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Three out of ten people misidentify themselves as overweight, underweight, or normal weight

Despite public health campaigns urging Americans to reach and maintain a healthy weight, over half of American adults are overweight or obese, and many normal weight women have eating disorders or diet excessively to lose weight unnecessarily. Three out of ten adults mistakenly identify themselves as overweight, underweight, or normal weight, concludes a study supported in part by the Agency for Healthcare Research and Quality (National Research Service Award training grant HS00084).

About 28 percent of overweight people judged their weight to be "just about right," while 24 percent of people who thought they were overweight were in fact normal weight or underweight according to their body mass index (BMI, weight in kg divided by the square of height in meters). Overall, 17 percent of people underassessed their weight category, and 12 percent overassessed their weight category, based on their BMI.

Men were more likely than women to fail to recognize that they were overweight—40 percent of overweight men considered their weight to be "just about right" compared with 15 percent of overweight women. On the other hand, 29 percent of normal weight women thought they were overweight compared with 8 percent of normal weight men.

Adults who were white, younger, more educated, or more affluent were more likely than others to consider themselves heavier than their actual BMI. This suggests that there are norms of acceptable range for body size that depend on one's age, race, and socioeconomic status, which may differ from an externally imposed clinical standard, explain University of Chicago researchers, Virginia W. Chang, M.D., M.A., and Nicholas A. Christakis, M.D., Ph.D., M.P.H. Their findings are based on an analysis of how adults classified their weight in response to the 1991 Health Promotion and Disease Prevention Supplement of the National Health Interview Survey.

See "Extent and determinants of discrepancy between self-evaluations of weight status and clinical standards," by Drs. Chang and Christakis, in the August 2001 Journal of General Internal Medicine 16, pp. 538-543.

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