Heavier patients with diabetes are more likely to overestimate their “healthiest” body weight compared to those of normal weight, according to a study published in the current issue of Diabetes Care.

“We wanted to understand how well patients with diabetes could identify healthy body weight because self-management is an essential part of diabetes treatment,” said Kathleen McTigue, M.D., M.P.H., assistant professor of medicine at the University of Pittsburgh and first author of the study. “Understanding weight-related health risk could be an important step toward setting healthy lifestyle goals and effective weight management.”

In a survey of 2,461 diabetes patients, responses revealed that many had a less-than-accurate view of healthy body weight.

“Among respondents, 41 percent reported a ‘healthiest’ weight for their height that actually measured in the overweight body mass index (BMI) range, and 6 percent reported a ‘healthiest’ weight that was obese,” said Dr. McTigue, who also is an internal medicine specialist associated with the University of Pittsburgh Diabetes Institute (UPDI). “One participant selected a BMI in the underweight range as ‘healthiest.’ “

Among respondents whose BMI measurements classified them as obese, 66 percent identified overweight or obese dimensions as ideal for health. Among the overweight, some 41 percent chose a higher-than-optimal body weight as healthy. In contrast, only 4 percent of normal-weight patients overestimated healthy body weight.

Body size and gender were associated with accurate choice of a healthy body weight. Interestingly, women were more likely than men to correctly identify a weight in the normal BMI range as healthy.

Even so, the survey revealed considerable confusion about body weight in general. Some 65 percent of those reporting normal-BMI height and weight considered themselves to be overweight, leading the authors to speculate that current educational initiatives may fall short.

“These findings are concerning given the importance of body weight in managing diabetes,” Dr. McTigue concluded. “Counseling regarding excess body size deserves more attention in the routine care of patients with diabetes.”

Nationally, diabetes is the fifth leading cause of death, according to the American Diabetes Association. Many people first become aware of the disease when confronted with one of its life-threatening complications such as heart disease, blindness, high blood pressure, stroke, kidney disease or circulatory problems leading to amputation. Women who develop gestational diabetes during pregnancy have a substantially increased risk of acquiring the disorder later in life, and women who have diabetes before becoming pregnant face a higher risk of complications for themselves and their babies. One out of every 10 health care dollars is spent on diabetes and its complications, for an estimated total of $132 billion a year in the U.S.

Today, the U.S. Centers for Disease Control and Prevention estimates that 20.8 million Americans - some 7 percent of the U.S. population - already have diabetes. Because diabetes risk is associated with increased age and obesity - itself becoming epidemic - the number of people being affected by the disorder is expected to grow to 30 million by 2050.

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