To determine the prevalence of high weight at different characteristics, understand the perceptions and behaviours towards high body weight, and determine potential influencing factors of body weight misperception among high-weight adults in Jilin Province.

A cross-sectional survey with complex sampling design was conducted. We described the prevalence and perception of high body weight.

Northeast China in 2012.

Adults (n 20 552) aged 18–79 years.

Of overweight individuals, 37·4 % considered themselves as ‘normal weight’, 4·8 % reported themselves as being ‘very thin’ and only 53·1 % were aware of their own weight being ‘overweight’. About 1·8 % of both male and female obese individuals perceived themselves as ‘very thin’. Only 29·1 % of obese people thought of themselves as ‘too fat’. Nearly 30·0 % of centrally obese men and women perceived that their waist circumference was about right and they were of ‘normal weight’; 5·7 % of the centrally obese even perceived themselves as being ‘very thin’. Only 51·8 and 12·5 % of centrally obese individuals reported themselves to be ‘overweight’ or ‘too fat’. Body weight misperception was more common in rural residents (OR; 95 % CI: 1·340; 1·191, 1·509). The prevalence of body weight misperception increased with age (middle age: 1·826; 1·605, 2·078; old people: 3·101; 2·648, 3·632) and declined with increased education level (junior middle school: 0·628; 0·545, 0·723; senior middle school: 0·498; 0·426, 0·583; undergraduate and above: 0·395; 0·320, 0·487).

Body weight misperception was common among adults from Jilin Province.