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Obesity survey: The disconnect between size and weight

ASHINGTON, D.C.— According to the Centers for Disease Control and Prevention, an estimated 66 percent of U.S. adults are overweight (33 percent) or obese (33 percent) but, according to a new National Consumers League study conducted by Harris Interactive®, only 12 percent of U.S. adults say they have ever been told by a doctor, nurse, or other health care professional that they are obese. Following the recent announcement by RAND Corporation, which notes that the prevalence of American adults who are classified with severe or morbid obesity is increasing at a much faster rate than the prevalence of moderate obesity, the National Consumers League today is releasing troubling new survey data about consumers’ misconceptions about their weight and knowledge of weight-loss options. NCL is also announcing new Web resources for consumers who may need to lose weight but don’t know where to begin the daunting process.
The survey of 1,978 adult Americans, was conducted online by Harris Interactive from March 6th to 12th, 2007. NCL has launched a new consumer education campaign, “Choose to Lose”. The new materials available at www.nclnet.org/obesity aim to help consumers overcome the overwhelming task of honestly evaluating their individual weight and work with their doctor to do something about it.
‘Obesity’: Not Admitted by Most
NCL’s new survey found a startling disconnect between the way people perceive their weight, and their actual weight category based on the body mass index (BMI), the most common measurement for obesity. U.S. adults were much more likely to refer to themselves as “overweight” rather than “obese”, and consistently identified themselves as being in less severely overweight groups.  In fact, 52 percent of respondents referred to themselves as overweight, and only 12 percent as obese, severely obese, or morbidly obese. But, based on actual BMI calculations using self-reported height and weight information, among the 96 percent of respondents who reported height and weight, 35 percent are actually “overweight,” whereas 34 percent are actually obese, severely obese, or morbidly obese. Among respondents who are obese according to BMI, 82 percent consider themselves to be simply “overweight.” Alarmingly, only a minority of all respondents (20 percent) claimed to know their BMI number.
“This discrepancy between perceived and actual weight categories suggests that the stigma associated with being obese is a powerful one; many consumers would benefit from a more realistic picture of their own weight,” said NCL President Linda Golodner. “We wanted to find out how consumers feel about their weight, their health, their need to lose pounds, and the stigma surrounding treatment options. We found that while many consumers view obesity as a legitimate disease, they don’t want to identify themselves as ‘obese.’ Weight is a highly personalized, complicated issue, and many overweight and obese consumers are in need of help.”
Perceptions about Obesity: Real Disease, Real Treatment, Real Stigma
Despite the commonly held view that obesity is a serious disease, significant levels of cultural bias persist. Most respondents (78 percent) say that obesity is a serious, chronic disease and that it requires medical treatment (54 percent). Most U.S. adults (61 percent) report, however, that obesity is considered taboo in society today, and half (50 percent) attribute the condition to a “lack of will power.” More than a third of U.S. adults (37 percent) agree that obese people should pay more for health insurance, and more than a quarter (27 percent) say that it is still acceptable to make fun of obesity. And, although many U.S. adults were accepting of many different types of treatment (more below), ranging from diet and exercise to acupuncture, there are still some negatives associated with certain options. For example, although 79 percent of respondents say weight-loss surgery can be a life-saving treatment, half (49 percent) agree that there is a stigma associated with using surgery as a weight-loss option. Moreover, forty-seven percent held a very negative or somewhat negative view of weight-loss surgery.
“There is a serious disconnect between an individual’s perception of both what it means to be overweight and the health risks of carrying extra pounds. While many consumers know that weight loss can improve the illnesses associated with excess weight, they do not have the information to separate unsubstantiated weight-loss claims from evidence-based strategies to support their weight-loss efforts,” said Madelyn H. Fernstrom, PhD, CNS, Associate Professor and founding Director of the Weight Management Center at the University of Pittsburgh Medical Center. “Consumers need accurate information about the lifestyle changes they need to make to not only lose weight, but keep it off. Lifestyle change is the foundation of successful weight loss, but other treatment options, including prescription medications and surgery, can be added to help support—not replace—the lifestyle effort. When it comes to losing weight, one size does not fit all, and obesity treatment should be individually tailored, with careful consideration to both biological and behavioral factors.”
Personal Reflections on Weight & Weight Loss
According to findings, 64 percent of respondents are not happy with their current weight, and many say that more time to exercise (59 percent), better access to healthful foods (31 percent, and more time to cook and eat at home (31 percent) would help them achieve and maintain a healthier weight. More than three quarters (77 percent) of respondents have tried to lose weight at some point, and among these, 60 percent agree that it is one of the hardest things they have ever tried to do. Despite the attempts, many are unsuccessful at either losing weight or keeping it off. Less than a third (29 percent) of those who have ever tried to lose weight report being successful, and about a third (34 percent) have only been able to keep off the weight they lost for less than one year.
“I was fortunate to have a doctor tell me that I seriously needed to lose weight. But not all consumers who need that push from their healthcare professional get it,” said Peggy Kindler, a 51-year-old Pittsburgh, PA resident who has battled weight issues all her life. In the year since gastric banding surgery, Kindler has lost 53 pounds but continues to struggle with the challenges of weight-loss. “As someone who has experienced the very real benefits of losing a significant amount of weight, and being able to keep it off, I truly hope that these new materials for consumers at www.nclnet.org will help people recognize their weight problem, understand the weight-loss options available and motivate them to get help.”
Getting on Track for Weight Loss
About half (52 percent) of people say that they have talked about losing weight with their doctor, although respondents who are obese are more likely to have done so. Among those who have discussed weight loss with their doctor, nearly three in five (59 percent) report that their doctors recommended a diet change (47 percent) and/or exercise regimen (35 percent). However, only one third discussed the health risks associated with their weight, and only ten percent said their doctor helped them develop a plan to lose weight.
Of the weight-loss options other than regular diet and exercise discussed in the survey, respondents reported being most familiar with: organized weight loss programs (56 percent); over-the-counter medications (42 percent); weight-loss surgery (41 percent); and prescription medications (39 percent). Organized weight-loss plans also were perceived very or somewhat positively by most (69 percent) respondents, followed by counseling/psychiatry (55 percent), and intensive weight loss “camp” (45 percent). More than a third (38 percent) held a very positive or somewhat positive view of weight-loss surgery, while a third thought positively of prescription weight-loss medications (35 percent), acupuncture (34 percent), and hypnosis (33 percent).
About the Survey
The survey was conducted online within the United States from March 6 to 12, 2007 by Harris Interactive® on behalf of the National Consumers League among 1,978 adults aged 18+ according to BMI calculations out of this sample of 1,978; 25 are underweight, 528 are normal weight, 679 are overweight, 351 are obese, 164 are severely obese, 138 are morbidly obese. According to self-assessment 58 are underweight, 590 are normal weight, 1,032 are overweight, 180 are obese, 60 are severely obese, and 48 are morbidly obese. Figures for age, gender, race/ethnicity, education, region and household income were weighted where necessary to bring them into line with their respective total populations. Propensity score weighting was also used to adjust for respondents’ propensity to be online.
With a pure probability sample of 1,978 adults one could say with a 95 percent probability that the overall results would have a sampling error of +/-5 percentage points would have a sampling error of +/-3 percentage points.  Sampling error for data from sub-samples may be higher and vary.  However, that does not take other sources of error into account. The online survey is not based on a probability sample and therefore no theoretical sampling error can be calculated.
NCL thanks Allergan, Inc. for an unrestricted educational grant that made this survey and educational effort possible.

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