With obesity reaching epidemic numbers, cultural marketing  has long been attempting to tell women that they're beautiful no matter what size they are.   Perception is about to run up against medical health, according to a new study out of Temple University.

In the American Journal of Obstetrics and Gynecology research, Temple researchers studied the body image perceptions of 81 underweight, normal weight, overweight or obese women in the North Philadelphia area and found that as their body mass index (BMI) increased, two-thirds of the women still felt they were at an ideal body size.

"So the question for doctors then becomes, 'How can we effectively treat our overweight and obese patients, when they don't feel they're in harm's way?'" said study researcher Marisa Rose, M.D., assistant professor of Obstetrics, Gynecology and Reproductive Sciences in the Temple University School of Medicine. "It stresses a need for culturally sensitive education for this population."

All participants were measured for height and weight and completed an anonymous survey to determine their self-perceived, current and ideal body sizes. Each woman was then shown an illustration of different-sized women that correlated with increasing BMIs, and were asked which size they felt they were at currently, and what their ideal would be.

While most of the participants selected illustrations of women in the normal to overweight range, about 20 percent of the obese women selected an overweight or obese silhouette as their ideal body shape. Further, 68 percent (15 out 22) of overweight participants and 84 percent (26 of 31) of obese women underestimated their current BMI. African-American and Hispanic women had significantly underestimated their current body size, while the white women overestimated.

Rose and her fellow researchers say this is the first study to evaluate body image discrepancy specifically in the inner-city population of women seeking gynecologic care.

"For this group, gynecologists often serve as the primary care provider as well," said Rose. "As more women become obese and overweight, it becomes critical for gynecologists to know how to talk to their patients about the adverse effects of obesity."

The researchers say that their next course of action is to determine from a more diverse population whether the trend of women incorrectly perceiving their body size extends to most underweight, overweight and obese women or whether the trend is specific to the inner-city population.

"Informing our patients about the dangers of obesity, even when they feel they're not at risk, can help empower them to change their lifestyles and lead healthier lives," said Rose.

Other authors on the study were: Sushma Potti, M.D.; Marina Milli, M.D.; Stacey Jeronis, M.D.; and John P. Gaughan, Ph.D of Temple University School of Medicine.