As we look forward into a new year, it is also worthwhile to cast a glance backwards in time to understand how perceptions and attitudes towards weight loss may be changing, in the face of a landscape where obesity is on the rise.

One of the most read 2017 studies in the Journal of the American Medical Association used the American National Health And Nutritional Examination Survey (NHANES) data to assess whether there has been any change in the percentage of people with overweight or obesity (defined as BMI of 25 or greater) trying to lose weight during the time frames of 1988-1994, 1999-2004, and 2009-2014.

Upon analysis of the data from 27,350 people aged 20-59, they found that the percentage of people with overweight or obesity increased over time, from 52.7% in 1988-1994, to 65.6% in 2009-2014.

The percentage of people trying to lose weight decreased during the same period, from 55.7% in 1988-1994, to 49.2% in 2009-2014.

So why would the proportion of people trying to lose weight be decreasing, while obesity is actually on the rise?

Well, we know that there has been a generational shift in perceptions of body weight norms – in other words, people with overweight are less likely to classify themselves as such as they did in years past, because overweight may be perceived more like the ‘new normal’.  So if people who carry excess weight perceive themselves to be of a healthy weight, they would be less inclined to try to lose weight.
The authors of this study suggest that the length of time that people struggle with obesity may be a factor – the longer people live with obesity, the more frustrated they may be come with unsuccessful weight loss attempts and thus less likely to try to manage their weight.
I think the issues go even deeper – and likely have much to do with barriers to effective obesity care that we know exist.  The ACTION study in USA highlighted some of these important barriers that needed to be addressed.  Data collection for the ACTION study in Canada (for which I am an author and member of the Steering Committee) is now complete; we are currently working hard to put together and publish our results, to better understand barriers that exist, and how we as a country can overcome these barriers to better help Canadians with weight management.
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