Question of the Week

October 20, 2008


For many teens, the perception of what they feel is the correct weight and the reality of what constitutes a healthy weight are very different.

"Over 13,000 teens from 150 high schools completed questionnaires... To determine weight perception, participants were asked to describe themselves as very or slightly underweight, 'about the right weight,' or slightly or very overweight. ... The mean BMI for the 2001 sample was 23.7, which is considered to be normal weight; the range was from 16.8, underweight, to 54.98, morbidly obese. ... There were significant differences in the ways boys and girls viewed their weight. For example, 25% of normal weight boys viewed themselves as underweight, the exact same percentage of normal weight girls who viewed themselves as overweight. A majority of overweight boys, 56%, viewed their weight as 'OK,' while only 24% of overweight girls reported the same perception. Even 19% of obese boys reported their weight as OK, as compared with 7% of obese girls. Combined, these results support the theory that actual weight and concept of weight are separate entities."

The separation between perception and reality is not just an issue for teens. It can also affect children and adults. Just as teens can struggle to know what weight is "normal," children can have a difficult time figuring out what they "should" weigh, and parents can struggle to know if their children and teens are at a healthy weight.

"Data on 2,100 Australian children found 40% of parents with an overweight or underweight child had not spotted this. Among children, the underweight were more likely to think of themselves as average than the overweight. ... We live in a society where being big is becoming far more common, and is seen as normal. Child obesity is thought to be increasing fast in many countries, and experts are hunting for effective ways to intervene, both at school, and home. ... The Melbourne researchers analysed the 2,100 children using both Body Mass Index and waist circumference, to try to establish which fell into the 'underweight', 'overweight' and 'average' groups. They then compared these results with the recorded perceptions of their parents. In total 43% of parents of overweight or underweight children placed their child in the 'average' bracket. ... When the children themselves were asked, six out of 10 underweight girls and half of underweight boys did not assess their weight correctly."

The perception of what is healthy or "normal" can come from different sources. People of all ages can compare themselves to their peers, their family members, and/or the celebrities they see in the media.

If people are inspired by those around them to begin making healthier lifestyle choices, then the comparisons can lead to a positive outcome. Far too often, however, these comparisons lead to unrealistic expectations and unhealthy choices.

"TV, movies, and magazines are full of images of bodies that are too perfect to be real. Children and teens see these images all the time, and they may wish they could look like the ultra-thin models they see. What they may not know is that almost every picture in a fashion magazine has been "touched up" in some way to make the models look better. Teens often try to look like these unreal pictures by going on extreme diets. ... Research shows that about two-thirds of teen girls and about one-quarter of teen boys are trying to control their weight. Changing your diet can be a good thing. For instance, some teens may decide to stay away from junk food, add more fruits and vegetables to their diets, or exercise more often. These healthy choices can help people control their weight safely."

While having friends who encourage healthy choices can be a positive influence that helps people make lifestyle changes for the better, it can be a recipe for disaster when people use their friends as a gage as to what is healthy and what is not. A study published in 2007 provides one example as to how:

"The study, conducted by Dr. Nicholas A. Christakis of Harvard Medical School and James H. Fowler of UC San Diego, is the first to document the spread of obesity through a social network -- a pattern of contagion most often associated with infectious diseases such as influenza and AIDS. Instead of transmitting germs or viruses, people infected each other with their perceptions of weight. For example, a man attending a Thanksgiving meal may notice his brother has gained weight and conclude that it's OK to be heavier, Christakis said. 'It's about the spread of norms from person to person,' said Christakis, a professor of medical sociology. The phenomenon worked in the other direction as well. People who become thinner, increase the chances that their friends and relatives will lose weight too, researchers said."

Once again, perception and reality can have a difficult time finding common ground when people look to those around them for what is considered "normal." While this can be problematic at any age, it can be especially difficult for tweens and teens.

"People have different body types, so there's no single number that's the right weight for everyone. Even among people who are the same height and age, some are more muscular or more developed than others. That's because not all teens have the same body type or develop at the same time. It is possible to find out if you are in a healthy weight range for your height, though -- it just takes a little effort. ... During puberty, the body begins making hormones that spark physical changes like faster muscle growth (particularly in guys) and spurts in height and weight gain in both guys and girls. ... All that new weight gain can be perfectly fine — as long as body fat, muscle, and bone are in the right proportion. Because some kids start developing as early as age 8 and some not until age 14 or so, it can be normal for two people who are the same height and age to have very different weights."

The media will continue to show its perception of what can be considered the "correct" weight. In contrast, with obesity on the rise, the general (public) perception of what is considered a "normal" weight will continue to change.

"Obesity continued to increase dramatically during the late 1990s for Americans of all ages according to the data collected and analyzed by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention (CDC). The percent of children and teens who are overweight also continues to increase. Among children and teens ages 6-19, 15 percent (almost 9 million) are overweight according to the 1999-2000 data, or triple what the proportion was in 1980. In addition, the data shows that another 15 percent of children and teens ages 6 to 19 are considered at risk of becoming overweight. Obesity can be defined as an excessive accumulation of body fat, which results in individuals being at least 20 percent heavier than their ideal body weight. 'Overweight' is defined as any weight in excess of the ideal range. Obesity is a common eating disorder associated with adolescence."

Unfortunately, the mental images that fill the minds and lives of most people come from the extremes. The images of people who are below what is considered healthy according to BMI calculations and people who are above what is considered a healthy BMI are everywhere. As the middle ground gets more difficult to find in everyday life, it is becoming more and more important for people of all ages to discuss with a medical professional what would be considered a healthy weight for them.

For more information about BMI, visit:

Questions of the Week:
What factors should you take into consideration when trying to determine what would be a healthy and appropriate weight for you? What factors should be considered before comparing your weight to that of others? How might the weight that is right for you vary from what would be considered healthy for your peers and/or family members? Where can you and your peers look for an objective perspective of what can be considered a healthy and appropriate weight? In what ways do you and your friends influence each others' perceptions about what is appropriate in the areas of weight and healthy lifestyle choices? What changes can you make in order to be a more positive influence on those around you?

Please email me with any ideas or suggestions.
Note: Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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