The relationship between the pattern of perceived body weight and some socio-demographic characteristics of study participants is presented on (Table 2), illustrated that there was a statistically significant relationship between perceived body weight and age group (χ² = 14.14, p = 0.007) marital status: (χ² = 20.68, p = 0.000) and educational status (χ² = 20.2, p = 0.002).

Individuals’ body weight perception is a strong determinant of body weight control activities [1,11]. This study set out to determine the self-perception of weight by study participants who were clinic attendees of the GOPC, Calabar. It was noted that there were more female clinic attendees than male attendees. This follows a pattern noted that females have better health seeking behaviour than males [12,13]. Civil servants were more than other occupation groups and this is so noted because the study setting is in Cross River state, which is predominantly populated by civil servants as the middle class [14]. The predominant religion in the study environment is Christianity as reflected in the study. This is similar to findings of two researches done in same region by Ezedinachi et al and Erah et al that found 99.1% and 91.2% respectively as Christians [15,16].

This study found the prevalence of overweight to be 25.2% and obesity 20.1% including varying grades of obesity based on the WHO classification of BMI (table 1). This fell within the range of what was obtained in previous study in Nigeria where the prevalence was puts at 20.3-35.1% for overweight and 8.1-22.2% for obesity [3]. In Ghana a national prevalence of overweight and obesity has been placed at 25.4% and 17.1% respectively [17,18]. The prevalence of obesity in both countries and in the present study suggest a rising prevalence of obesity based on the West African prevalence which was put at 10.0% in a meta-analysis of West African studies by Abubakar., et al. [19]. This shows the increasing prevalence of obesity in many parts of the world including the West African sub-region. Many sub-Urban African cultures do not consider obesity as a problem; instead obesity and corpulence are widely viewed as a sign of good living and index of affluence, and in women an index of beauty and fertility [8,18]. This cultural view puts additional pressure on the females to desire to gain weight in an attempt to attract the males and therefore better chance of marriage which is also very important [8]. The acceptance of female corpulence especially among the people of South East and South-South Nigeria is expressed in the “fattening room” practice in which young women go through prior to marriage to make them more sexually attractive to their husband and also to learn the basic home keeping [20,21]. Other reason obesity is prevalent in the study environment may be increase in number and usage of fast food as a means of quick meals especially as the study took place in the urban centre where fast food outlets are found in abundance.

Concerning weight perception, 280 (74.3%) of the study participants perceived their weight as normal while only 48.3% had normal weights based on the calculated BMI. It was therefore obvious that there is a discrepancy between self-perceived body weight and actual weight with overall 211 (57.56%) misperceiving their body weight. Specifically, it was noticed that a good number of those who perceived their weight to be normal were either overweight or obese. This finding was similar to what was obtained among rural dwellers in Nigeria by Akinpelu., et al. where 54% of the participants misperceived their weight. [22] Wrong perception of one’s actual body size and having a personal preference for an ideal body size that is larger than the actual might reduce a person’s motivation to engage in body weight management practices that will help in maintaining healthy weight. Misperception of body weight may even be more dangerous among Underweight individuals who wrongly perceive themselves to be overweight or obese as they may try weight control measures which may lead to further loss of weight and predisposition to various health problems related to their underweight. On the other hand, perceiving oneself as normal when overweight/obese may limit their attempts at weight control leading the complications of obesity.

The study found that socio-demographic factors of an individual like education, marital status and age significantly (p < 0.05) affected their body weight perception. This is to be expected since education will enlighten the individual about appropriate weight through reading and exposure to other educational materials. On the centrally a study carried out in Korea showed that the higher the level of education the more likely an individual will misperceive his/her weight [23]. This may stem from overconfidence or wrong understanding of certain facts. Marriage on the other hand does influence weight perception through the tendency to please the marriage partner, while age through value changes and understanding of what is best or appropriate.

While factors like sex, occupation and the tribe they come from did not significantly (p > 0.05) affect how they perceived their body weight. This is contrarily to the Korean study in which it was documented that females more commonly misperceive their weight than males, even though this was not stated to be a statistically significant association [23]. This difference may be due to the difference in population and also the composition of the sample.

Because body weight perceptions held by people has important health implications on weight management behaviours, it is important that clinicians gain understanding of these perceptions. This will form the basis for providing patient-specific counselling to patients based on their perceptions and healthy weight-related behaviours. The limitations of the study are that participants are likely to give false weight perception.

The findings of this study can be used as a basis for promoting interventions on accurate weight understanding which will influence weight perception and consequently self-weight management practices. This will ultimately influence body size and obesity and its attendant co-morbidities.

Acknowledgement
The authors appreciated the effort of Miss P. Archibong who typed the questionnaires. The statistician’s advice from Mrs Kelechi C. Okeke was also well appreciated.