A Comparison of Body Size Evaluations of Obesity Surgery Patients and General Population Adults

RAND, COLLEEN S. W., JAQUELYN LISS RESNIK, AND ALEX M. C. MACGREGOR. A comparison of body size evaluations of obesity surgery patients and general population adults. Obes Res. Objective: To compare post-operative obesity surgery patients and general population adults in their assessments of a wide range of body sizes. Research Methods and Procedures: Obesity surgery patients (n = 274) and general population adults (n = 326) rated ideal and socially acceptable body sizes in separate arrays of babies, children, young adults, and middle-aged and older adults. Nine line figure drawings ranging from very thin to very obese were rated for each array. Results: Both groups selected the same ideal body size for all arrays except for babies. Both groups rejected obese and very thin body sizes as socially acceptable. However, the obesity surgery patients were more restrictive than general population adults in their ratings of socially acceptable body sizes. Current obesity status did not impact ratings for the patient or general population subjects. In the patient sample, time since surgery did not influence body size evaluations. Discussion: The study of body size ratings limited only to the “ideal” size may be misleading because it may mask subtle but meaningful differences between groups. The consistent difference in more restrictive ratings of obesity surgery patients compared to general population adults may be due to patients' greater psychological investment in endorsing the societal ideal body size. It may also be due to patients' status as peripheral group members of the normal weight community. The inability of some patients to maintain their post-operative weight loss may be particularly problematic for those who have defined “socially acceptable” body size most narrowly.     

Weight loss expectations and goals in a population sample of overweight and obese US adults

The purpose of this study was to investigate weight loss expectations and goals in a population sample of US adults who planned to make a weight loss attempt, and to examine predictors of those expectations and goals. Participants were 658 overweight and obese adults (55% women, mean age = 47.9 years, BMI = 31.8 kg/m(2)) who responded to a telephone survey about weight loss. Respondents reported weight loss expectations (i.e., reductions they realistically expected) and goals (i.e., reductions they ideally desired) for an upcoming "serious and deliberate" weight loss attempt. They also reported the expectations they had, and the reductions they actually achieved, in a previous attempt. Respondents' weight loss expectations for their upcoming attempt (8.0% reduction in initial weight) were significantly more modest than their goals for that attempt (16.8%), and smaller than the losses that they expected (12.0%), and achieved (8.9%) in their most recent past attempt (Ps 相似文献   

Body mass indices in patients with disabling hip osteoarthritis

Hip osteoarthritis (OA) is a degenerative joint disease that results in substantial morbidity. The disease may be preventable in some instances by reducing risk factors associated with the disease. We undertook a study to determine whether being overweight or obese, a health risk that applies to younger and older age groups, is commonly associated with hip joint OA. The body mass indices (BMIs) of 1021 males and females ranging in age from 23 to 94 years and requiring surgery for end-stage hip joint OA were analyzed to find the prevalence of high body weights at the time of surgery. Being overweight was defined as having a BMI of 25-29.9 kg/m2 and being obese as having a BMI >30 kg/m2. BMIs indicative of overweight were recorded for 68% of the patients surveyed. Of 35 patients aged 30-39 years, 53.3% had BMIs >25, with a mean of 28.8, which nearly reaches the lower limit defined for obesity. On average, patients who had had previous surgery and complications warranting reimplantation of new surgical devices had BMIs in the obese range. Our findings suggest that a high percentage of patients with end-stage hip OA are overweight, including younger adults and those with symptoms of 3-6 months' duration. Moreover, patients whose BMIs are in the obese range may be at increased risk for removal and reimplantation of their prosthesis.     

