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Still, the larger health concern is with those who are overweight. Two-thirds of adult American women fall into the overweight or obese category, according to their BMIs. Just last week a report from the Centers for Disease Control found that the prevalence of obesity among U.S. adults doubled between 1980 and 2004 and has since stabilized at an alarmingly high level. Compared to women of a generation ago, we're 24 pounds heavier on average, and there's been an especially alarming increase in those at the upper end of the scale (not just obese, defined as a BMI of 30 or higher, but significantly obese, with a BMI above 35).
Because high BMIs are associated with increased risk of diabetes, high blood pressure, some cancers and heart problems, there's a lot of public health interest in turning this situation around. One way to do it may be to better understand the psychology of weight loss. Neighbors said it's possible that the overweight women in her study aimed for such modest diet goals because lower numbers on the scale seemed unattainable to them. "If you're five-foot-two and 200 pounds, maybe it seems like a pipe dream that your weight could be 120 pounds," she says. Still, that may just mean that women who are very overweight might need to achieve small weight loss goals before they can envision larger losses and change their eating and exercise behaviors accordingly.