Study: Too Many Fat Women Don’t Even Know They’re Fat

by Cara on November 23, 2010

in beauty myths, bigotry, fat-shaming, media, misogyny, patriarchy, race and racism, stereotypes, women’s health

So there’s a fascinating new study out about how women perceive their weight, with the results being that a significant proportion of women who were deemed “overweight” by the BMI did not view themselves as such. Cue the body-shaming, junk reporting, and photographs of fat1 people with their heads cut off.

In the most neutral reporting of the new research, Web MD states:

Nearly one in four women who is overweight perceives her weight as normal, according to a new study.

The study also shows 16% of the normal-weight women studied had weight misperceptions, considering themselves overweight, says researcher Mahbubur Rahman, PhD, MBBS, assistant professor of obstetrics and gynecology and a senior fellow at the Center for Interdisciplinary Research in Women’s Health at the University of Texas Medical Branch, Galveston. [...]

“The fact that people misperceive their body weight was already known,” says Rahman, so the new research echoes some previous information. But in his study, he also wanted to see if the body weight misperceptions influenced health behavior.

Rahman obtained height and weight information from the medical charts of 2,224 women, ages 18 to 25.

The women answered questions about healthy weight-related practices in the 30 days prior — including eating less, eating differently, or exercising. They also answered questions about unhealthy behaviors, such as the use of diet pills, use of diuretics, vomiting, laxative use for weight control, cigarette smoking, or skipping meals.

For the study, Rahman used the standard definitions for normal, overweight, and obese, with BMIs below 25 termed normal, those 25-29 overweight, and 30 and higher obese.

The women also answered questions about education, ethnicity, marital status, household income, employment, and Internet use.

The women were divided into four categories:

  • Overweight women who thought they were normal or underweight
  • Overweight women who knew they were overweight
  • Normal-weight women who thought they were overweight
  • Normal-weight women who thought they were normal or underweight

Interestingly, they didn’t have a category for “Women who knew their bodies were fine just the way they were and thought we should go fuck ourselves.”

Less sarcastically, I think it’s incredibly damaging to have a universal weight category defined as “normal” when for a whole lot of “overweight” people, being “overweight” is normal. The same goes for those who are described as “underweight” (notably a group that was seemingly not studied here). “Normal” is relative. Trying to define and impose your definition of normal on other people — whether it be in relation to gender, sexuality, physical ability, neurological workings, weight, or some other category entirely, is alienating, damaging, and oppressive. There’s no way that defining people in opposition to “normal” and telling them that they must become normal for their own good is not harmful.

But, of course, this is the very basis of the entire BMI — to build a neat little box, tell everyone that they need to fit into it, and then shame and admonish those who don’t, usually through the even more abusive practice of telling them that it’s in their best interest. And that’s also precisely what this study is about. This research was explicitly done to see how self-perception affects behavior. When the results came in, the question became how to better inform those poor fat people that they’re fat. As if fat people don’t generally get enough of that.

Mistaken notions of one’s weight status can have implications for behavior, and perhaps health, the researchers noted. For example, women who were overweight but thought they were normal size were less likely to try to lose any excess weight by dieting or other means. On the other hand, women who saw themselves as fatter than they were, were more likely to use diet pills or diuretics, to induce vomiting or to smoke cigarettes, often as ways to control or lessen their weight.

“Unfortunately, women can’t do anything to lose weight if they don’t perceive themselves as overweight. It does start there,” said Keri Gans, a registered dietician based in New York City and a spokeswoman for the American Dietetic Association. “If they don’t perceive themselves as overweight, they’re not going to adopt healthy behaviors to lose weight and prevent disease. Meanwhile, the normal-weight people who don’t recognize they’re at normal weight are engaging in behaviors that put them at risk for illness.”

Here’s the thing: in a society where fat is almost universally vilified, a woman proclaiming that she does not view herself as overweight may indeed be doing nothing more than making a statement of self-confidence. On the one hand, I find this really sad — one should not find fat and bodily pride to be mutually exclusive, and “overweight” should not be synonymous with “bad” or “unattractive.” At the same time, I’m also unwilling to outright reject women’s expressions of satisfaction with their bodies, wherever I can find them. Such expressions are much too rare for us to have the luxury to pick and choose which ones we celebrate, even if we should critique some means of celebration.

