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The fatter we get, the less we seem to notice

Thursday, August 12, 2010 Posted by Peter Janiszewski, PhD
Does this look "normal" to you?

A 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.


Originally posted November, 2009

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6 Response to "The fatter we get, the less we seem to notice"

  1. Ken Leebow Said,

    While the CDC uses the percentage of 66 for overweight/obese, my eyes tell me a different story. I believe the percentage is much higher.

    In the U.S., if you are fit/slim, there is no doubt, you are in the minority.

    Posted on August 12, 2010 at 2:36 PM

  2. Anonymous Said,

    Well, at least you did not use photographs of fat people in extremely unflattering clothing or circumstances, as almost every story about obesity does. Your cartoon figure is still not amusing to those of us who battle the bulge.

    Ken, did you know that the government keeps lowering the values for what it considered overweight, hypertensive, or diabetic? Considering that most people gain weight as they age, and we are an aging society, it won't be long until we are all tagged with the overweight, obese, and diseased label.

    As for not noticing as we get fatter, they didn't ask any fat people I know. Fat people are keenly aware of their state, and if they weren't, others are always eager to remind them of how unacceptable they are either through telling them they are going to keel over at any moment, that they are ugly and lazy, or that their very existence costs too much money. Every fat person I know hates what he or she sees in the mirror. Some fat kids are driven to suicide by bullies.

    Whether you think obesity is due to a personality flaw, a moral failing, food industry conspiracy, or genetics, the current prescription for achieving weight loss and fitness is obviously not working for most fat people. Perhaps the only solution is to round us up and put us all in camps, eh? Sterilization, maybe?

    I have often wondered how people who have never struggled with their weight would maintain their sense of moral superiority if obesity were to disappear.

    Nothing would make me happier than to see a naturally slender person suddenly gain weight and see what it means to be constantly trying to lose it. Then they would understand what it is to eat only 1200 to 1500 calories a day; go to bed with stomach growling; be constantly irritable, hungry, and tired; exercise every day; and lose maybe 1/2 pound a week. Ah, if only I had a magic wand!

    Bitter? You bet I am.

    Posted on August 12, 2010 at 3:36 PM

  3. ruthdemitroff Said,

    Distorted body image - very complex subject. When I was young, I perceived weight as being the exclusive reason I didn't get chosen to do things and thought I was grotesquely obese even though I was wearing regular sizes. Between 30 and 50, having 4 kids and a husband in a profession that involved moving, weight was a minor issue in lack of opportunities so I had a more realistic image of my body. After 45/50, even the prettiest women in my age group looked like ex-cheerleaders, ex-beauty queens and were just beginning to deal with their body not giving them a competitive edge. Invisible is invisible - body image is now about health not shape.

    Posted on August 12, 2010 at 5:02 PM

  4. Stephanie Said,

    Interesting post Peter. It goes along nicely with the concept that self-reported weight/BMI is not generally the same as measured BMI. As a population we generally report weighing less than we do. See:

    Connor Gorber et al. 2007. A comparison of direct vs. self-report measures for assessing height, weight and body mass index: a systematic review. Obesity Reviews, 8(4): 307-326.

    Posted on August 13, 2010 at 8:18 AM

  5. Peter Janiszewski, PhD Said,

    @KenLeebow - You could very well be right, especially when most estimates are based on large population surveys using self-report data. Then again, even if it is accurate - it would suggest that at best only 1 in 3 individuals are of "normal weight"

    @Stephanie - Yes, that paper is very interesting. I remember covering this issue during my PhD comprehensive exam. In addition to under-estimating weight, everyone also over-estimates their height. This combo leads to very skewed BMIs. It was also interesting that the degree of under-reporting of weight increased as the distance of the subject from the examiner increased. For example, when the information was acquired via a mail survey - high under-reporting. If by telephone, slightly better accuracy. And finally, when in person even better accuracy.

    Social desirability is an interesting phenomenon.

    Posted on August 13, 2010 at 12:57 PM

  6. Anonymous Said,

    When I was in my twenties and thirties, I weighed around 142 and wore a size (US) 12. Now I am in my fifties and I weigh a little more - 147. But now I wear a size 8.

    Part of the distortion is that clothing sizes have changed. The clothing manufactors know that the average person doesn't want the stigma of wearing extra-large sizes, so they've adjusted the clothing sizes. All part of a complex system as to why we don't seem to notice we are getting fatter.

    Posted on August 15, 2010 at 7:56 PM


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We are PhD students in the School of Kinesiology and Health Studies at Queen's University in Kingston, Ontario. Our research focuses on the relationships between obesity, physical activity, and health risk. This blog is our attempt to consider the many "cures" for obesity that we read about on a daily basis. Enjoy.


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