How does obesity affect cognition

illness Obesity: Obese people estimate themselves 23 pounds thinner

As is well known, perception is a question of perspective; self-image and image of others often do not match. The perception of one's own body obeys special laws. This is particularly evident with overweight and underweight. Anorexic people perceive themselves as having normal weight in front of the mirror, they do not realize how emaciated they are, that the bones protrude and their face sags. The distorted body perception in anorexia is still a mystery to scientists around the world.

But even extremely overweight people, obese people seem to suffer from distorted body perception. Conversely, they perceive themselves to be much thinner than they really are. This distorted perception can make obese people less motivated to lose weight. This is the result of a long-term study from Sweden that has just been presented at the International Congress on Obesity (ECOICO 2020).

According to the classification of the World Health Organization (WHO), the BMI values ​​for a normal weight are between 18.5 and 24.9. From a body mass index of 25 we speak of overweight and from 30 of obesity (obesity).

Surveyed over 2,000 obese people over ten years

The researchers surveyed more than 2,000 obese people over a period of ten years. "People with obesity often suffer from body image distortion because they tend to underestimate their own body size," explains author Verena Parzer from the Rudolfstiftung Hospital in Vienna. "This means that people are less dissatisfied with their own bodies and consequently have less motivation to lose weight."

Respondents determined their body shape on a silhouette scale

The scientists compared the test subjects' statements as to whether there was a difference in body image perception between "weight gainers" and "weight maintainers". Each year the participants were asked to determine their own body figure with the help of nine silhouette drawings on an existing Stunkard scale. The scientists then calculated the body awareness index (BPI). They divided the estimated body mass index (BMI) by the actual BMI. Almost three quarters of those surveyed were women with an average age of 49 years. None of the study participants had their stomach made smaller by surgery.

Participants estimate that they are 21 kilograms thinner

The results showed that all respondents perceived themselves to be much thinner and slimmer than they actually were. Those participants who had gained weight during the survey period undercut their weight particularly significantly. After just three years, they estimated their actual body size to be around 21 kilograms less. This corresponds to about 7.5 BMI units. The participants who had lost weight misjudged themselves less, but still perceived themselves to be around 17 kilograms (6 BMI points) thinner.

Our results suggest that body image distortion may be related to the regulation of body weight.

Magdalena Taube co-author from the University of Gothenburg, Sweden

According to the researchers, the incorrect perception of the respondents did not increase disproportionately in the course of the study. The misperception of one's own body corrected itself a little even with the "weight maintainers". They thought they were about 15 kilograms thinner. For those who continued to gain weight, however, the distorted body perception worsened. They underestimated their weight by an average of eight BMI units. That corresponds to a total of 23 kilograms.

Associations give no indication of cause and effect

Authors concede that the results of their study show associations. No cause-and-effect conclusions could be drawn from this. They also pointed out that the fullness scales may not be large enough to depict people with severe obesity.

Obese people wait a long time before seeking help

So it's not just that people with obesity often don't lose weight because they can't. They simply perceive themselves to be less fat than they actually are. But there is another reason why it is difficult for them to lose weight. Obese people wait a long time before seeking help. Analysis of a global obesity study has now shown that obese people in the UK waited an average of nine years to seek health or medical help. That is longer than the global average; people here went to the doctor after just six years.

The authors say, "UK healthcare providers underestimate the health impact of obesity," the study researchers wrote. "Few also believe that their patients are motivated to lose weight." In addition, in Great Britain the time from the first conversation to the treatment was above average. The delayed medical care increases the risk of obese people to develop diseases even more.

"Understandings and perceptions of obesity need to change across society," the authors explain. The focus should be less on the individual responsibility that stigmata promote. Rather, it should also look at the reasons for obesity and the barriers that obese people have in the way of losing weight.

Obesity is considered a lifestyle disease. According to the World Health Organization (WHO), obesity has already reached epidemic proportions. At least 2.8 million people worldwide die each year as a result of overweight and obesity. It is estimated that almost a quarter of all women and men in Europe are obese. In Germany, half of adults are considered overweight. Almost a quarter of Germans are morbidly overweight.

In addition, 15 percent of children and adolescents are overweight. Six percent are even already considered obese. The commercial health insurance company had just warned of a sharp rise in obesity among children and adolescents. "We are watching this development with great concern," it said. "Every obese adolescent has a high risk of falling ill as an adult at the latest."

According to the WHO, overweight and obesity are important risk factors for a number of chronic diseases such as diabetes, stroke, cancer, arteriosclerosis, gout, fatty liver and lipid metabolism disorders, as well as back and joint diseases. In addition, there is a lower life expectancy comparable to that of smokers. The WHO also points out that overweight people are exposed to prejudice and stigmatization.

In recent years, the global food industry has been a topic of discussion in connection with obesity. The criticism was that there were hidden sugars and fats in many products. In addition, access to healthy food is often difficult for low-income people in particular.