Assessment of Socially Acceptable Body Sizes by University Students

RAND, COLLEEN SW, JAQUELYN L RESNICK, ROBERTA S SELDMAN. Assessment of socially acceptable body sizes by university students. The objective of this study was to determine if more than one body size (the ideal) is considered socially acceptable. Two hundred undergraduates rated ideal male and female sizes, all socially acceptable male and female sizes, and their own current and desired sizes. Stimuli were arrays of nine outline drawings illustrating extremely thin to very fat male and female sizes. Most students considered three of nine sizes socially acceptable. There was high consensus on the sizes considered ideal. Although nearly three-quarters of women and half of men desired to be a different size, most considered their current size socially acceptable for other people. The results clearly demonstrate the existence of a range of socially acceptable male and female body sizes. The current size of most students was within this range. Exclusive focus on ideal body size distorts understanding of both other-size and own-size evaluations.     

Body mass indices in patients with disabling hip osteoarthritis

Hip osteoarthritis (OA) is a degenerative joint disease that results in substantial morbidity. The disease may be preventable in some instances by reducing risk factors associated with the disease. We undertook a study to determine whether being overweight or obese, a health risk that applies to younger and older age groups, is commonly associated with hip joint OA. The body mass indices (BMIs) of 1021 males and females ranging in age from 23 to 94 years and requiring surgery for end-stage hip joint OA were analyzed to find the prevalence of high body weights at the time of surgery. Being overweight was defined as having a BMI of 25–29.9 kg/m² and being obese as having a BMI >30 kg/m². BMIs indicative of overweight were recorded for 68% of the patients surveyed. Of 35 patients aged 30–39 years, 53.3% had BMIs >25, with a mean of 28.8, which nearly reaches the lower limit defined for obesity. On average, patients who had had previous surgery and complications warranting reimplantation of new surgical devices had BMIs in the obese range. Our findings suggest that a high percentage of patients with end-stage hip OA are overweight, including younger adults and those with symptoms of 3–6 months' duration. Moreover, patients whose BMIs are in the obese range may be at increased risk for removal and reimplantation of their prosthesis.     

Walking attenuates the relationships of high-meat, low-fruit dietary intake to total and regional adiposity in men and women

Vigorous physical activity (running) has been shown to attenuate the association between diet and body weight. Walking is the most popular physical activity, but is a moderate-intensity physical activity because it requires less than sixfold the energy expenditure of sitting at rest. We therefore examined whether reported distance walked per week affected the relationship of diet to BMI and circumferences of the waist, hip, and chest in 30,014 female and 7,133 male participants of the National Walkers' Health Study. Reported meat and fruit intakes served as indicators of high-risk diets for weight gain. The analyses showed that higher meat and lower fruit intake were significantly and consistently associated with greater BMI and waist circumference at all activity levels. Longer usual walking distance significantly attenuated the concordant relationships of diet with women's BMIs (P < 10(-8)), men's BMIs (P = 0.04), and women's waist (P < 10(-6)), hip (P = 0.0001), and chest circumferences (P < 10(-5)). Compared to walkers who averaged <1.5 km/day, the association of diet with adiposity in subjects who walked ≥1.5 km/day was reduced 21% in women and 31% in men for BMI; 20% in women and 27% in men for waist circumference; 19% for women's hip circumference; and 26% for women's chest circumference. Thus we conclude that diets characterized by high-meat/low-fruit intake were significantly associated with greater BMI, and this association was attenuated by moderate physical activity. The weaker results in men than women probably related to the smaller sample size, and reduced statistical power of the men.     

Does Ethnicity Influence Body-Size Preference? A Comparison of Body Image and Body Size

Objective: Obesity is most common in the United States among women of ethnic minority groups (black and Hispanic). Researchers have hypothesized that these subcultures are more accepting of overweight figures. The purpose of this study was to examine body image and body size assessments in a large community sample of men and women. Research Methods and Procedures: Participants were 801 women and 428 men: 23% Asian, 45% Hispanic, 17% black, and 15% white. The figure rating scale was used to rate: body dissatisfaction, attractive male and female shapes, acceptable female size, and perceptions of underweight to obese female figures. Results: Controlling for age, education, and body weight, no ethnic differences were found for men. Asian women reported less body dissatisfaction than the other groups. Women were more dissatisfied with their size than men and chose thinner female figures as attractive and acceptable. Discussion: Ethnicity, independent of age, education, and body weight, does not influence preference for female and male shapes or tolerance for obesity.     

