Objective: To examine the concordance between self-described weight status and BMI, the prevalence of self-reported comorbidities, and the association between comorbidities and self-rated health among overweight African-American and Hispanic US adults.

Methods and Procedures: A nationally representative sample of 537 African-American and 526 Hispanic adults who were identified using a combination of random digit dialing and listed household sampling and self-described as being slightly or very overweight participated in a telephone interview. Self-reported height and weight were used to calculate BMI.

Results: More than half of African Americans (56%) and one-third of Hispanics (34%) who self-described as “slightly” overweight would be classified as obese based on BMI. One-third (33%) of African Americans reported high blood pressure, followed by arthritis (20%), high cholesterol (18%), and diabetes (15%). Among Hispanics, high cholesterol was the most frequently reported comorbidity (17%), followed by high blood pressure (15%), and difficulty sleeping (12%). Almost three-quarters of African Americans surveyed (72%) reported that their overall health was good to excellent compared to 62% for Hispanics.

Discussion: Self-reported rates of obesity-related comorbidities fall below what would be expected based on prevalence data derived from physiologic measures, suggesting a lack of awareness of actual risk. Despite the greater self-reported prevalence of certain risk factors for poor health, African Americans have a more optimistic view of their overall health and weight status compared to Hispanics. Physicians have an important opportunity to communicate to their minority patients the serious health consequences associated with excess weight.