Focus on Weight Undermines Motivation for Healthy Lifestyle Changes Among People of All Sizes

Date: July 27, 2006

Published in the June edition of the peer-reviewed journal Obesity, the cross-cultural study finds that women are more likely to categorize themselves as overweight than men, both overall and within each ethnic group. In addition, African Americans are least likely and whites most likely to consider themselves overweight. The study finds that even among many adults of average or normal weight — men in particular — a self-perceived weight problem correlates with sedentary behavior.

White women of average weight are the only ethnic-gender group studied in which the proportion of sedentary individuals is not higher among those who consider themselves overweight, versus average weight, the study shows. White women are also the only ethnic-gender group in which average-weight individuals comprise the majority.

The researchers noted that in addition to cultural expectations, greater access to fitness programs, "walkable" neighborhoods, quality child and elder care, and flexible work hours all help make the choice to be active easier for white women overall than their Latina and African American counterparts.

"These data suggest that our society's emphasis on weight loss rather than lifestyle change may inadvertently discourage even non-obese people from adopting or maintaining the physical activity necessary for long-term good health," said Dr. Antronette Yancey, lead author of the study and associate professor of health services at the UCLA School of Public Health.

"All groups may benefit from messages that shift the focus away from a specific target weight and associated calorie counting, and instead promote increased physical activity and healthy eating habits," Yancey said. "We still need to learn more about the relationship between overweight self-perception and healthy lifestyle change, and the apparent protective role of the cultural valuation of thinness and stigmatization of obesity in the battle of the bulge."
The study used data from the 2002–03 Los Angeles County Health Survey, a random telephone survey conducted by the Los Angeles County Department of Health Services. Of 14,154 eligible adults contacted, 8,167 completed interviews, or 58 percent. Body mass index (BMI) was calculated from self-reported weight and height, and each individual was classified as underweight, normal, overweight or obese. Self-perceived weight status was measured using direct questions asking participants to identify themselves as overweight, underweight or average for their height. Sedentary behavior was measured using standardized questions from an adaptation of the short version of the International Physical Activity Questionnaire.

Among specific findings:

• The prevalence of overweight and obesity among adult Angelenos by race/ethnicity and gender was fairly typical of national samples. The combined prevalence of overweight and obesity was highest in African Americans and Latinos, intermediate in whites, and lowest in Asians-Pacific Islanders. The pattern was consistent among both men and women within each group.
• 73.2 percent of overweight/non-obese and 24.1 percent of average-weight women considered themselves overweight, compared with 44.5 percent of overweight/ non-obese and 5.6 percent of average-weight men.
• 41.3 percent of overweight/non-obese African Americans identified themselves as overweight, compared with 60.6 percent of overweight/non-obese whites.
• Overweight self-perception, versus average-weight self-perception, correlated with sedentary behavior among average-weight adults (45.3 percent versus 33.0 percent), overweight adults (43.4 percent versus 33.6 percent), average-weight and overweight men (38.4 percent versus 27.8 percent), overweight whites (41.9 percent versus 29.7 percent), and African Americans and Latinos (41.6 percent versus 33.9 percent).

The Centers for Disease Control and Prevention and the National Cancer Institute provided some funding for the research. Co-authors included Dr. Paul A. Simon and Amy S. Lightstone of the Los Angeles County Office of Health Assessment and Epidemiology; William J. McCarthy of the department of health services at the UCLA School of Public Health and the department of psychology at the UCLA College of Letters and Science; and Dr. Jonathan E. Fielding of the UCLA Department of Health Services and director of public health for the Los Angeles County Department of Health Services.

The UCLA School of Public Health is dedicated to enhancing the public’s health by conducting innovative research, training future leaders and health professionals, translating research into policy and practice, and serving local, national and international communities. For more information, see http://www.ph.ucla.edu/.

-UCLA-
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