New research warns that the normalisation of 'plus-size' body shapes may be leading to an increasing number of people underestimating their weight - undermining efforts to tackle England's ever-growing obesity problem.
While attempts to reduce stigmatisation of larger body sizes - for example with the launch of plus-size clothing ranges - help promote body positivity, the study highlights an unintentional negative consequence that may prevent recognition of the health risks of being overweight.
The study by Dr Raya Muttarak, from the University of East Anglia (UEA) and the International Institute for Applied Systems Analysis (IIASA), in Austria, examined the demographic and socioeconomic characteristics associated with underestimation of weight status to reveal social inequalities in patterns of weight misperception.
Analysis of data from almost 23,460 people who are overweight or obese revealed that weight misperception has increased in England. Men and individuals with lower levels of education and income are more likely to underestimate their weight status and consequently less likely to try to lose weight.
Members of minority ethnic groups are also more likely to underestimate their weight than the white population, however they are more likely to try to lose weight. Overall, those underestimating their weight are 85% less likely to try to lose weight compared with people who accurately identified their weight status.
The results, published today in the journal Obesity, show that the number of overweight individuals who are misperceiving their weight has increased over time, from 48.4% to 57.9% in men and 24.5% to 30.6% in women between 1997 and 2015. Similarly, among individuals classified as obese, the proportion of men misperceiving their weight in 2015 was almost double that of 1997 (12% vs 6.6%).
The study comes amid growing global concern about rising obesity rates and follows a 2017 report by the Organisation for Economic Co-operation and Development (OECD) that showed 63% of adults in the UK are overweight or obese.
Dr Muttarak, a senior lecturer in UEA's School of International Development, says her findings have important implications for public health policies.
"Seeing the huge potential of the fuller-sized fashion market, retailers may have contributed to the normalisation of being overweight and obese," said Dr Muttarak. "While this type of body positive movement helps reduce stigmatisation of larger-sized bodies, it can potentially undermine the recognition of being overweight and its health consequences. The increase in weight misperception in England is alarming and possibly a result of this normalisation.
"Likewise, the higher prevalence of being overweight and obesity among individuals with lower levels of education and income may contribute to visual normalisation, that is, more regular visual exposure to people with excess weight than their counterparts with higher socioeconomic status have.
"To achieve effective public health intervention programmes, it is therefore vital to prioritise inequalities in overweight- and obesity-related risks. Identifying those prone to misperceiving their weight can help in designing obesity-prevention strategies targeting the specific needs of different groups."
Dr Muttarak added: "The causes of socioeconomic inequalities in obesity are complex. Not only does access to health care services matter, but socioeconomic determinants related to living and working conditions and health literacy also substantially influence health and health behaviours.
"Given the price of healthier foods such as fresh fruits and vegetables are higher than processed and energy-dense foods in this country, as a sociologist, I feel these inequalities should be addressed. The continuing problem of people underestimating their weight reflects unsuccessful interventions of health professionals in tackling the overweight and obesity issue."
The study used data from the annual Health Survey for England, which contains a question on weight perception.
Focusing on respondents with a BMI of 25 or over, about two-thirds were classified as being overweight and one-third as obese. In order to assess trends in self-perception of weight status, the analysis was based on pooled data from five years - 1997, 1998, 2002, 2014, 2015 - of the survey.
The proportion underestimating their weight status was higher among overweight individuals compared with those with obesity (40.8% vs 8.4%). Correspondingly, only about half of overweight individuals were trying to lose weight compared with more than two-thirds of people with obesity.
'Normalization of Plus Size and the Danger of Unseen Overweight and Obesity in England', Raya Muttarak, is published in Obesity, volume 26, number 7, July 2018.
Notori0usPIG on June 22nd, 2018 at 14:10 UTC »
Im a very fat guy. I could care less what the public calls it. Whether it be fat, obese, plus-size, big boned or whatever.
I call it dead at 40 if i dont change. So im working on it.
Edit: you guys are great, thanks. Edit2: all this fat karma. This is weird. Its fun tho.
JDSRK on June 22nd, 2018 at 13:48 UTC »
The big problem I have with these kind of discussions is how people try to make it seem like it's black or white.
I started this year at 370 pounds, currently at 298. I have never felt better, however, my journey (which is barely half way through) has taught me a couple of things.
I started this because it was affecting my health, social life, and self esteem all around. I will never tell you that being overweight is a good or healthy thing. What I will tell you is that the "fat acceptance" movement is completely distorted from its original intent.
I agree we should dismiss the notion that it is somehow a healthy thing to be obese, but the original intent of the movement had nothing to do with this.
Losing weight is a hard journey, and I've noticed a lot of obese people just hate themselves, and won't allow themselves to shed off that hate until the weight is off. All the times I failed was because of this mentality, and failing would only increase that feeling of self loathing. The most important thing that I learned is that before you start the journey you have to forgive yourself, and accept who you are.
You need that "fat acceptance" that lets you know that even at your heaviest you are still a worthy person who can have goals and achieve dreams, and you are not a lesser human being than others. This mentality will allow you to recover from failing and help you keep going.
This is referring to one self, but there's also another aspect, which is how other people perceive you. I feel good after my results, and I have faith in myself that I can keep going. My blood pressure is back to 120/80 and I'm finally off the meds. However, to your average person on the street I'm just another ugly 300lb unhealthy man who they make all sorts of assumptions about.
A lot of people online have no idea what other people are going through. That 400lb man you are body shaming now might have been 500lbs just a year ago, his health is improving, blood pressure getting better, he is learning discipline, and learning to love life again.
Yet, these people who have no idea about this will just go ahead and harrass/body shame that person. The "fat acceptance" movement was never about thinking of being obese as something healthy, but to let obese people know they can rise above the harassment, accept themselves and do something for their lives.
So yes, you, you 400lb person, accept yourself, forgive yourself, and take in into your hands to become a better person. It can be painful I know, you will feel so behind, so many missed opportunities, but there is a light at the end of the road, I promise you. We all carry our own crosses, and just because yours is a lot more visible than others, it doesn't mean you are a lesser person. You can do it, and I believe in you!
elunaar on June 22nd, 2018 at 12:30 UTC »
I used to think that you could be healthy and fat, just eat the correct nutrients and you were good. I got a wake up call when I my body physically couldn't handle my weight anymore. I have a herniated disk because of that, and the back of my left thigh has been numb for a couple years. Even at my heaviest it wasn't as extreme as a lot of people, I was 349lb at 6ft 1 and 23 years old and it was still too much. I've lost a pile of weight since, and it makes my blood boil to watch people promote/normalise being obese, because i know first hand that you cannot truly be fat and healthy, it puts so much extra strain on your body. It might be fine now, but it will catch up to you.
Edit for clarity: My apologies if I was misinterpreted by a couple of folks, maybe it came across that I was trying to normalise being overweight. I was trying to convey that we've begun to accept as normal is actually a very unhealthy weight. When i say "even at my heaviest it wasn't as extreme", what i mean is that, while i was absolutely way heavier than i should have ever been, there are so many people who are heavier and show it more, that until that point, I didn't realise exactly how abnormal my weight should have been. Which is what this article was talking about.