Methods: 22 men and 3 women completed a questionnaire which used multiple choice items and drawings (ascending in "stoutness") to assess perceptions of present body size and shape, satisfaction with current weight and preferred size and shape. Objective measurements of relative weight (body mass index), percent ideal body weight, percent body fat and CD4 were also obtained. All participants were patients in a community based "early intervention" clinic. The questionnaire given here was part of a larger study aimed at longitudinal evaluation of factors involved in AIDS related weight change and wasting.

Results: Twenty-six percent of subjects described themselves as "somewhat thin", 39% as "about right" and 35% as "somewhat heavy". There were no subjects reporting self-perceptions that were "extremely thin" or "extremely heavy". Self-perceptions of present size and weight were consistent with objectively measured relative weight [body mass index = 21.5 ("somewhat thin"), 23.8 ("about right") and 28.3 ("somewhat heavy")] and percent ideal body weight (94%, 99% and 122%, respectively), as both objective measures ascended with self-reported size and weight. Self-reports of being "somewhat heavy" were associated with higher CD4 counts (M=397) than either "about right" (M=189) or "thin" (M=193). Only one subject (4%) selected a figure at the extreme thinness as closest to the size he "would like to be" (preferred size). All remaining subjects chose figures which were central on the continuum of body size. Nevertheless, paired comparisons indicated that preferred size was significantly smaller than self-reported present size (t=2.11, p < .05).

Conclusions: We found that reported perceptions of body size and weight are not distorted among relatively healthy men and women with HIV/AIDS. Preferred size was significantly lower than perceived current size, a finding which is consistent with the goal of many people to achieve a slim ideal. A person's preference for thinness should be understood as possibly incompatible with the clinical goal of preventing weight loss in HIV/AIDS.

Contact: RL-Brunner, Department of Pediatrics, 411 W. 2nd St., Reno, NV 89503, USA. Telephone: 775.784.6170, Fax: 775.784.4828, or email at brunner@unr.edu.