Could Normalization of ‘Plus-size’ Body Shapes Overshadow Health Risks Related to Obesity?

 In Naturopathic News

Node Smith, ND

A new research study shows that the normalization of larger body shapes may actually be causing a growing number of people underestimating their weight, and in effect underestimating the risk associated with obesity.1

Drive to remove cultural stigmas fuels obesity normalization, but could body-positive be a health-negative?

As obesity becomes more and more common there is a drive to remove cultural stigmas, which have been placed on larger individuals, leading to judgement and ridicule. This is a very positive cultural progression, that has intentions of supporting self-esteem, removing obstacles for “plus-size’ individuals, and being more inclusive. There is however, the potential of allowing this “normalization” to overshadow the very real health risks that accompany increases in body fat.

The study was conducted in Austria and looked at the demographic and socioeconomic trends associated with an underestimation of weight. The study intended to draw attention to potential social inequalities in patterns of weight misperception.

23,000 overweight or obese people included in the study

Roughly 23,000 overweight or obese people were included in the study. An overall increase in misperception of weight was seen. Men and people with lower income and levels of education were more likely to underestimate weight status, and also less likely to attempt to lose weight. Minority groups also were seen to have a greater chance at underestimating their weight – however, were more likely to attempt to lose weight.

Why this misperception is important

The reason why this misperception is important is that perceiving weight accurately increases the likelihood that someone will take action to lose weight when/if necessary. The study found that those misperceiving their weight were 85 percent less likely to lose weight compared with individuals who accurately considered their weight.

The number of individuals who are misperceiving their weight has increased over the past 2 decades. Almost 60 percent of obese men misperceived their weight in 2015, compared to 48 percent in 1997. Less of an increase in women, from 24 percent to 30 percent.

Global obesity epidemic

This study occurs within a context of a global obesity epidemic. Estimates show that roughly two-thirds of the adult population in developed countries are overweight or obese. Metabolic conditions, likewise, are at epidemic proportions, and are considered to be intimately related.

The author of the paper, Dr. Raya Muttarak, says this of the trend to normalize ‘plus-size’ individuals:

“While this type of body positive movement helps reduce stigmatization of larger-sized bodies, it can potentially undermine the recognition of being overweight and its health consequences. The increase in weight misperception in England is alarming and possibly a result of this normalization.”


  1. Muttarak R. Normalization of Plus Size and the Danger of Unseen Overweight and Obesity in England. Obesity, volume 26, number 7, July 2018.
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Node Smith, ND, is a naturopathic physician in Portland, OR and associate editor for NDNR. He has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp-out where naturopathic medicine and medical philosophy are experienced in nature. Four years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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