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Body Weight and Body Image

Marion P. Olmsted, PhD and Traci McFarlane, PhD (Toronto General Hospital)

Health Issue

Body weight is of both physical and psychological importance to Canadian women. It is associated with health status, physical activity, body image, and self-evaluation. Although the problems associated with overweight and obesity are indeed serious, being underweight also carries its own risks . The relationship between body mass index (BMI) and risk of death has been characterized graphically as a U-shaped function for both men and women, with increased risk of death when BMI is less than 23 or greater than 28. Weight prejudice, the dieting industry, and the pressure to have an acceptable body weight intensify body-image concerns for Canadian women and have a significantly negative impact on their self-esteem.

Key Findings

Analysis of National Population Health Survey (NPHS) data shows that, on average, women have lower BMIs than men, a lower incidence of overweight, and a higher incidence of underweight. However, women are more dissatisfied than men with their bodies, and this dissatisfaction occurs across all weight categories. For instance, women with BMIs between 20 and 22 (below average but "acceptable") reported their ideal weight to be, on average, 3 kg less than their actual weight, whereas men in the same BMI range believed that their ideal weight was almost 7 kg more than their actual weight. According to the Physical Activity Index of the NPHS, 59.5% of women are inactive, as compared with 57.6% of men; 17.0% of women and 20.0% of men are classified as active. Women with a BMI of 27 or greater are more likely to be inactive than women with lower BMIs. The data show that women do seem to be aware of the health benefits of exercise, in that they endorsed increased exercise as the top priority for health improvement in all BMI categories. There is a gap, however, between knowledge and practice. When asked about barriers to health improvement, 39.7% of women cited lack of time and 39.2% lack of willpower. Nominating lack of willpower as the main problem is self-blaming and self-defeating, as there is no clear way to change the situation. Being overweight, and having child - and homecare responsibilities have been suggested as barriers to fitness for women.

Data Gaps and Recommendations

The authors identified the following data gaps and made the following recommendations:

• Weight prejudice must be made unacceptable.
• Positive body image should be encouraged and diversity valued, as in the approach taken to promote multiculturalism.
• Body image disparagement, chronic dieting, and exercise to improve appearance need to be acknowledged as vehicles of oppression for women. Policies should encourage all Canadians to take pride in developing a healthy lifestyle with a focus on healthy eating and healthy activity every day.
• Physical activities that mothers can participate in with their families should be encouraged as one method of addressing competing demands and limited time.
• Research should be funded to elucidate the most effective methods of getting women to become and remain physically active without focusing on weight control or appearance.

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