class was quantified using weighted Kappa. The association between demographic characteristics and perception class was explored using the Cohen’s w (nominal) or Cohen’s f (continuous) effect size.
Results: The median age was 48; 56% were male, 63% were Hispanic, 23% were African-American and 69% identified themselves as heterosexual. Median year since HIV diagnosis was 12. Median CD4 count was 539; 61% had viral load < 20 copies/ml. 83% were on HAART and 22% had history of lipodystrophy. Median BMI was 27; BMI was normal (33%), overweight (30%), obese (16%) and morbidly obese (20%). Agreement between actual and perceived weight class was poor (weighted Kappa 0.39). 48% underestimated their weight class; 47% correctly identified and 5% overestimated their weight class. Among patient classified as obese/morbidly obese, 34/36 (94%) underestimated their weight class. Bisexual patients also tended to underestimate their weight. There was no association between correct weight perception and age, gender, race, CD4 count or HIV viral load.
Conclusion: Obesity was common in our cohort and was higher than recent national estimates (Medical Monitoring Project, 26.5%). Obese HIV+ patients tended to underestimate their weight class, potentially complicating providers’ efforts to encourage weight loss and to reduce cardiovascular risk.
K. Costa, None
D. Skiest, None