Further, the fact is that some of these women who don’t “realize” they’re fat might not be fat at all. Fat is socially a pretty subjective concept to begin with, but it’s not as scientifically concrete as we might think, either. The BMI has all kinds of problems and lots of people are amazed to see how simultaneously rigid and inconsistent its standards are, yet the metric is used in this study. Indeed, the study authors and most of the articles make a big deal out of the fact that Black and Latina women were a lot more likely than white women to say they were not overweight in spite of falling into the BMI’s “overweight” category. These women are treated like they are sadly and pathetically ignorant, without it ever being considered that they might be right. What do women of color know about their own damn bodies in the face of white-biased scientific institutions? Clearly nothing, so it’s best to just forget the fact that there have been critiques of the BMI system as racist for years, and the studies showing that these claims very well might have a lot of merit.

And lastly, as someone who was once blissfully unaware that she was fat and that her body was therefore socially perceived as gross and unacceptable, I say that whether someone already “knows” they’re fat or not, there’s absolutely no good reason besides shaming to tell them. As I once wrote elsewhere about my experience of being lectured on my weight for the first time by my doctor during a yearly physical:

“You’ve put on weight,” she said. “You’re getting kind of big. Here’s a BMI chart. See, you’re here, just hovering on the overweight category. You know that if you keep putting on weight, the other kids are going to start making fun of you.”

I remember sitting up on the table in my hospital gown and looking at the floor, unable to look anywhere else. I remember thinking that if the kids did make fun of me, it couldn’t possible be any worse than this. I remember feeling ashamed. Not just because I’d just been told that I was too fat. But because I hadn’t even noticed. I didn’t even realize. I was fat? And I was just going to keep getting fatter? How could I not have known?

Now, I think the much better question is what would have possessed anyone to look at my 10-year-old self and decide to tell me.

I concluded, “I don’t think I’ve been unaware of my body and its size, my fat and its shape, how big I am and what other people are going to think of it, ever since.”

Now, I don’t claim my experience is universal among those who are fat yet still possess enough thin privilege to not be told about it on a daily basis. It’s just mine. Personally, I’d prefer to live in a world where being told that you’re fat is not an awful thing, because fat is not an awful thing. I’d greatly prefer to live in a world where fat just is. But since we don’t currently live there, I say for the love of god — let those who have gone relatively un-shamed stay that way. Chances are that even most fat women who don’t view themselves as “overweight” still have tons of body issues, anyway.

Of course, lots and lots of people — they’re not difficult to find — would argue that it’s important for fat people to know they’re fat, because fat is so unhealthy. The problem is that, well, not really. And even if fat were universally unhealthy, dieting is, too. Not to mention, it doesn’t work.

Further, while scientists might ostensibly care most about health, most social fat-shamers use “but I’m just concerned for your health!” as a cover up for their moralizing and attempted enforcement of their own aesthetic preferences. And though scientists are supposed to care most about health, the fact that there are a whole lot more quotes from the researchers about the failure of fat people to diet — again, even though diets don’t work — than the fact that many thin people are engaging in really unhealthy activities in order to be thinner is pretty telling.

The findings have serious consequences for obesity prevention, the researchers said, as many women do not recognise they are overweight and so will not join programmes.[...]

Lead author Prof Abbey Berenson, said: “Weight misperception is a threat to the success of obesity prevention programs.

“Overweight individuals who do not recognise that they are overweight are far less likely to eat healthfully and exercise.

“These patients are at risk for cardiovascular disease, type 2 diabetes and other serious problems.

“This is especially important for reproductive-age women because they are more likely to be obese than similarly aged men, often because they’ve had at least one child and have not lost pregnancy weight and find that their schedules make it difficult to exercise and eat healthfully.”

Of course, no one is also talking about the fact that lots of fat people are also engaging in dangerous practices like smoking, taking laxatives, or throwing up to try to be thin. Because, I mean, who cares — they’re still fat. And no one is talking about thin people who eat foods high in fat and don’t exercise, because who cares — they’re thin.

The point is, this clearly isn’t about health, or we’d be talking about unhealthy habits across the board. And if we want to talk about the unhealthy habits of those thin people who are trying to be even thinner, the problem isn’t that they don’t know just how thin they are. The problem is that thanks to this fatphobic culture we’re living in, they’re so terrified of being fat that they’d rather put their health at risk than be perceived as “unhealthy” and unattractive.

Which is to say that I’m extremely concerned about women’s health, probably a lot more so than most people. I just think that studies like this, and the kind of rhetoric and behaviors they inspire are making women’s health a whole hell of a lot worse.

