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Perceiving Yourself as Overweight Poses Health Risks

New research suggests it can create a negative self-image, which may result in a downward spiral.
Boy on scale

As a rule, self-deception isn't a great idea, especially when it comes to health-related habits. But newly published research suggests that, at least in one arena, raw, painful honesty may have negative repercussions.

It reports thinking of yourself as overweight is associated with poorer mental and physical health. What's more, these adverse effects were found regardless of a person's actual body-mass index (BMI).

The stigma that accompanies the "overweight" label "may trigger a cycle of stress, maladaptive coping responses, further weight gain, and poor health," a research team led by Michael Daly of the University of Stirling writes in the journal Psychological Science. "These findings underscore the importance of evaluating whether weight-feedback interventions may have unforeseen adverse consequences."

The researchers examined data on 3,582 young Americans who participated in the National Longitudinal Study of Adolescent Health. They were assessed in 2001–02, when their average age was just under 22, and again seven years later.

As part of their initial assessment, they were asked to rate themselves on a scale of one (very underweight) to five (very overweight). Height and weight measurements were taken to estimate their BMI.

If these findings are confirmed, medical personnel will have to rethink the way they speak with patients about their weight.

At the follow-up, "participants were examined by qualified staff who collected measures of cardiovascular, inflammatory, and metabolic health." Participants also rated their health on a five-point scale, and noted any depressive symptoms they had recently experienced.

The results were clear: Perceiving yourself as overweight was associated with "less healthy physiological functioning, declines in subjective health, and increases in depressive symptoms over a seven-year follow-up period," the researchers write. "These associations were independent of initial BMI levels and sociodemographic characteristics, were not significantly different for males and females, and were meaningful in magnitude. Perceived overweight is an important predictor of subsequent health, irrespective of the accuracy of that perception."

One reason for this: Those who perceived themselves as overweight gained more pounds, on average, over the seven years than those who did not. That increase accounted for about half of the decline in physical health markers, such as blood pressure and inflammation. The remainder was apparently due to the "daily stress" and negative emotions associated with a self-image as a fat person.

If these findings are confirmed, medical personnel will have to rethink the way they speak with patients about their weight. Presumably, many give their patients the "overweight" label in order to nudge, or scare, them into healthier behavior.

In fact, they may be doing more harm than good.