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The Fatter we Get, the Less We Seem to Notice

Monday, November 30, 2009 Posted by Peter Janiszewski, PhD
Does this look "normal" to you?


This post was chosen as an Editor's Selection for ResearchBlogging.orgA significant number of overweight and obese individuals believe their body weight to be appropriate or normal and are satisfied with their body size. Misperception of overweight status is most common among the poor vs wealthy, African Americans vs white Americans, and men vs women. The unfortunate consequence is that overweight individuals who perceive themselves to be of normal weight are less likely to want to lose weight in contrast to overweight individuals with accurate perceptions. Such individuals are also more likely to smoke, have a poor diet, and be physically inactive.

An interesting hypothesis tested by Burke and colleagues in a recent Obesity journal article is that misperception of overweight status can actually increase over time in response to the secular increase in the average BMI of the US population. In other words, due to a possible anchoring effect, the more overweight the people around you become, the more one’s sense of “normal” weight is raised upwards, and thus the less likely you are to consider yourself overweight, even though you actually may be. Indeed, given that most individuals you interact with on a regular basis are likely to be overweight or obese, it becomes tough to define what someone with a normal weight looks like.

To answer the question at hand, the authors compared two representative cohorts of the United States population (NHANES) – one surveyed in the early 90’s and the other surveyed in the early 2000’s. Stated simply, they divided each cohort by gender and weight status (BMI) and compared the general perceptions of the individual’s weight.

What did they find?

Just as the researchers predicted, overweight individuals today are less likely to classify themselves as “overweight” in contrast to overweight individuals surveyed over a decade ago. For example, the proportion of overweight women who perceive their weight o be “about right” increased from 14% to 21%, and that among overweight men from 41 to 46%. This latter point also well illustrates the gender bias of weight misclassification.

Interestingly it was among individuals aged 20-25 that the greatest shift towards inaccurate weight classification occurred – overweight individuals in this age group were most likely to see themselves as “normal” weight.

Additionally, independent of the effect of time, this study confirmed a number of factors influencing one’s ability to accurately gauge their own weight status: those who are educated are more likely to self-classify as overweight than those who are not, those with higher incomes are more likely to feel overweight than those with the lowest incomes, married people are more likely to feel overweight than never-married people, and members of minority groups are less likely than whites to consider themselves overweight.

So there you have it – as a population, we are all getting fatter. Making matters worse, the fatter we all get, the less we seem to notice and the less likely we are to do anything about our bulging waistlines.

These are dangerous trends.


Peter

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Burke, M., Heiland, F., & Nadler, C. (2009). From “Overweight” to “About Right”: Evidence of a Generational Shift in Body Weight Norms Obesity DOI: 10.1038/oby.2009.369

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8 Response to "The Fatter we Get, the Less We Seem to Notice"

  1. Greg Shenaut Said,

    This may be similar to what happens with bodyweight norms for different age groups: as we get older, the average person gets fatter and less muscular, resulting in norms reflecting this. The "norm", which is the statistical fact, somehow becomes the "goal" for healthy aging. On its face, this seems at least somewhat parallel to the effect noted in the blog entry.

    Posted on November 30, 2009 at 1:46 PM

     
  2. Lyn Said,

    I expect this has to do a lot with social referencing -- not just of other people, but of the environment. A good example is shopping for clothes -- for women, being unable to find clothes in 'regular' shops is a sign of being very overweight. But 'regular' shops have increased their size range, so that merely overweight people fall right in the middle of the sizing (this would be so at middle-level chains. High end chains and speciality shops still have quite small sizing).

    A few years ago, when I weighed about 30 lbs more than I do now, the airlines lost my luggage on the Hong Kong -Barcelona flight. They gave me some money to buy clothes in Barcelona, but there was nothing that even came close to fitting me in the shops. I felt huge! The average woman is quite slim in Barcelona, where the three major food groups seem to be pork, alcohol, and cigarettes.

