Am I Fat?

“Am I fat?”

It's a frequent question among girlfriends and spouses, and a rather weird and awkward one. Weight is, after all, measurable, a fact, and a second opinion from family members shouldn’t be necessary.

Maybe the question really begs for other reassurance, way beyond BMI, waist circumference, and pounds; sort of an “Am I pretty?”

But a new article by Eric Robinson, published in Obesity Reviews, shows that the question is actually relevant in its literal sense.

People just don’t know where they stand.

Studies consistently show that people underestimate their weight status. A study from the UK showed that 55 percent of men and 31 percent of overweight women assessed their weight as ‘about right’. Another study including 16,000 Americans found that 48 percent of men and 23 percent of women – all of whom were overweight – thought their weight was just right. Even among obese people there’s remarkable underestimation, and in one study fewer than 10 percent of obese people thought they were ‘very overweight’.

People not only fail to assess their own weight status, they also don’t see it in their kids. In an analysis including 60,000 kids and their families 50 percent of parents failed to see their child is overweight or obese. A significant percentage even thought an obese child is ‘about right’.

Is our subjectivity regarding ourselves our family and friends obscuring our clarity? Perhaps, but consider this: even doctors regularly failed to identify overweight men from visuals alone. In a study of experienced physicians from Germany doctors correctly assessed only 30 percent of overweight and only 50 percent of obese patients.

And if doctors can’t do it, lay people definitely can’t.

Not seeing what’s right in front us

One of the key features of us humans is that we’re, overall, an optimistic bunch. Most of us imagine the best possible outcomes, think that we’re above average, and think that we can beat the odds. It’s a wonderful trait that keeps us going.

And perhaps that comes into play in our blindness to our obesity crisis.

Robinson, though, offers another explanation: visual normalization. Since the entire population gained weight we have recalibrated our own normal, and in much the same way that you stop hearing crickets once they’ve been chirping for days, overweight stops being noticeable. Studies show that as obesity spread over the past decades, as our body size gradually increased, we’ve become less likely to notice it. Support for this notion comes from studies that demonstrate that in areas were obesity is more prevalent, moms, classmates and friends are less likely to identify overweight and obesity than in areas with slimmer networks.

In other words, our eyes and minds recalibrate depending on what’s around us, and since overweight and obesity are so common it’s become the new normal – unnoticed and unremarkable. We have adapted to the new normal, and our perception has changed.

What’s wrong with the new normal?

Since food’s so tasty, and losing weight’s so hard, can’t we just live in ignorant bliss? Isn’t it better that people who are overweight think their weight is just fine and feel good about it?

Well, the stigma attached to being overweight is certainly something we should fight. But overweight – especially severe overweight – is a health issue; it affects quality of life and is a risk factor for many nasty diseases. Failing to notice when the pounds pile on leads to further weight gain.

Ignorance of the situation is guaranteed inaction in the face of a growing problem. What you don’t see you don’t treat.

As to the “Am I fat?” question: perhaps it should be best addressed to someone who doesn’t just eyeball you. The correct answer, evidently, requires some objective measurements. And maybe the right question should be more clinical, devoid of beauty and acceptability factors, and of judgment.

“Is my weight healthy?” is a better way to phrase it.

Dr. Ayala