From “Overweight” to “About Right”: Evidence of a Generational Shift in Body Weight Norms

Abstract

In this article, we describe differences in the self‐perception of weight status in the United States between the two most recent National Health and Nutrition Examination Survey (NHANES) periods (1988–1994 and 1999–2004), and test the hypothesis that secular increases in adult mean BMI, adult obesity, and childhood obesity contributed to changes over time in weight perceptions. We find that the probability of self‐classifying as overweight is significantly lower on average in the more recent survey, for both women and men, controlling for objective weight status and other factors. Among women, the decline in the tendency to self‐classify as overweight is concentrated in the 17–35 age range, and is more pronounced among women with normal BMI than those with overweight BMI. Among men, the shift away from feeling overweight is roughly equal across age groups. Overweight men exhibit a sharper decline in feeling overweight than normal weight men. Despite the declines in feeling overweight between surveys, weight misperception did not increase significantly for men and decreased by a sizable margin among women. We interpret the findings as evidence of a generational shift in social norms related to body weight. As a result, people may be less likely to desire weight loss than previously, limiting the effectiveness of public health campaigns aimed at weight reduction. On the other hand, there may be health benefits associated with improved body image.

Overweight but unseen: a review of the underestimation of weight status and a visual normalization theory

“…Johnson and colleagues examined self‐perceived overweight between 1999 and 2007 in the UK adults and found that during this period of population weight gain, the percentage of individuals with overweight or obesity underestimating their weight status increased. Burke and colleagues 54 reported conceptually similar findings in the US participants: from 1988 to 2004, a period that was associated with rapid increases in population‐level weight gain in the USA, men and women with overweight or obesity became less likely to identify their weight status as being ‘overweight’. A similar pattern of findings has been reported in longitudinal studies examining weight status misperceptions using other US data, among European adults and in studies that have examined temporal changes in parental underestimation of child overweight status over time 13, 55, 56.…”

“…One prediction of this theory is that under‐detection should have become more common as the obesity epidemic has unfolded. In support of this, a number of longitudinal studies have documented that the tendency for individuals with overweight to fail to identify their adiposity and parental underestimation of child overweight have increased concurrently alongside population obesity prevalence 13, 14, 54, 55, 56. Johnson and colleagues examined self‐perceived overweight between 1999 and 2007 in the UK adults and found that during this period of population weight gain, the percentage of individuals with overweight or obesity underestimating their weight status increased.…”

“…Regardless of whether they are objectively overweight, if a person's body size is statistically close to the ‘average’ weight of a population, it is unlikely they will recognize that their body size is overweight 69. Variants of this ‘normalization’ explanation have been offered to explain why increases in obesity prevalence have been associated with increased misperception of weight status 14, 19, 54, 69, but until recently, these suggestions have been based on observational data and not formally tested. A series of recent experimental studies lend direct support to a ‘norm‐comparison’ explanation of perceived weight status.…”

“…It has been widely assumed that large numbers of individuals failing to identify that they are overweight or obese is a public health concern on the grounds that a failure to identify overweight or obesity will be a hindrance to weight management or intervention efforts 10, 14, 21, 53, 54, 108, 109; if one fails to recognize that they are overweight, then they are presumed to be unlikely to take the correct steps to address this. This line of reasoning bleeds over into public health intervention efforts that are designed to improve detection and educate people that they are ‘overweight’ 110.…”

High- and persistent- body-weight misperception levels in overweight and obese Swiss adults, 1997–2007

“…Possible explanations include aging, as body dissatisfaction tends to decrease with age, 3 or a shift in social norms related to body weight. 4 Still, these are relevant findings as the persistence of high body-weight misperception levels is likely to limit the effectiveness of campaigns aimed at weight reduction. In summary, we found a high bodyweight misperception among overweight and obese Swiss adults but, contrary to Spain, no significant increase during period 1997-2007 was observed.…”