Realistic Weight Perception and Body Size Assessment in a Racially Diverse Community Sample of Dieters

Recently, a shift in obesity treatment away from emphasizing ideal weight loss goals to establishing realistic weight loss goals has been proposed; yet, what constitutes “realistic” weight loss for different populations is not clear. This study examined notions of realistic shape and weight as well as body size assessment in a large community-based sample of African-American, Asian, Hispanic, and white men and women. Participants were 1893 survey respondents who were all dieters and primarily overweight. Groups were compared on various variables of body image assessment using silhouette ratings. No significant race differences were found in silhouette ratings, nor in perceptions of realistic shape or reasonable weight loss. Realistic shape and weight ratings by both women and men were smaller than current shape and weight but larger than ideal shape and weight ratings. Compared with male dieters, female dieters considered greater weight loss to be realistic. Implications of the findings for the treatment of obesity are discussed.     

Ethnic and gender consensus for the effect of waist-to-hip ratio on judgment of women’s attractiveness

The western consensus is that obese women are considered attractive by Afro-Americans and by many societies from nonwestern developing countries. This belief rests mainly on results of nonstandardized surveys dealing only with body weight and size, ignoring body fat distribution. The anatomical distribution of female body fat as measured by the ratio of waist to hip circumference (WHR) is related to reproductive age, fertility, and risk for various major diseases and thus might play a role in judgment of attractiveness. Previous research (Singh 1993a, 1993b) has shown that in the United States Caucasian men and women judge female figures with feminine WHRs as attractive and healthy. To investigate whether young Indonesian and Afro-American men and women rate such figures similarly, female figures representing three body sizes (underweight, normal weight, and overweight) and four WHRs (two feminine and two masculine) were used. Results show that neither Indonesian nor Afro-American subjects judge overweight figures as attractive and healthy regardless of the size of WHR. They judged normal weight figures with feminine WHRs as most attractive, healthy, and youthful. The consensus on women’s attractiveness among Indonesian, Afro-American, and U.S. Caucasian male and female subjects suggests that various cultural groups have similar criteria for judging the ideal woman’s shape.     

Female waist-to-hip ratio,body mass index and sexual attractiveness in China

Men and women at Northwest University (n=751), Xi'an, China were asked to judge the attractiveness of photographs of female patients who had undergone micrograft surgery to reduce their waist-to-hip ratios (WHR). Micrograft surgery involves harvesting adipose tissue from the waist and reshaping the buttocks to produce a low WHR and an 'hourglass' female figure. This gynoid distribution of female body fat has been shown to correlate with measures of fertility and health. Significantly larger numbers of subjects, of both sexes, chose post-operative photographs, with lower WHRs, as more attractive than pre-operative photographs of the same women. Some patients had gained, and some had lost weight, post-operatively, with resultant changes in body mass index (BMI). However, these changes in BMI were not related to judgments of attractiveness. These results show that the hourglass female figure is rated as attractive in China, and that WHR, rather than BMI, plays a crucial role in such attractiveness judgments.     

Male preferences for female waist‐to‐hip ratio and body mass index in the highlands of Papua New Guinea

One hundred men, living in three villages in a remote region of the Eastern Highlands of Papua New Guinea were asked to judge the attractiveness of photographs of women who had undergone micrograft surgery to reduce their waist‐to‐hip ratios (WHRs). Micrograft surgery involves harvesting adipose tissue from the waist and reshaping the buttocks to produce a low WHR and an “hourglass” female figure. Men consistently chose postoperative photographs as being more attractive than preoperative photographs of the same women. Some women gained, and some lost weight, postoperatively, with resultant changes in body mass index (BMI). However, changes in BMI were not related to men's judgments of attractiveness. These results show that the hourglass female figure is rated as attractive by men living in a remote, indigenous community, and that when controlling for BMI, WHR plays a crucial role in their attractiveness judgments. Am J Phys Anthropol, 2010. © 2009 Wiley‐Liss, Inc.     

