Analysis of Health-Related Behaviors of Adult Korean Women at Normal BMI with Different Body Image Perceptions: Results from the 2013–2017 Korea National Health and Nutrition Examination Survey (KNHNES)

The tendency of misperceiving one’s body image was found to be higher among those at normal body mass index (BMI). Thus, the present study aims to provide basic data to seek solutions for ideal physical activities and right body image perception by comparing health-related behaviors of women at normal BMI. Among the 39,225 respondents from the Korea National Health and Nutrition Examination Survey (KNHNES) conducted from 2013 to 2017, 10,798 adult women with World Health Organization (WHO) BMI Classifications of 18.5 ≤ BMI < 25 (Asia-Pacific) were considered, from which pregnant and breast-feeding women and women whose body image perception was not identified were excluded, leading to a total of 9288 women. Data were analyzed utilizing SAS ver. 9.4 for frequency analysis, cross tabulation, GLM (generalized linear model), and logistic regression analysis with complex samples design, in conformity with the guidelines of the KNHNES. The results showed that approximately most (87.6%) of adult Korean women misperceived their body image. Misperception of body image was related to inappropriate health-related behaviors such as smoking, insufficient sleeping, and excessive body weight management; those who had underestimated their body image (≤64 odds ratio (OR) (0.718 (confidence interval (C.I.) 0.594–0.866))) carried out fewer health-related behaviors, while women aged 65 or above engaged in more health-related behaviors when they perceived themselves as obese (OR 1.683 (C.I. 1.260–2.248; overestimation)). To sum up, it was found that lack of health management, inappropriate body weight control, and health-related behaviors are related to body image misperception compared with real BMI. As such, it is necessary to have educational programs to encourage building proper perception of one’s body image and body weight, and to carry out health-related behaviors.