An analysis of National Health and Nutrition Examination Survey data found more than 40% of U.S. adults who were overweight and nearly 10% did not consider themselves to be overweight.

Researchers at the University of Chicago Medicine analyzed the data to investigate trends of self-awareness in overweight or obese adults.

Survey participants were asked about self-perception of weight using the question: “Do you consider yourself to be overweight, underweight or about the right weight?”

The answers showed more than a significant proportion did not recognize they had a weight issue.

This trend has increased over the past two decades and was especially true of non-Hispanic Blacks and people with low socioeconomic status, the researchers found. Their findings are published in the Annals of Internal Medicine.

The authors found that as Americans’ body mass index increases, people adjust their views on what a normal weight range is to promote positive body images.

They suggest it might be necessary to use varying BMI cutoffs to define overweight and obesity when comparing varying demographic subsets.

The researcers also found the study data showed people with obesity who did not view their weight to be an issue were less likely to try to lose weight, and this could contribute to increasing obesity rates in the United States.

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