I think therefore I am: Perceived ideal weight as a determinant of health

Objectives. We examined whether stress related to negative body image perception and the desire to lose weight explained some of the body mass index-health gradient. Methods. We used 2003 Behavioral Risk Factor Surveillance System data to examine the impact of desired body weight, independent of actual body mass index, on the amount of physically and mentally unhealthy days by race, ethnicity, and gender. Results. The difference between actual and desired body weight was a stronger predictor than was body mass index (BMI) of mental and physical health. When we controlled for BMI and age, men who wished to lose 1%, 10%, and 20% of their body weight respectively suffered a net increase of 0.1, 0.9, and 2.7 unhealthy days per month relative to those who were happy with their weight. For women, the corresponding numbers were 0.1, 1.6, and 4.3 unhealthy days per month. The desire to lose weight was more predictive of unhealthy days among women than among men and among Whites than among Blacks or Hispanics. Conclusions. Our results raise the possibility that some of the health effects of the obesity epidemic are related to the way we see our bodies.