Mirror, mirror on the wall, am I fat? Just right? Too thin? (Is there such a thing?)
It should be quite easy to tell, shouldn’t it? One look in the mirror should tell all, right?
Apparently not! Self assessment often isn’t correct, and many people’s perception of where they stand in the weight spectrum is just wrong!
A recent article in the journal Obesity shows that weight misperception is highly prevalent among all US adults: more than 20% of healthy weight adults considered themselves overweight, and close to 40% of overweight adults and about 8% of obese adults considered themselves to be "about the right weight."
The study sample consisted of more than 17,000 adults. Subjects reported self-perception of their weight status, and their assessment was compared to a calculated Body Mass Index, or BMI, which is the measured weight in kilograms divided by measured height in meters squared.
As you’d probably guess, there was a big difference between individual’s body image perception between men and women.
Underestimation of body fat by overweight and obese subjects was more common in men than it was for women:
• 49% of overweight men misdiagnosed themselves as underweight or healthy weight, compared to 22% of overweight women.
• 12% of overweight men misdiagnosed themselves as underweight or healthy weight, compared to 4.5% of women.
Overestimation of body fat went the other way:
• 32% of women with healthy weight perceived themselves as overweight, compared with 8% of healthy weight men reporting they were overweight.
What I found quite interesting was that weight misperception was more widespread among racial/ethnic minorities and people with lower education. The study found that, although overweight and obesity was more prevalent among ethnic minorities, so was the misperception of these conditions. For example:
• Overall 12% of obese men misclassified themselves as healthy weight; the prevalence of misperception was 9% for non-Hispanic whites, 25% for non-Hispanic blacks and 17% for Mexican Americans.
The study limited itself to the self-reported ethnic classification mentioned above due to the limited sample size of other ethnic groups.
The authors, lead by Rashinda R. Dorsey, conclude:
“Misperception, that is incorrect self-assessment of measured weight, was common among healthy weight, overweight and obese adults in the United States. Minorities were more likely to have a weight misperception, as well as men and persons with lower educational levels. Addressing the issue of weight misperception may help address the problem of obesity in the United States by increasing awareness of healthy weight levels, which may subsequently have an impact on weight-related behavior change. Additionally, targeting weight management interventions at groups disproportionately reporting weight misperception may be beneficial.”
I wasn’t at all surprised by the study’s findings because I’ve seen many studies showing the same results. The current issue of Pediatrics includes a study that shows that a large percentage of overweight and obese patients remain undiagnosed even by their pediatrician. There are several studies showing that parents fail to notice their kids are overweight.
Bottom line: Body fat status needs to be objectively assessed. Calculating the BMI (after measuring weight and height) is one important tool, but BMI doesn’t distinguish between fat tissue and muscle, and can misclassify people with muscular builds as overweight. The other important measure is waist circumference or waist-to-hip ratio.
As I discussed in a previous post, extra belly fat carries an extra health risk for chronic diseases, such as diabetes and heart disease, and there are people with normal BMIs who are generally thin, but have big bellies.
Another important, practical tool that doesn’t require a visit to the physician’s office, is to simply examine your own trend. If you’re gradually gaining a few pounds over the months or years, or can’t fit into clothes you wore last season, it’s time to take a look at what you eat and how much you exercise, and consider a few adjustments. Weight is usually accumulated very slowly, and it’s best to “catch” this risk factor early, when it’s less painful to overcome. After all, it’s much easier to stop gaining further weight or to lose 10 pounds than it is to face a goal of losing 40 pounds.
It’s also worth paying attention to the significant percentage of people (mostly women) in this study who are plagued by a negative self image, and view themselves as overweight despite not being unhealthfully so. While in some societies large body size is both acceptable and the statistical norm, and leads overweight people to complacency and inaction, in other societies the pursuit of incredible thinness leads people (usually women) of perfectly healthy weights to continuously pursue unattainable and unnecessary goals.
People usually face high blood pressure or high cholesterol in a matter-of-fact way, and find ways to deal with it without great injury to their self esteem. Don’t you wish weight were just like any other health risk?
I believe we should accept and love ourselves at any weight, but still pursue a healthy weight (and not perhaps the most fashionable one) for health’s sake.
Easier said than done.
Would love to hear your thoughts!