Half Of Americans' Thoughts on Obesity Don't Reflect Reality

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The good news is that Americans have realized what public health experts have been sayng for years — obesity is a huge problem leading to a myriad of negative health outcomes. The not-so-great news is that many aren't realistic about their own body weight. according to a recent survey by NORC (pronounced N-O-R-C), at the University of Chicago, in collaboration with the American Society for Metabolic and Bariatric Surgery (ASMBS).

The survey included about 1,500 adults over the age of 18. They were queried in person, by phone, and on the internet, and the sample was weighted to represent the national distribution of ethnic groups, ages and genders. Participants gave their weight and height, and investigators used those data to determine their body mass indices (BMIs — weight in kgm divided by height in meters2).

According to their calculated BMIs, about one third of respondents were normal weight, 29 percent were overweight, and 35 percent were obese. When asked to define themselves as to their weight status, the overwhelming majority of those classified as obese said they were overweight — which of course is correct. But nearly half (47 percent) of those who fell into the obese category said they were only overweight. And 9 percent said they were of normal weight. Men were more likely than women to underestimate their weight classification.

While this may seem a minor issue, it really isn't, because 57 percent of those whose self-classification were incorrect were less likely to speak to a doctor about their situation. In contrast, 76 percent of those who correctly identified themselves as obese would speak to a doctor.

The survey also assessed people's estimation of the causes of obesity as either lifestyle choices, or a combination of genetic, environmental, and social factors. Those in the former group were less likely to speak to a doctor about their weight (35 percent) than were the latter (46 percent).

Personal versus government responsibility - the cultural divide

The preponderance of people surveyed think that something 'should be done' to prevent obesity. But they diverge on who is responsible — 58 percent think it's up to individuals to deal with the issue, while 41 percent believe it's up to the government and the health care system. Republicans, older people, and those with only a high school education or less believe that 'individuals should cope with obesity', as in it is a personal responsibility to consume fewer calories or exercise more, while Democrats, younger Americans, and those with some college or more education felt like the government and the health care system should be handling it.

Some caution must be used in assessing the validity of this survey, since participants' body weights and heights were self-reported, and BMI is not the best indicator of obesity. Still, it is a concern that Americans seem often to be deceiving themselves about their weight status. And of course it's problematic that this self-deception makes it less likely that a person will seek professional help. Thus, it's important that if these individuals seek medical help for other conditions (or just for annual checkups), that their health care providers include an assessment of their body weight when discussing their health - and it is essential that fewer people believe it is up to the health care system or the government to make people go on diets, since no group forced anyone to eat all that pizza.


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