Nearly one obese person in 10 feels no need to lose weight or prevent further weight gain, researchers found.
Most obese people with these body size misperceptions thought their health was above average and their lifetime cardiovascular and diabetes risk low, said Dr. Tiffany Powell of the University of Texas Southwestern Medical Center in Dallas and colleagues.
Their analysis of the Dallas Heart Study, reported at the American Heart Association meeting last week, suggested that physicians have a role in correcting these impressions.
"We can't necessarily just say you have to be comfortable with who you are," Powell said. "We have to really emphasize the direct link between obesity, risk factors, and cardiovascular disease."
Obese individuals in the study who didn't think they needed to lose weight appeared not to be getting those messages.
They were much less likely than other obese individuals to have heard from any healthcare professional about diet (38 percent versus 64 percent), exercise (45 percent versus 66 percent), or losing weight (38 percent versus 68 percent).
Rather than trying to find and target patients with an unrealistic body image, physicians need to step up efforts to ensure that all patients understand their risk and what to do about it, she recommended.
Powell's group analyzed the Dallas Heart Study, a representative population-based study of 6,101 residents of Dallas County ages 18 to 65.
To measure body perception, the participants were asked to choose a silhouette on the gender-specific Stunkard figure-rating scale that they thought best represented how they looked, and also to select one that represented how they would ideally like to look.
Of the 2,056 individuals with a body mass index of 30 kg/m2 or greater, 266 -- or 8 percent -- reported an ideal body size that was greater than or equal to perceived body size.
Half of the individuals with these misperceptions thought they were in better health than most for their age, compared with 32 percent of those who knew they needed to lose weight.
They were also more likely than other obese people to think of themselves as low risk for heart attacks, diabetes, hypertension, and even obesity -- despite the fact that they already fell in that category.
"We have to help people understand that despite loving what you look like, if you are obese you are at risk," Powell said. "We walk a fine line in helping people understand the impact of obesity without making them feel bad about themselves."