Assessing Impact of Weight on Quality of Life

This paper is a preliminary report on the development of a new instrument, the Impact of Weight on Quality of Life (IWQOL) questionnaire, that assesses the effects of weight on various areas of life. We conducted two studies utilizing subjects in treatment for obesity at Duke University Diet and Fitness Center. The first study describes item development, assesses reliability, and compares pre- and post-treatment scores on the IWQOL. In the second study we examined the effects of body mass index (BMI), gender, and age on subjects' perceptions of impact of weight on quality of life. Results indicate adequate psychometric properties with test-retest reliabilities averaging .75 for single items, and .89 for scales. Scale internal consistency averaged .87. Post-treatment scores differed significantly from pre-treatment scores on all scales, indicating that treatment produced positive changes in impact of weight on quality of life. The results of the second study indicate that the impact of weight generally worsened as the patients' size increased. However for women there was no association between BMI and impact of weight on Self-Esteem and Sexual Life. Even at the lowest BMI tertile studied, women reported that weight had a substantial impact in these areas. There were also significant gender differences, with women showing greater impact of weight on Self-Esteem and Sexual Life compared with men. The impact of age was a bit surprising, with some areas showing positive changes and others showing no change.     

Nutritional status of Ribeirinhos in Brazil and the nutrition transition

Anthropometric and household data (size, composition, economic activity) were collected from a population of Ribeirinhos living in a rural setting in the eastern Amazon. Data are compared to international reference standards and to other Amazonian populations with the goals of increasing our understanding of the Amazon's largest ethnic group and identifying the relationship between changes in subsistence strategies and nutritional status. Data on height, weight, skinfolds, and circumferences were collected from 471 adults and subadults. The population showed a high degree of stunting with an average HAZ below -2.0 for all age groups over 3 years, and 60% of adult men and 70% of adult women were stunted. Wasting was rare. Average skinfold thicknesses and upper-arm muscle area were near or below average but within the normal range compared to the reference standard, indicating adequate energy and protein stores. Thirty-one percent of males and 29% of females were overweight/obese, and the highest average BMIs were found among men and women in their 40s. Adult males who participated in wage labor had higher weights, BMIs, and UMA values, and were more likely to be overweight and obese compared with those who did not work in wage-labor jobs. Children of fathers who worked in wage labor had higher BMI and UMA values, but there was no significant effect on the nutritional status of other adults in these same households. Signs of the nutrition transition were most noticeable among adult males involved in wage labor because of changes in their diet and activity patterns.     

Are BMI and other anthropometric measures appropriate as indices for obesity? A study in an Asian population

We have examined the relationships between percentage of body fat (PBF) and risk factors for cardiovascular disease and insulin resistance and how good body mass index (BMI) and other anthropometric measures are as indices of obesity. High PBF levels were associated with increased risk of cardiovascular disease and insulin resistance. The World Health Organization BMI of 30 kg/m(2) for obesity has low sensitivity, 6.7% and 13.4% for men and women, respectively. For every obese man and woman identified, 6.7 and 1.76 times nonobese men and women, respectively, will be misclassified as obese. With the locally established BMI cutoff point for obesity of 27 kg/m(2) for men and 25 kg/m(2) for women, the sensitivity was improved to 46.7% and 60.8%, respectively. For every obese man and woman identified, 3.76 and 1.64 times nonobese men and women, respectively, will be misclassified as obese. None of the other anthropometric indices was better than the locally established BMIs. We showed that the BMIs for obesity for our local men and women are different. These BMIs were most precise among all indices studied. However, they still lead to high false-positive rates. For more effective management of the problem of obesity, we need to develop more precise, simple, and cost-effective methods for the measurement of PBF.     

