Metabolic syndrome and discrepancy between actual and self-identified good weight: Aerobics Center Longitudinal Study

• Weight discrepancy was defined as measured minus self-reported goal weight.
• Weight discrepancy was associated with smoking and physical inactivity at baseline.
• Chronic high weight discrepancy was associated with metabolic syndrome risk.
• Interventions targeting weight discrepancy may help lower metabolic syndrome risk.

This study examined whether the discrepancy between measured and self-identified good weight (weight discrepancy) predicts metabolic syndrome (MetSyn). This study included 6,413 participants enrolled in the Aerobics Center Longitudinal Study (mean follow-up: 4.8 ± 3.8 years). Weight discrepancy was defined as measured weight minus self-identified good weight. MetSyn was defined using standard definitions. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) for incident MetSyn, by weight discrepancy category, were estimated using Cox proportional hazards regression. The multivariable-adjusted HR for MetSyn was 3.48 (95% CI = 2.48–4.86) for those who maintained higher weight discrepancy over time compared to individuals with lower weight discrepancy. Additional adjustment for body mass index did not change this interpretation (HR = 3.44; 95% CI = 2.46–4.82). Weight discrepancy may be a useful screening characteristic and target for future interventions to further reduce the risk of chronic weight-related disorders, included MetSyn.