Identifying oneself as being overweight may be associated with adverse health outcomes, yet prospective tests of this possibility are lacking. Over 7 years, we examined associations between perceptions of being overweight and subsequent health in a sample of 3,582 U.S. adults. Perceiving oneself as being overweight predicted longitudinal declines in subjective health (d = −0.22, p < .001), increases in depressive symptoms (d = 0.09, p < .05), and raised levels of physiological dysregulation (d = 0.24, p < .001), as gauged by clinical indicators of cardiovascular, inflammatory, and metabolic functioning. These associations remained after controlling for a range of potential confounders and were observed irrespective of whether perceptions of being overweight were accurate or inaccurate. This research highlights the possibility that identifying oneself as overweight may act independently of body mass index to contribute to unhealthy profiles of physiological functioning and impaired health over time. These findings underscore the importance of evaluating whether weight-feedback interventions may have unforeseen adverse consequences.
AlmondD.LeeA.SchwartzA. E. (2016). Impacts of classifying New York City students as overweight. Proceedings of the National Academy of Sciences, USA, 113, 3488–3491.
2.
AtlantisE.BakerM. (2008). Obesity effects on depression: Systematic review of epidemiological studies. International Journal of Obesity, 32, 881–891.
3.
BlodornA.MajorB.HungerJ. M.MillerC. (2016). Unpacking the psychological weight of weight stigma: A rejection-expectation pathway. Journal of Experimental Social Psychology, 63, 69–76.
4.
BrewisA. A. (2014). Stigma and the perpetuation of obesity. Social Science & Medicine, 118, 152–158.
5.
CuypersK.KvaløyK.BratbergG.MidthjellK.HolmenJ.HolmenT. L. (2012). Being normal weight but feeling overweight in adolescence may affect weight development into young adulthood—an 11-year followup: The HUNT study, Norway. Journal of Obesity, 2012, Article 601872. doi:10.1155/2012/601872
6.
DalyM.BoyceC. J.WoodA. M. (2015). A social rank explanation of how money influences health. Health Psy-chology, 34, 222–230.
7.
DattiloA. M.Kris-EthertonP. M. (1992). Effects of weight reduction on blood lipids and lipoproteins: A meta-analysis. The American Journal of Clinical Nutrition, 56, 320–328.
8.
DeSalvoK. B.FanV. S.McDonellM. B.FihnS. D. (2005). Predicting mortality and healthcare utilization with a single question. Health Services Research, 40, 1234–1246.
9.
DuncanD. T.WolinK. Y.Scharoun-LeeM.DingE. L.WarnerE. T.BennettG. G. (2011). Does perception equal reality? Weight misperception in relation to weight-related attitudes and behaviors among overweight and obese US adults. International Journal of Behavioral Nutrition and Physical Activity, 8, 20. doi:10.1186/1479-5868-8-20
EpelE. S.LapidusR.McEwenB.BrownellK. (2001). Stress may add bite to appetite in women: A laboratory study of stress-induced cortisol and eating behavior. Psycho-neuroendocrinology, 26, 37–49.
12.
FaithM. S.ButrynM.WaddenT. A.FabricatoreA.NguyenA. M.HeymsfieldS. B. (2011). Evidence for prospective associations among depression and obesity in population-based studies. Obesity Reviews, 12, e438–e453. doi:10.1111/j.1467-789X.2010.00843.x
13.
GannaA.IngelssonE. (2015). 5 year mortality predictors in 498 103 UK Biobank participants: A prospective population-based study. The Lancet, 386, 533–540.
14.
HampsonS. E.EdmondsG. W.GoldbergL. R.DubanoskiJ. P.HillierT. A. (2013). Childhood conscientiousness relates to objectively measured adult physical health four decades later. Health Psychology, 32, 925–928.
15.
HarrisK. M.HalpernC. T.WhitselE.HusseyJ.TaborJ.EntzelP.UdryJ. R. (2009). The National Longitudinal Study of Adolescent to Adult Health: Research design.Retrieved from http://www.cpc.unc.edu/projects/addhealth/design
16.
HayesA. F. (2013). An introduction to mediation, moderation, and conditional process modeling: A regression-based approach. New York, NY: Guilford Press.
17.
HaywardJ.MillarL.PetersenS.SwinburnB.LewisA. J. (2014). When ignorance is bliss: Weight perception, body mass index and quality of life in adolescents. International Journal of Obesity, 38, 1328–1334.
18.
HeuerC. A.McClureK. J.PuhlR. M. (2011). Obesity stigma in online news: A visual content analysis. Journal of Health Communication, 16, 976–987.
19.
HimmelsteinM. S.Incollingo BelskyA. C.TomiyamaA. J. (2015). The weight of stigma: Cortisol reactivity to manipulated weight stigma. Obesity, 23, 368–374.
