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Tuesday, October 26, 2010

Misperceptions About Weight and Size


Perception is everything in the way we see our weight. Satisfaction and dissatisfaction are based a private reality. Some fat people think they are thin and some thin people think they are fat, which shouldn't be a problem except that perception influences the way we take care of ourselves and our self-care, in turn, determines our likelihood of staying healthy.

Assessing Weight Perception

In research settings, when clinicians assess satisfaction with weight and body image, they use instruments to gauge the way individuals think about their appearance. For instance, Stunkard’s 1983 classic Figure Rating Scale (shown below) is commonly used to assess body image perception in studies. Research subjects would be asked to select the figures that represent their current, actual, and ideal size, which would then be compared to figures selected by the research scientists. This scale and others are appropriate for initial screening of whether perception is off at either end of the range.

“I'm not fat; I'm fluffy, big-boned, etc.”

A study published in the Archives of Internal Medicine last week showed perception is off for a subset of the obese population. The study consisted of a survey of more than 2000 men and women who participated in the Dallas Heart Study between 2000 and 2002. Everyone in the survey was in the obese range with a Body Mass Index (BMI) of 30 or more. (At 5’4”, BMI 30 is 174 pounds and at 5’11", it is 209 pounds.)

The participants were asked to look at images of nine figures that varied in size from underweight to overweight (like Stunkard’s Figure Rating Scale) and to chose the figure that looked most like them. Eight percent of the respondents saw themselves at a normal weight even though they were actually obese and two-thirds of them said they were at low risk of ever becoming obese.

Most Likely to Misperceive

This study concluded that underestimation of body size is more common among African-Americans, Hispanics, and heavy people who are active. It’s easy to see how we could miss a weight problem when everyone around us is overweight. Other studies have shown that, in general, people with more education and higher earnings have a more realistic view of their appearance, and that women, are more likely to see themselves as heavier, regardless of size, presently or in the past. Likewise, people living in societies that put a premium on thinness commonly express the opposite misperception, seeing themselves as fat when they are thin. How often do we hear people say, “I can’t stand my body,” when their bodies are perfectly functioning and normal in every way.

Ignorance is Bliss

Reuters reports that, in the Dallas survey, people who misperceived their body weight were happier with their health and felt healthier than those who did recognize their obesity. They were also more likely to think they would not develop high blood pressure or diabetes or have a heart attack or stroke during their lifetimes. In addition, they were less likely to see their doctors or seek out screenings for diabetes, blood pressure, and their potential for stroke.

The Bottom Line: It’s great to have a positive body image regardless of weight and size and, in the short run, one is only as healthy as he or she feels. But it is also na├»ve to think that the complications of obesity don’t apply to any of us. It's not a good idea to be blind to risks down the road. For ourselves and our loved ones, it is best to use objective health determinants like height for weight, BMI and body composition to identify impending problems and to nip them in the bud.

By Mary_RD on Oct 26, 2010 10:00 AM in Tips & Updates

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