  1. For those unfamiliar with the term “fat” as anything other than an insult, I want to be clear that I use the term here both to refer to myself and other people as an entirely neutral descriptor with no value judgment attached.  I say that I’m fat in the same way that I might also say that my hair is brunette — or in the same way I might say that person is tall, or that shirt is blue, or that dog is large.
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{ 9 comments }

1 The Goldfish November 23, 2010 at 3:11 pm

I note that they looked at “healthy weight-related practices in the 30 days prior — including eating less, eating differently, or exercising.” They don’t seem to have asked overweight women about their normal diet and exercise levels. The data would be far more informative if they looked at lifestyle overall – it could be that overweight women who perceive themselves as “normal” do so because they know they live healthily, that they exercise plenty and eat well. Or not. We just don’t know.

The BMI thing really bugs me. The data is also rendered meaningless by what can amount to subtle differences in body shape, bone density and so on. If BMI is to be used at all, they should have looked categories of people with more widely varying BMIs – such as “obese” and “normal”. To consider two women with BMIs of 24 and 25 and imagining them to have significantly different health risks relating to weight…?

2 The Goldfish November 23, 2010 at 3:14 pm

Not to suggest that using more significantly varying categories would make this stuff okay, and certainly not the tone of the research or its reporting, but it would mean you were looking at one group of people who certainly carry more weight than another. I didn’t mean to suggest “Leave merely overweight folks alone – pick on obese people!”

3 meerkat November 25, 2010 at 11:05 am

*applause*

I like how “eating less” (and “eating differently”) are “healthy practices” regardless of how much and what you were eating before. Like if I replace a filling dinner from that restaurant that serves all organic vegetables and tofu with an 80-calorie pack of highly processed snack food, that is clearly much, much healthier. And if I was eating [obviously inadequate amount of calories] before, [even less calories] is much healthier.

I am not currently told I am fat every day (in a direct way) but I was in elementary school. However, I discounted that because I knew they were only saying that because it was the absolute most hurtful thing they could say (and all their other insults were actually much less factual). Plus I knew “fat” meant “completely horrible and worthless” which I did not want to think I was (did not meet “fat as neutral descriptor” for another 20 years). So thanks to parents who understand genetics (well enough to conclude that if everyone in our family has a trait, it is probably genetic) nobody really nagged me about it until I was forced to see a doctor other than my family doctor (who doesn’t seem to have drunk the obesity panic Kool-Aid).

4 Barbara November 25, 2010 at 12:44 pm

I know I am fat :(
I just lost 30 lbs. so am not longer obese but am still severely overweight. But those charts say I should weigh just ten pounds more than I did in high school and I’m 51 ! That is insane.

Interesting research, thanks for sharing.

5 Sajia November 28, 2010 at 4:58 pm

I know I am not fat. At most I am voluptuous. I have reclaimed my identity as an average sized woman precisely because I don’t want to be appropriating the pain of women who are above a size 12 and will never manage to be a politically correct “healthy” weight no matter how much society shames them. There’s an article I wrote on my livejournal about this, about how women who are a size 8 get cast as the acceptable face of fatness. I don’t want to be part of this system. My friends don’t perceive me as fat, so I don’t feel that I should wallow in shame over my fat or claim fat pride that I don’t deserve. I believe that the more average sized women refuse to be called fat, the easier it will be for plus-sized women to empower themselves. I’m pro-fat activism and have healed my body image problems and eating disorder by reading The Fat Nutritionist. But I believe that for an average sized woman to claim sympathy by claiming that she is fat is the equivalent of a white liberal claiming empathy for people of color by claiming a Cherokee grandmother.

6 Katrina December 2, 2010 at 11:05 am

If this study focused more on actual health than appearance, it could have helped a lot of people. For example, if they did a quick finger prick to test colestoral and glucose levels. Some people who saw themselves as healthy would see the results and think, “Hm….my glucose level came back a little high. May be I should eat less sweets.” That would be a healthy way to let people know that something in their diet should change before they develop more severe health problems.

Unfortunately, the study didn’t actually test for health factors influenced by weight and just did the BMI-Fits-All dance. This could have been a good study on how people who preceive themselves as heathy are actually in danger of developing conditions like diabities, high colestoral, high blood pressure, ect. It is possible to be overweight and not have heath problems so some people could who are over weight can still be healthier than some who is skinny. To declare every person who is not a 25 on the BMI scale as unhealthy is just ass backwards to me.

