Tuesday, October 26, 2010

“Body Size Misperception” May Be a Factor Contributing to the Obesity Epidemic

Did you ever wonder, as I often have, what obese people are thinking as they keep putting on weight? Why doesn’t it occur to them as they pass, say 250 lbs., that maybe they should stop eating so much? As published two weeks ago in Archives of Internal Medicine*, researchers in Dallas suggest that a substantial number of obese people have what they term “Body Size Misperception.” More than 2000 obese adults were shown drawings of human figures on a 9 point scale, ranging from very thin to very obese. They then were told to pick both a figure that they felt would be ideal and a figure that represented how they thought they appeared. Body size misperception existed if the subject chose an ideal body size that was the same or larger than his/her actual size.

Some 8% of the group exhibited body size misperception. In other words, these people did not recognize that they were obese. Further examples of denial were that the body size misperception cohort felt they had a low lifetime risk of heart attack, high blood pressure and diabetes. The most amazing revelation is that a full two-thirds of these already obese individuals considered themselves at low risk for developing obesity. The authors of the paper think this issue is under-publicized and generally not dealt with well by physicians.

Maybe the concept of body size misperception, an entity that I certainly was not aware of before, can explain the apparent lack of self-recognition that one might be obese. And lacking the ability to see this obviously explains not only why some people become morbidly obese but also why they don’t seem inclined to correct the situation.

*Powell TM, et al. Body size misperception: a novel determinant in the obesity epidemic. Arch Intern Med. 2010 Oct 11;170:1695-7. [No abstract available]


Michael Kirsch, M.D. said...

Misperceptions are not limited to our bodily dimensions. I suspect that all of us have an innacurate view of many of our personal traits and physician characteristics. Sometimes, we extend this grade inflation to others. For example, everyone's kid is above average.

Anonymous said...

I am one of those 8% with no perception of body size. Intellectually, I know I am obese, but I cannot visualize my size relative to other people except to know that I am larger. Even looking in a mirror does not help. I have to have somebody else point out another person who is near my size to get any feel for how large I actually am. I wish there were a way to change my perception.

Skeptical Scalpel said...

Anonymous, I found your comment very interesting. Being a mere surgeon, I am at a loss as to how to advise you to effect a change in your perception. I wonder if a psychiatrist could help. Nowadays they all want to treat people with drugs, which does not seem to me to be a solution for you. I hope you can solve the problem.

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