A startling number of overweight and normal-weight women of reproductive age inaccurately perceive their body weight, according to new research from the University of Texas Medical Branch (UTMB) at Galveston.
"What we found reflects the 'fattening' of America," says corresponding author Dr. Mahbubur Rahman, assistant professor Department of Obstetrics and Gynecology and Center for Interdisciplinary Research in Women's Health.
"As obesity numbers climb, many women identify overweight as normal, not based on the scale but on how they view themselves."
Inaccurately perceiving body weight can have dire consequences.
Overweight women who think they're at a normal weight could be affecting their weight-related behaviors and making themselves vulnerable to cardiovascular and other obesity-related diseases.
Normal or underweight women who think they're overweight fall victim to such destructive behavior as skipping meals, taking diet pills or smoking more to kill hunger pangs.
In the December issue of Obstetrics and Gynecology, the researchers report that nearly 25 percent of overweight and 16 percent of normal weight reproductive-age women misperceive their body weight.
This is the first study to examine reproductive-age women's weight-related behaviors associated with self-perception of weight.
The study analyzed more than 2,200 women 18-25 years old based on survey questions pertaining to sociodemographic variables, height, weight, weight perceptions and weight-related behaviors.
Women with BMIs below 25 were considered normal weight and those with BMIs of 25 or more were considered overweight.
Using calculated BMI and participants' responses to self-perception questions of weight, the researchers divided the women into four categories:
- 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.
Respondents were also asked about the number of days over the last week that they exercised for at least 30 minutes continuously.
Overall, 52 percent of the study participants were considered overweight or obese, but according to the study findings, many of them did not realize that.
Overweight and obese Hispanic and African American women are significantly more likely than white women to misjudge their weight, categorizing themselves as normal.
Hispanic and African Americans -- nearly 25 and 30 percent, respectively -- were Overweight Misperceivers compared with white women, 15 percent of whom were included in this category.
Troubling numbers considering currently, 82 percent of African American women and 75 percent of Mexican-American women meet the criteria for being overweight or obese.
Hispanic women also fell into the Normal Weight Misperceivers category, along with white women. 20% of Hispanic and 16% of white women think they're overweight when they're actually not.
Overweight Misperceivers had significantly lower odds of participating in healthy or unhealthy weight-related behaviors.
Normal Weight Misperceivers were more than twice as likely to diet, skip meals and smoke more cigarettes; the respective odds were nearly four and five times higher with regard to using diet pills, powder, liquids and diuretics.
These findings were especially concerning, as the lower likelihood of Overweight Misperceivers to practice healthy weight loss behaviors has a negative impact on obesity prevention, and the higher likelihood of Normal Weight Misperceivers to practice unhealthy weight loss behaviors can lead to harmful medical and psychological consequences.
"Weight misperception is a threat to the success of obesity prevention programs," says lead author Dr. Abbey Berenson, professor, Department of Obstetrics and Gynecology and director of the Center for Interdisciplinary Research in Women's Health.
"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."
The researchers recommend that clinicians calculate patients' BMI at each visit as part of their vital signs, routinely screen for misperceptions of body weight and inquire about unhealthy weight-related behaviors so that they can counsel patients appropriately.
"This is especially important for reproductive-age women because they are more likely to be obese than similarly aged men, often because they've had at least one child and have not lost pregnancy weight and find that their schedules make it difficult to exercise and eat healthfully," adds Berenson.