In fact, I wonder if they warned women that they were underweight. It was mentioned in passing that thin women who continue to diet put themselves at risk but I noticed there were no catagories for:
Underweight women who thought they were fat
Underweight women who thought they were normal
Underweight women who know they are underweight
If they truely care about women’s health, they need 7 catagories not just 4. If they are honestly worried about how weight affects health, they can’t ignore Bulemia, anorexia, and poor body image.

No matter how I look at this study, it is only irresponsible and damaging. If a woman who said she was a healthy weight but scored a 25.1, would they attack her eating habits? Would they do the same fo a woman who scored a 19.9? Or do they round up to the nearest whole number? My BMI of 24.6 (checked it once out of curiosity) could become 25 if the tens place is ignored.

Hopefully no women were scared into poor eating habits (i.e. speed dieting) just because of this study. I would just tell the bastards to keep walking if they pointed out the fact that my tummy isn’t toned and my thighs giggle. But a woman who has low selfesteem could actually develope an eating disorder over news like that. Especially if she recieves it at a very trying time in her life. If the researchers kept their mouths shut and released the study as nothing more than statistics, I wouldn’t be so pissed. But telling women that they don’t know their own bodies and are ignorant for not being as thin as they feel is a personal attack.

7 Miss Andrist December 10, 2010 at 8:36 am

Ten pounds.

That’s the difference by which a boyfriend will sit up immediately after having sex with me and say, “We need to feed you.” Coworkers strike up conversations – how do I do it? I get cold easily; I have to bring a jacket and gloves to work to deal with the air conditioning. When I say anything about being cold, I am blamed: it’s cos you’re so skinny. When I was a kid growing up, I was harassed and ridiculed and beaten up for being too skinny – “flat,” because apparently, from fifth grade on, boys unanimously agreed that I had a responsibility to blossom double D’s that I was too stupid to fulfill.

Fat-hate is by far the most endemic, the most common and the most virulent manifestation of hatred of women’s bodies. But hating fat is just easiest – the underlying premise of fat hate is that women are not allowed to perceive our bodies with satisfaction, ever. None of us. Cindy Crawford, when asked about the centerfold shot in that issue of Sports Illustrated Swimsuit, said “I hate that picture. Every woman hates how she looks from behind.” That’s right, not even Cindy Crawford gets to live in peace with her ass. The patriarchy needs us to be constantly consumed with the need to satisfy men. Not even “men in general,” as in most men – every individual man gets to have an opinion, which you are required to hear, and he thoroughly believes you owe it to him to be sexually appealing to him. (He has no such illusions about his own appeal to you or women in general.) I clearly recall finding myself marvelling at men who did not hesitate to list my physical shortcomings quite publicly to my face, oblivious to their own and as if I were somehow indebted to them – and finding myself bristling, trying to cover these so-called flaws or make excuses for having them.

Marvelling, because I was modelling at the time.

Even then, I Wasn’t Good Enough.

None of us will ever be, and it doesn’t actually have anything to do with weight. Not even Cindy Crawford got to be good enough. I blame the patriarchy.

8 LTF December 11, 2010 at 3:00 pm

I think I am 1 cupcake away from a BMI of 25 even though I exercise everyday. No one I know thinks I’m fat at a size 6. And seriously, what about all the men that are fat but just think they are “husky”?

9 Anna K December 16, 2010 at 8:43 pm

I agree that the survey methods were flawed, and I like Katrina’s idea that future surveys focus on true health-focused measurables, like cholesterol and blood sugar levels.

I’m 5’7 and a total gym rat. At one point I was so fixated on getting to a “healthy” weight that I got down to 19% body fat and had friends and family telling me I looked sick. My BMI was on the low end of normal at that point, but my body didn’t like it one bit.

When I stopped focusing on caloric restriction and turned to eating “normal” foods in moderation and running or lifting weights four times a week, I gained 25 pounds. That was enough to push my BMI to the high side of normal, at 24. Nobody has ever guessed that I weigh as much as I do, or that my BMI number would be so high. This is my body’s happy weight, and I’m even getting sick less often now than I did when I was fixating on the number on the scale. I’ve been able to run longer and faster now that I’ve put on muscle, too!

I’ll admit, I do sometimes prejudge bigger women without consciously realizing it. However, when I look at the issue objectively, some of my girlfriends who outweigh me by a good 20-30 pounds can also outrun me in a foot race. My prejudices are the result of my own body fears. I need to let them go.

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