Self-Perception of Overweight and Obesity, Part 1

My Bariatric Life Health Guide
  • Self-Perception of Overweight and Obesity, Part 1


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    Self-Perception of Obesity

    We are aware that there is a growing obesity epidemic in America. But, do we know exactly what the term obesity means?


    I recall the first time that I heard the word “obesity” applied to me. It was at the “diet pill doctor” in my hometown. At 15-years of age I was 5’7” and 185-lbs; on my chart he wrote a diagnosis of “obesity.” I was shocked because my self-perception was that I was overweight – not obese.


    denial of obesity

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    Denial of Obesity

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    Self-perception that denies one’s obesity is common. A great many people realize that an obesity problem exists in America, but the problem might be exacerbated by beliefs that it is only other people who are obese. “I’m fine but they’re fat.”


    Defining Obesity

    How do you, personally, define obesity?


    Many people describe obesity as “being very fat.” This isn’t far from the technical definition provided by the World Health Origination (WHO), which defines obesity as “a condition of excess fat accumulation in adipose tissue to the extent that health may be impaired.”


    The descriptions of very and excess used in these definitions can be interpreted in an infinite number of ways. Although several classifications and definitions for degrees of obesity are accepted, the most widely accepted classifications are those based on body mass index (BMI). The WHO designations are as follows:

    • Grade 1 overweight (commonly and simply called overweight) - BMI of 25-29.9 kg/m2
    • Grade 2 overweight (commonly called obesity) - BMI of 30-39.9 kg/m2
    • Grade 3 overweight (commonly called severe or morbid obesity) - BMI ≥40 kg/m2

    Some authorities advocate a definition of obesity based on percentage of body fat, as follows:

    • Men - Percentage of body fat greater than 25%, with 21-25% being borderline
    • Women - Percentage of body fat great than 33%, with 31-33% being borderline

    Armed with these quantitative definitions, it theoretically should be easy to understand the difference between overweight and obesity. However, Raaj S. Mehta, AB, Harvard Medical School, has studied perceptions of obesity and finds that a significant and increasing proportion of the U.S. population does not have a firm understanding of how to recognize obesity. He brings this to life with the following account:


    “In November 2011, I was preparing to greet my patient, Susan, for the first time, but when I stepped out into the laparoscopic surgery waiting room, I couldn’t pick her out from the other 20 people around her. Not everyone was waiting for the weight loss clinic, of course, but I still found it difficult to say who was morbidly obese and who wasn’t; who was waiting for the bariatric surgeon and not for a gallbladder removal. Interestingly, a week after my patient and I did connect, she confessed that she never saw herself as morbidly obese when looking in the mirror. She knew she was overweight and that her BMI was 43kg/m2, but she “always thought that gastric bypass was for really fat people.” It wasn’t until her mom who was a nurse gave her “a reality check” that she began to explore surgical interventions. Her perception of obesity, like mine, was off, and her BMI number ultimately meant very little for her body image.”


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    Misperception of Obesity

    In “Trends in the Perception of Obesity,” published in Body Mind and Inspiration, Mehta claims that perception in obesity is an understudied topic in the treatment of obesity and, if better understood, could have tremendous implications for the epidemic.


    Continue to part 2 of this article to learn about Mehta’s theories on why more people are misperceiving their own obese/overweight status and ways we can address this issue.


    Related article:

    Denial of Overweight and Obesity in America



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    WHO Obesity and Overweight Fact Sheet

    Medscape Obesity

    Trends in the Perception of Obesity, Body Mind Image Magazine

Published On: July 31, 2013