    Posted on November 30, 2009 at 3:01 PM

     
  3. Peter Janiszewski, PhD (Cand.), MSc Said,

    In a way, that's right Greg. As only a minority of the population now fall into the previous "norm", those criteria no longer define the normal or average weight for a given height. That is, our current norm (the greatest part of the population distribution of BMI) now lies in the overweight category, rather than the normal weight category - representing a rightward shift of the BMI curve.

    The problem is that the further we move away from our old norm, the less able we become at judging what is abnormal (or overweight). As overweight and obesity become commonplace, we become more complacent about excess weight.

    Posted on November 30, 2009 at 3:07 PM

     
  4. Beth Said,

    I think it was Tom Naughton who addressed this recently on his blog (or maybe it was in Fat Head). Since BMI is a bell curve, a lot of people who are technically "overweight" (according to the stupid BMI measure) are actually very close to what is "normal" BMI.

    So it's possible that this has an effect -- people may not see themselves as overweight because they are only arbitrarily a couple of points over, which translates to a fairly small number of pounds.

    Posted on November 30, 2009 at 3:37 PM

     
  5. Peter Janiszewski, PhD (Cand.), MSc Said,

    @ Lyn - Excellent thoughts! There is no doubt that trends in commercial goods may also skew our perception of normal weight and body size - i.e. size of car interiors, airplane seats, actors on tv and movies - even cartoon characters may decrease our sensitivity to "overweight" (think the cute and chubby child character from Up!).

    @Beth Good point - you are absolutely correct that the BMI distribution is on a bell curve, and the temporal trend has been for that curve to shift rightwards. If I remember correctly, the authors of this study did not differentiate between the BMI distribution of overweight individuals in 90's vs 00's (to see if within that 25-29.9 BMI range the 2 cohorts were distributed differently). Nevertheless, the fact that almost half of overweight men surveyed said they percieved themselves to be of normal weight is alarming and is unlikely to be explained by a a slight rightward shift of the BMI curve.

    Great points of discussion everyone - keep them coming!

    Posted on November 30, 2009 at 5:13 PM

     
  6. M Said,

    Interestingly it was among individuals aged 20-25 that the greatest shift towards inaccurate weight classification occurred – overweight individuals in this age group were most likely to see themselves as “normal” weight.

    This statement could be misconstrued to mean that overweight individuals aged 20-25 are more likely to see themselves as “normal” weight than older overweight individuals. But given the fact that older people are more likely to be overweight than younger people, older overweight individuals should be more likely to see themselves as “normal” weight than younger overweight individuals. (I assume that they didn’t survey people younger than twenty at all.)

    Posted on November 30, 2009 at 8:44 PM

     
  7. Peter Janiszewski, PhD (Cand.), MSc Said,

    @M In fact, the only point to be made from this paper (and from my poorly constructed sentence) is simply that the RATE OF CHANGE in the misperceptions of overweight has increased most sharply among the younger demographic. This does not suggest that at any timepoint misperception was higher in the younger group - simply that the increase in misperception was greatest over the 10 years surveyed.

    Thanks for catching that!

    Posted on November 30, 2009 at 11:13 PM

     
  8. Anonymous Said,

    You are misreading your study's findings.

    This another reason that thin people should not try to study the lives of fat people. You can't relate so you jump to stupid conclusions.

    While a couple of ultra thin guys like the study's authors may hate fat people, you can't expect those of us with a little meat on our bones to spend our lives in perpetual self loathing.

    Most people who are overweight have tried and failed at losing the weight.

    Once you have tried and failed to lose the weight, you can do one of two things -- 1) learn to live with being fat or 2) kill yourself.

    In my case, I'll take door number 1.

    I could spend my life in the gym eating like a bird and hating my fat ass or I could choose to enjoy my life.

    I am fat. I know I am fat.

    I'm OK with that.

    Most fat people know they are fat, they just have come to accept it.

    When someone with a high BMI says that their weight is "about right" it simply means that they are OK with their body and with their weight.

    -- it doesn't mean they notice less or are delusional, it just means that they refuse to hate themselves just because others do or some chart says they should.

    Posted on December 10, 2009 at 2:41 AM

     

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