Objectives. The objectives of the study were to measure actual BMI in patients attending chronic disease clinics in health centres and to relate this to the patients’ own perceptions of their body image and the need to lose weight. Study Design. A cross sectional study. Methods. The actual BMIs in patients who attended chronic disease clinics in 14 health centres were measured. All participants were asked to state where they thought they were on a visual body image scale and were also asked if they thought they needed to lose weight. Results. All participants approached agreed to participate (RR 100%). 70% of patients were found to have a raised BMI. Approximately 73% of patients using the visual scale indicated that an overweight or obese BMI was ideal for them. Conclusions. Patients think they are thinner than they actually are, with obvious implications for health and health seeking behaviour. A whole of society approach is needed to change weight status perceptions and improve exercise and dietary behaviour. 1. Introduction According to the World Health Organization, obesity has reached epidemic proportions globally, with more than 1 billion adults overweight and at least 300 million classified as clinically obese [1]. Obesity has been identified as the main contributor to the major causes of death [2, 3] and therefore presents an important global public health problem. Haslam and James in 2005 [4] reported that excess bodyweight is the sixth most important risk factor contributing to the overall burden of disease worldwide and that 1.1 billion adults and 10% of children were classified as overweight or obese. In 2010, overweight and obesity accounted for 3.4 million deaths, 3.9% of years of life lost, and 3.8% of disability-adjusted life-years (DALYs) worldwide [5]. Obesity is associated with medical conditions such as diabetes, cardiovascular disease, pulmonary disease, metabolic syndrome, and obstructive sleep apnea. Obesity is being observed more frequently in orthopaedic patients. Orthopaedic patients with obesity-related comorbidities require specific preoperative and postoperative measures to improve their surgical outcomes. Furthermore, patients who are obese are at risk for increased perioperative complications [6]. Obesity impacts not only on the sufferers in terms of associated health effects but also on their families and society as a whole. The health effects associated with obesity result in healthcare costs to the state and costs in terms of the drop in productivity both at school and at work [7]. In two decades there has been a 400%
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