Many Overweight Women Perceive Weight as Normal

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Researchers say they have uncovered surprising information that twenty-five percent of overweight women involved in a survey viewed their weight as normal, leading to health behaviors that put them at risk for heart and other obesity related disease. Some women whose weight was normal misperceived themselves as being overweight, leading to meal skipping and diet pill use.

Weight Perception Drives Women’s Health Related Behavior

The study is important because self-perception of weight drives health related behaviors. Corresponding study author Dr. Mahbubur Rahman, assistant professor Department of Obstetrics and Gynecology and Center for Interdisciplinary Research in Women's Health says, "What we found reflects the 'fattening' of America. As obesity numbers climb, many women identify overweight as normal, not based on the scale but on how they view themselves.”

Researchers analyzed surveys from 2,200 women ages 18 to 25, dividing into four groups –

•“Overweight misperceivers," overweight women who describe themselves as under- or normal weight
• Overweight accurate perceivers," overweight women who described themselves as overweight
• Normal weight misperceivers," normal weight women who described themselves as overweight
• Normal weight accurate perceivers, “normal weight women who described themselves as normal- or under-weight.”

Fifty two percent of the women were considered overweight, defined as body mass index (BMI) greater than 25. The surveys included information about weight related behaviors, socio-demographics, height, weight and perception of weight.

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Weight related behaviors included use of diet pills, diuretics, laxatives, skipping meals, dieting, and carbohydrate counting. They were also asked whether they had exercised for 30 minutes or more in the past week.

The results showed that nearly 25 percent of Hispanic women and 30 percent of African-American women had misperceptions about being overweight, compared to white women and fifteen percent of white women were “overweight misperceivers”. Sixteen percent of white women and 20 percent of Hispanics whose weight was normal felt they were overweight.

The distorted vision of weight found among the women drives healthy and unhealthy decisions. Normal weight women were more likely to smoke cigarettes, skip meals and take diet pills, while overweight women were less likely to participate in healthy or unhealthy weight related behaviors.

Dr. Abbey Berenson, professor, Department of Obstetrics and Gynecology and director of the Center for Interdisciplinary Research in Women's Health says, "Weight misperception is a threat to the success of obesity prevention programs. Overweight individuals who do not recognize that they are overweight are far less likely to eat healthfully and exercise. These patients are at risk for cardiovascular disease, type 2 diabetes and other serious problems."

Dr Berenson adds the findings are especially important for women in their reproductive years who have had children, little time, and more likely to be obese compared to men of the same age. Over half of reproductive age women are overweight, and the new study shows 25 percent of women analyzed failed to view themselves as overweight.

Obstetrics & Gynecology. 116(6):1274-1280, December 2010.
doi: 10.1097/AOG.0b013e3181fdfc47

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