About 75% of U.S. adults realize that being overweight or obese is a serious health problem, a new poll shows. And most know that it can increase the risk of diabetes, heart disease and heart attack. But few are aware of some other health problems linked with obesity, the poll found. About 21% said excess weight increases the risk of high blood pressure. Even smaller numbers linked obesity with arthritis (14%), high cholesterol (12%), depression (11%) and stroke (10%). Only 7% knew about the link between obesity and some forms of cancer. About 5% mentioned respiratory problems, such as sleep apnea. Excess weight increases the risk of all of these conditions. The Associated Press (AP) and the NORC Center for Public Affairs Research conducted the poll. More than 1,000 adults were surveyed. AP wrote about it January 7.

By Reena L. Pande, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

This week, the Associated Press and the NORC (National Opinion Research Center) released results of a telephone survey of more than 1,000 U.S. adults. The goal was to understand what we understand and believe about obesity. Though we have made progress, the survey reveals that there are big gaps in our knowledge.

Here's the skinny. First, the good news. Overall, most people in the United States know that obesity or being overweight is bad for your health. Women are more likely than men to consider being obese as a serious health issue.

Also reassuring was what people said about the major causes of obesity. We generally seem to understand that not moving enough is a problem. Nearly 82% mentioned too much screen time (in front of a TV or computer) as a major contributor to obesity. Poor eating habits, including how easy it is to get cheap and unhealthy fast food, were also mentioned as problems.

Public perceptions about the health risks linked with obesity are also improving. Most people asked knew that obesity increases a person's risk of diabetes, heart disease and heart attack. That's critical, given that heart disease remains the No. 1 cause of death for U.S. adults.

But here's the bad news: Very few people knew that obesity could increase your risk of many other health issues and death. The health problems include:

• High blood pressure
• Joint problems, or arthritis
• High cholesterol
• Depression and other mental health issues
• Stroke
• Cancer
• Sleep apnea

Only 7% of those surveyed mentioned cancer as a risk of obesity. Yet it is well recognized that obesity can increase the risk of certain cancers and sometimes make them harder to treat.

Another major problem is that we are not very good at knowing when we are overweight. Many overweight people surveyed did not recognize that their weight was even a problem.

What Changes Can I Make Now?

Obviously, we have a lot of work to do to improve understanding about the risks linked with being overweight and obese. Here are some things you can do:

1. Get educated. Know your risks. Ask your doctor. Many people don't realize that their aches and pains or more serious medical issues may be related to their weight. Do you have trouble sleeping? Feel tired during the day? Have joint issues? Feel depressed? Your weight may be contributing to all these issues.



2. Know your body mass index (BMI). As mentioned above, many people don't even realize they are overweight or obese. In today's world, with increasing numbers of overweight adults and children, being overweight can almost seem normal. But the risks still exist. First, it's important to figure out whether you are overweight or obese. One way to know is to calculate your BMI, which is based on your height and your weight. This is not a perfect measure. However, it is one of the simplest screening tools we have to know whether you are in a more dangerous weight category. Here's what the numbers mean:
   
   • Below 18.5, underweight
   • 18.5 to 24.9, normal
   • 25.0 to 29.9, overweight
   • 30.0 and above, obese


3. Shed the pounds. We know this is not an easy task, but you've got to start somewhere. If nothing else, this first full week of 2013 can be your time to make a plan. Think about changes you can make in your diet or ways that you can begin to increase your physical activity. Losing weight can have a major impact on your health. It's never too late to feel better.

What Can I Expect Looking to the Future?

It's great news that so many people understand that obesity increases the risk of heart disease and diabetes. Still, this is only part of the story. Too few people understand that too much weight raises the risk of many other serious health conditions.

More and more programs exist to raise awareness about the risks posed by obesity and the tools people can use to lose weight. But the results of this survey tell us we still have a lot of work to do to educate the public about the serious health conditions that can result from being overweight. Education and awareness are the first step. Only then can we tackle this huge problem.