ORLANDO, Fla. — A new study has found that about 12 percent of people who are classified medically as obese believe they have a healthy body size and do not need to lose weight — despite the fact that many have high blood pressure, elevated cholesterol and diabetes. The results imply that physicians cannot assume that obese patients realize the health implications of excess weight.

The research involved members of the Dallas Heart Study. The study is tracking a cross section of almost 6,000 people in Dallas County, Texas, mainly from a largely minority and urban population. After asking participants to classify their body size as below normal, normal or above normal, the researchers found that about one of every eight people who were obese rated his body size as normal and healthy. Yet 35 percent of those who misjudged their body size had high blood pressure, 15 percent had high cholesterol and 14 percent had diabetes.

“Perception affects behavior,” said Tiffany Powell, a cardiology fellow at the University of Texas Southwestern Medical Center at Dallas who reported the findings November 17 at the American Heart Association’s Scientific Sessions 2009. Obese patients who misperceived their body size were less likely to see a physician, she said: 44 percent had not seen a doctor in the past year, compared with 26 percent of obese patients who thought they needed to lose weight. For someone to become motivated enough to improve diet and exercise habits, she said, “they have to understand that obesity is not benign.”

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