Weight misperception among deaf and hard-of-hearing adults in the United States: Results from NHANES, 1999-2018
Mbogo, B. P.; Schooler, D.; Varnes, J. R.; James, T. G.
Show abstract
Weight misperception is a critical indicator of body dissatisfaction and cardiovascular risk, yet remains understudied in Deaf and Hard-of-Hearing (DHH) populations who face unique barriers to health literacy. Addressing this gap is vital given the potential for "visual normalization," where limited access to health information can influence how weight status is interpreted without adequate health literacy. This study investigated weight misperception prevalence among DHH adults using a representative weighted sample of over 213 million from the National Health and Nutrition Examination Survey (1999-2018). We assessed agreement between self-perceived weight and two objective metrics: Body Mass Index (BMI) and Waist-to-Height Ratio (WHtR). Results show that while DHH individuals demonstrated higher odds of accurate perception using standard BMI categories, they were significantly more likely (>34%) to misperceive their weight status when assessed via WHtR. This discrepancy suggests that DHH individuals may struggle with visual assessments of adiposity, supporting the visual normalization hypothesis. We posit that linguistic inaccessibility drives health literacy disparities, underscoring the urgent need for competent health communication to mitigate body dissatisfaction and long-term health risks in the DHH community.
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