In denial: misperceptions of weight change among adults in the United States

Obesity is associated with several chronic conditions, increased medical costs, and premature death. Proper assessment of changes in body weight is crucial to control the spread of obesity. We used data from the Behavioral Risk Factor Surveillance System to explore how adults in the United States recall their weight change and to identify characteristics associated with weight changes.

Data from two cross-sections of adults aged ≥18 years from the 2008 (n=385,416) and 2009 (n=394,700) Behavioral Risk Factor Surveillance System were analyzed. Body mass index was calculated from self-reported height and weight. Self-reported estimates of weight 1 year prior to the interview were used to calculate changes in weight and obesity status between 2008 and 2009.

If self-reported changes in weight between 2008 and 2009 are to be believed, the obesity prevalence among men and women in the United States would have declined by 2.0% and 0.9% respectively. Yet, obesity prevalence increased 0.4%, overall, during this tim'e period. In general, American adults overestimated their previous weight and reported weight losses even though they had gained weight.

Public health and medical professionals should interpret self-reported weight changes with caution when developing, implementing, and evaluating programs to control and prevent weight gain.