Black and White Females' Perceptions of Ideal Body Size and Social Norms

Different cultural norms and standards for appropriate female body size might contribute to the disparity in obesity rates between black and white adult females (46.0% and 24.6% respectively). The purpose of this study was to measure adolescents' perceptions of ideal size and social norms regarding female body size as well as adolescents' perceptions of significant others' evaluation and expectations of the adolescents' body size. Subjects included 437 adolescent girls (247 white and 190 black) aged 13 to 19 (x=44.9, SD=.979) from six randomly selected public schools. The subjects, heights and weights were measured. Responses to a body image questionnaire and a series of nine female body drawings (arranged ordinally, 1 to 9, from thinnest to heaviest) were analyzed using the General Linear Model and Logistic Regression. The female body size considered ideal by black females was significantly larger than the size selected as ideal by white females (x= 3.47 and x= 3.13 respectively, p< 0.001). Black females were two times more likely than white females to describe themselves as thinner than other girls their age (O.R. = 2.01, 95% C.I.1.34, 3.01) and seven times as likely to say that they were not overweight (O.R. = 7.08, 95% C.I. 3.72, 13.45). White females wanted to be a smaller size than they currently were and felt encouraged by significant others to lose weight or reduce their size. Black females did not indicate as great a desire as whites to be smaller and they tended to feel that their size was considered satisfactory by significant others. Only subjects from the low SES group perceived that significant others wanted them to gain weight. The differences between black and white subjects' beliefs and perceptions about body size norms may explain, in part, why heavier body weights persist in some cultural groups.     

The Eating Inventory and Body Adiposity from Leanness to Massive Obesity: a Study of 2509 Adults

Objective: To examine how chronic dietary restraint, disinhibition, and hunger, as assessed by the Eating Inventory, vary over a broad range of BMI values from leanness to massive obesity, in subjects with family obesity. Eating Inventory factors were also studied as a function of personal weight history. Research Methods and Procedures: Subjects were 2509 participants in a genetic study of obesity. BMIs ranged from 15 to 87 kg/m². Six BMI groups were formed (<27, 27 to 30, 30 to 35, 35 to 40, 40 to 45, and >45). Results: Multivariate analyses showed that restraint and disinhibition were significantly associated with BMI in men, whereas only disinhibition was in women. Disinhibition scores correlated strongly with hunger scores in both genders in all BMI categories; dietary restraint tended to correlate with the other two factors positively in leaner subjects and negatively in the highest BMI categories. Highly restrained normal‐weight subjects were likely to exhibit disinhibition and hunger, whereas massively obese persons with very high disinhibition scores showed high hunger but little restraint. The highest restraint scores were observed in nonobese adult women with previous obesity in childhood and/or adolescence. Discussion: The factor most strongly associated with BMI in this large population was disinhibition, suggesting that obesity treatment should target behaviors associated with disinhibition, especially in individuals showing a low level of dietary restraint. High restraint scores in formerly obese normal‐weight women suggest that dietary restraint may exert a beneficial influence on body weight control under conditions that deserve further investigation.     

The effect of high birth weight (400 g or more) on the weight and height of adult men and women

Three hundred and twenty eight examined adult men and 346 examined adult women were macrosomic at birth (4000 g or over). The control group consisted of 564 adult men and 749 adult women with birth weights of 2500 to 3999 g. Both male and female macrosomic babies achieve greater weights and heights in adulthood than those in the control group. There are more overweight and obese men in the macrosomic group than in the control group and the same is true of the women (p < 0.001). The mean values of the BMI (body mass index) for the macrosomic adults are greater than those for the control group (p < 0.001). Fetal macrosomia is a good predictor of the weight and height of adult men and women.     

