Many a clichéd punchline has followed a woman asking “Do I look fat in this?” Really, where would comedians be without women and their body issues? But while many perfectly healthy women worry they look too fat, it appears there are many other women who actually are overweight and obese but aren’t aware of it. A new study out of the U.S. finds that a surprising one in four overweight or obese young women thinks her weight is normal.

The study focused on more than 2,200 women between the ages of 18 to 25 in Texas. In all, 1,162 women were overweight as judged by body mass index (BMI), a somewhat controversial method of evaluating obesity that compares weight to height. The researchers found that 267 overweight women did not consider themselves overweight. In fact, 10.5 per cent of the women classified as obese (a BMI of 30 or above) believed their weight was normal.

There were also misperceptions on the flipside. Of the 1,062 women who were actually a healthy, normal weight or even underweight, 16 per cent believed themselves to be overweight. The researchers spotted a few demographic differences. African-Americans were more likely to underestimate their weight, while white and Hispanic women were more likely to overestimate it. Overweight women who had gone to college and who used the Internet were less likely than others to misperceive body weight. Misperceptions about body weight can have definite health consequences, the researchers say. The study found that among the normal-weight women who felt they were overweight, many had tried unhealthy weight-control tactics, such as skipping meals, using diuretics (water pills) or diet pills. As well, the overweight women who thought they were normal weight didn’t cut back on food, for instance.

It’s interesting to note that the study was conducted on women seeking help at reproductive health centres in Texas and appears in the journal, Obstetrics & Gynecology. Understanding the perceptions of these patients is important given that obesity can hamper a woman’s ability to get pregnant, as can anorexia or under-nutrition. Lead researcher Dr Mahbubur Rahman, an assistant professor of obstetrics and gynaecology at the University of Texas Medical Branch in Galveston, says the study also points to another problem: the “normalization” of obesity. Rahman told that the fact that so many overweight women view their body weight as normal reflects the ”fattening of America.”  “They see overweight people everywhere they go,” he says, and that becomes, for them, the new norm.

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