20.
HungerJ. M.MajorB.BlodornA.MillerC. (2015). Weighed down by stigma: How weight-based social identity threat influences weight gain and health. Social and Personality Psychology Compass, 9, 255–268.
21.
HusseyJ. M.NguyenQ. C.WhitselE. A.RichardsonL. J.HalpernC. T.Gordon-LarsenP.HarrisK. M. (2015). The reliability of in-home measures of height and weight in large cohort studies: Evidence from add health. Demographic Research, 32, 1081–1100.
22.
IkedaJ. P.CrawfordP. B.Woodward-LopezG. (2006). BMI screening in schools: Helpful or harmful. Health Education Research, 21, 761–769.
23.
Incollingo RodriguezA. C.HeldrethC. M.TomiyamaA. J. (2016). Putting on weight stigma: A randomized study of the effects of wearing a fat suit on eating, well-being, and cortisol. Obesity, 24, 1892–1898.
24.
JohnsonF.BeekenR. J.CrokerH.WardleJ. (2014). Do weight perceptions among obese adults in Great Britain match clinical definitions? Analysis of cross-sectional surveys from 2007 and 2012. BMJ Open, 4, Article e005561. doi:10.1136/bmjopen-2014-005561
25.
KunstA. E.BosV.LahelmaE.BartleyM.LissauI.RegidorE.HelmertU. (2005). Trends in socioeconomic inequalities in self-assessed health in 10 European countries. International Journal of Epidemiology, 34, 295–305.
26.
LinnR. L.SlindeJ. A. (1977). The determination of the significance of change between pre- and posttesting periods. Review of Educational Research, 47, 121–150.
27.
MartinB. C.DaltonW. T.WilliamsS. L.SlawsonD. L.DunnM. S.Johns-WommackR. (2014). Weight status misperception as related to selected health risk behaviors among middle school students. Journal of School Health, 84, 116–123.
28.
NeterJ. E.StamB. E.KokF. J.GrobbeeD. E.GeleijnseJ. M. (2003). Influence of weight reduction on blood pressure: A meta-analysis of randomized controlled trials. Hypertension, 42, 878–884.
29.
RadloffL. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
30.
RobinsonE.HungerJ. M.DalyM. (2015). Perceived weight status and risk of weight gain across life in US and UK adults. International Journal of Obesity, 12, 1721–1726.
31.
RobinsonE.OldhamM. (2016). Weight status misperceptions among UK adults: The use of self-reported vs. measured BMI. BMC Obesity, 3, Article 21. doi:10.1186/s40608-016-0102-8
32.
RobinsonE.SutinA. (2016). Parental perception of weight status and weight gain across childhood. Pediatrics, 137(5), Article e20153957. doi:10.1542/peds.2015-3957
33.
RobinsonE.SutinA. R.DalyM. (2017). Perceived weight discrimination mediates the longitudinal relation between obesity and depressive symptoms in US and UK adults. Health Psychology, 36, 112–121. doi:10.1037/hea0000426
34.
SeemanT. E.McEwenB. S.RoweJ. W.SingerB. H. (2001). Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. Proceedings of the National Academy of Sciences, USA, 98, 4770–4775.
35.
SikorskiC.LuppaM.LuckT.Riedel-HellerS. G. (2015). Weight stigma “gets under the skin”—evidence for an adapted psychological mediation framework—a systematic review. Obesity, 23, 266–276.
SutinA. R.StephanY.CarrettaH.TerraccianoA. (2015). Perceived discrimination and physical, cognitive, and emotional health in older adulthood. The American Journal of Geriatric Psychiatry, 23, 171–179.
38.
SutinA. R.StephanY.GrzywaczJ. G.RobinsonE.DalyM.TerraccianoA. (2016). Perceived weight discrimination, changes in health, and daily stressors. Obesity, 24, 2202–2209.
SutinA. R.TerraccianoA. (2015). Body weight misperception in adolescence and incident obesity in young adulthood. Psychological Science, 26, 507–511.
41.
SwahnM. H.ReynoldsM. R.TiceM.Miranda-PierangeliM. C.JonesC. R.JonesI. R. (2009). Perceived overweight, BMI, and risk for suicide attempts: Findings from the 2007 Youth Risk Behavior Survey. Journal of Adolescent Health, 45, 292–295.
42.
TeachmanB. A.BrownellK. D. (2001). Implicit anti-fat bias among health professionals: Is anyone immune?International Journal of Obesity & Related Metabolic Disorders, 25, 1525–1531.
43.
TomiyamaA. J. (2014). Weight stigma is stressful: A review of evidence for the Cyclic Obesity/Weight-Based Stigma model. Appetite, 82, 8–15.
44.
WilliamsD. R.MohammedS. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20–47.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