The Impact of Psychological Stress on Men's Judgements of Female Body Size

Background

Previous work has suggested that the experience of psychological stress may influence physical attractiveness ideals, but most evidence in favour of this hypothesis remains archival. The objective of this study was to experimentally investigate the impact of stress on men''s judgements of female body size.

Methods

Men were randomly assigned to either an experimental group, in which they took part in a task that heightened stress (experimental group, n = 41) or in which they did not take part in such a task (control group, n = 40). Both groups rated the attractiveness of female bodies varying in size from emaciated to obese, completed a measure of appetite sensation, and had their body mass indices (BMIs) measured.

Results

Between-groups analyses showed that the experimental group was matched with the control group in terms of mean age, BMI, and appetite sensation. Further analyses showed that men in the experimental group rated a significantly heavier female body size as maximally attractive than the control group. Men in the experimental group also rated heavier female bodies as more attractive and idealised a wider range of female figures than did the control group.

Conclusion

This study found that the experience of stress was associated with a preference among men for heavier female body sizes. These results indicate that human attractiveness judgements are sensitive to variations in local ecologies and reflect adaptive strategies for dealing with changing environmental conditions.     

The effects of gender and obesity on myocardial tolerance to ischemia

Obesity is increasing at an alarming rate globally. Several studies have shown that premenopausal women have a reduced risk of CV disease and a reduced myocardial susceptibility to ischemia/reperfusion injury. The effect of obesity on myocardial tolerance to ischemia in women has not been established. To determine how obesity affects myocardial susceptibility to ischemia/reperfusion injury in both males and females, we fed male and female Wistar rats a high caloric diet (HCD) or a control rat chow diet (CD) for 18 weeks. Rats were subsequently fasted overnight, anesthetized and blood was collected. In separate experiments, 18-week-fed (HCD and CD) rats underwent 45 min in vivo coronary artery ligation (CAL) followed by 2 hours reperfusion. Hearts were stained with TTC and infarct size determined. Both male and female HCD fed rats had increased body and visceral fat weights. Homeostasis model assessment (HOMA) index values were 13.95+/-3.04 for CD and 33.58+/-9.39 for HCD male rats (p<0.01) and 2.98+/-0.64 for CD and 2.99+/-0.72 for HCD fed female rats. Male HCD fed rats had larger infarct sizes than CD fed littermates (43.2+/-9.3 % vs. 24.4+/-7.6 %, p<0.05). Female HCD and CD diet fed rats had comparable infarct sizes (31.8+/-4.3 % vs. 23.9+/-3.3 %). We conclude that male rats on the HCD became viscerally obese, dyslipidemic and insulin-resistant, while female HCD fed rats became viscerally obese without developing dyslipidemia or insulin resistance. Obesity increased myocardial infarct size in males but not the females.     

Waist Circumference is an Independent Correlate of Errors in Self‐Reported BMI

Although there are issues of reporting bias surrounding the use of self‐reported BMI, it is frequently the method employed to establish the prevalence of obesity. The goal of this study was to assess whether, independently of measured BMI, waist circumference (WC) was associated with the magnitude of the difference between self‐reported and measured BMI within a large sample of European‐American (EA) and African‐American (AA) adults. Self‐reported height and weight, and measured height, weight, and WC were collected on 12,809 adults (61% women, 66% EA) aged 18–65 years. Mean negative BMI differences (self‐reported minus measured BMI) were identified in all race‐by‐sex groups (AA men: ?0.55; EA men: ?0.63; AA women: ?0.91; EA women: ?0.67). WC was negatively associated with the BMI difference such that a higher WC was associated with greater under‐reporting of BMI. However, after adjusting for age and measured BMI, WC was positively associated with the BMI difference in all race‐by‐sex groups. These results suggest that WC could be useful in gaining an insight into people's awareness of their own body size and fatness.