Chalk it up to denial, misunderstanding, or ill-fated optimism?



PROBLEM: Amid endless discussion about Americans are getting fatter, what weight loss strategies are actually effective, and the negative health effects associated with being overweight, obesity rates in the U.S. continue to climb. Are we getting the message? Do people obese people realize they're obese?

METHODOLOGY: The Behavioral Risk Factor Surveillance System is an annual survey that uses an independent cross-section of almost 400,000 U.S. adults to gather representative information about, among other things, the country's obesity rates. In 2008 and 2009, respondents were asked to report their current height and weight, along with how much they weighed one year prior to the study. Using this information to calculate Americans' average body mass index (those with a BMI of greater than 30 are considered obese), researchers at the University of Washington then compared what people thought happened -- the weight change reported by the 2009 respondents -- to what the data indicates actually occurred.

RESULTS: About 4.4. million obese adults went missing in the gap between measured and reported weight loss. The popular consensus was that obesity rates in the U.S. decreased in the year being studied: if men were to be taken at their word, they would have shown a decrease in obesity prevalence of 2 percent. In reality, their obesity prevalence increased by .3 percent. Similarly, women reported a decrease of .9 percent, but actually observed an increase in obesity prevalence of .5 percent.

Just as men were further off in their reported weight changes than were women, people over 50 also had a difficult time gauging their weight -- their reported weight gain was off by about 2 pounds. People diagnosed with chronic diseases, such as diabetes, are often advised to control their weight through diet and exercise. They reported substantial weight losses, but were generally off by as many as 4 pounds.

CONCLUSION: Americans misperceive, or are in denial about, their weight gain.

IMPLICATIONS: "We didn't have the ability to look specifically at the reasons driving these discrepancies," said Dr. Catherine Wetmore, the lead author of the study. "Certainly vanity or optimism could be one, or it could be a real true lack of awareness about what is happening." Regardless of why this is happening, it's clear that the first step in fighting obesity is acceptance. If we believe we're losing weight when we actually aren't, our further health behaviors will be misinformed and potentially harmful.

The full study, " In denial: Misperceptions of weight change among adults in the United States," is published in the journal Preventive Medicine.