臺灣成年女性肥胖、自覺肥胖和健康知識與教育程度之關係

The Relationship between Obesity, Subjective Perception of Obesity, Knowledge Base of Health Matters, and Level of Education among Taiwanese Adult Females

本研究目的在瞭解台灣成年女性身體質量指數(body mass index)與自覺肥胖情形，並探討健康知識、教育程度和客觀及自覺肥胖之關係。針對2002年7月至12月至台北市立馬偕紀念醫院接受成人免費健康檢查的成年女性為研究對象，本研究發現約有44%的受訪者有不正確的體重認知，這在教育程度較高的女性尤其明顯。其中，31%的女性根據BMI的定義屬於標準或過瘦體態，卻主觀認為自己體重過重或肥胖；相反地，僅約有1%的女性屬於肥胖，卻主觀認為自己體重標準或過瘦體態。這顯示肥胖對台灣女性帶來的社會壓力相當高，婦女普遍追求比客觀標準更為纖細的體態。在考慮健康知識的內生性質後，由聯立模型的估計結果顯示，教育程度愈高的女性，肥胖及主觀認為肥胖的機率明顯較低。這項發現支持Grossman的假說，顯示教育有助於減少肥胖發生的可能性。此外，肥胖也較少出現在年齡較輕、擁有健康知識較豐富以及蔬果攝取多的女性。因此，政府若欲抑制國內肥胖人口升高的趨勢，可採取的有效方式是針對教育程度較低的民眾加強肥胖之衛教以及持續增加教育投資，宣導民眾正確的體重認知，也可匡正盲目瘦身不必要之金錢浪費。

The purpose of this study was to examine the BMI (body mass index) and perceptions of obesity among Taiwanese adult females. Furthermore, we investigated the relationship between the subject's knowledge base of health matters, their level of education, objective measures of obesity, and their subjective perception of obesity. The survey was conducted at the Mackay Memorial Hospital with a target sample of women 40 years of age and older who participated in no-charge adult physical examinations from July to December 2002. The survey showed that about 44% of the respondents had inaccurate weight perceptions. While 31% of females perceived themselves as being overweight or obese even though they were not, approximately 1% of females perceived themselves as being normal or underweight, even though they were not. Thus, the results indicate that there is a pervasive stigmatization of obesity among Taiwanese women. Controlling for one's endogenous knowledge of health matters, formal schooling has a statistically significant negative effect on obesity and the perception of obesity among females. The findings support Grossman's hypothesis that schooling has a direct positive effect on health through reducing obesity. In addition, younger, highly-knowledgeable females, and those with a higher fiber intake, are less likely to be obese. The results suggest that increasing expenditures on general education and health matters could be viewed as an effective policy in terms of its role in reducing the prevalence of obesity.