Do you think you are overweight? How about obese? Chances are that you may recognise that you are overweight but not consider yourself to be obese.

What's the problem with that? Well if you don't accept or recognise that you are obese you don't realise your significant health risks, and consequently are not motivated to make real change.

This is the concern of doctoral student Kyla Raynor who has conducted a study on what Bermudians perceive their weight to be and the implications these perceptions play on their weight control practices.

"There is a tendency for people to be overweight and not realise it," she said.

She interviewed and weighed 500 Bermudian adults, both male and female. Her preliminary findings point to a difference between actual weight and that perceived by the individual.

"Most people think they are overweight," Ms Raynor said, "but what I found is that some people who think they are overweight are obese."

The difference, according to Ms Raynor, may be a matter of only a few pounds but the extra weight places people at a high risk for chronic illnesses.

These preliminary findings support the view of Sarah Burrows, programme manager for the Diabetes Association. Ms Burrows believes that an obesity clinic is needed in Bermuda in order to stem the incidence of diabetes.

"I think that's where we need to focus our energy because obesity affects a lot of diseases," she said.

Ms Raynor agreed that excess weight puts people at higher risk not only for diabetes but also for a slew of chronic diseases including hypertension, stroke, high blood pressure, and even cancer.

Ms Burrows noted that obese people have an increased risk of problems in pregnancy, psychological disorders and cancers of the prostate, colon, rectum, kidney, breast, oesophagus and gall bladder.

She said she felt much of the problem in Bermuda is that the medical definition of being overweight is at odds with the way it's perceived by the public.

"Even for myself. I admit that I am overweight. I need to lose 30 pounds, but when I go on the scale, according to the medical definition I am obese," she said.

"I think as a community we have come to accept larger sizes as the norm," said Ms Burrows. "We get larger cars, bigger seats and when we go to France we think the women are too thin."

Registered dietician Sarah McKittrick said that perception is much of the reason obesity has become widespread. "We can't make people do something when they don't think it's a problem," she said.

Ms Burrows said she believes people are also fooled by clothing manufacturers who study the human psyche. "I think they are playing mind games," she said. She believes that US manufacturers are making the same sizes larger, so that a size 12 dress bought five or 10 years ago is much smaller than a size 12 dress bought today.

Whatever the gimmicks, they appear to be working and Ms Raynor's research suggests that Bermudians equate obesity with morbid obesity.

Ms Burrows said her idea of an obesity clinic is one that would be all encompassing, looking not just at ways of losing weight, but of also offering psychological support for clients and their families.

Dr. Leonard Gibbons, Wellness Coordinator at King Edward VII Memorial Hospital said from a personal point of view he supports the idea of an obesity clinic.

"I think that as many options as we have to encourage people to eat healthier and exercise, the better," he said. "Something that focuses on obesity and best practice guidelines of what works and how people would utilise those tools, would be a good thing," he added.

"A lot of people lose weight temporarily and then they gain it back. To make it effective it would ultimately have to deal with the motivating factors that cause people to gain the weight, instead of a purely surface approach," he said.

He said people would have to be given more than a diet to follow. "People need more guidance and support to identify the triggers of what makes them eat more and exercise less," he said.

He said an obesity clinic would have to provide an environment conducive to success, that it would have to be supportive and teach people things like how to read food labels and grocery shop effectively.

Like Ms Burrows, Dr. Gibbons feels that clients of an obesity clinic should be taught how to exercise, and the facilities for doing so should be at the clinic.

"There would need to be a gym, and a swimming pool would be a must," said Ms Burrows. "It's unrealistic to try and have an obese person go from no activity into a gym. They need to work out gradually and swimming is the most practical way."

Ms Raynor, who conducted the research on Bermudians' perception of their weight, is not necessarily in favour of an obesity clinic.

"I think it's a good idea only if the community feel that it is needed," she said. She contends that just as people don't feel that they are obese, that they will not use an obesity clinic unless they recognise the need.

"One of the questions in my survey asked if people know where to go for help," she said. "Twelve percent said they didn't know here to go but 77 percent said they did. Yet not all of them were going to that place," she added.

She felt that a needs assessment would have to be done by the Government Health Department to determine exactly what type of programme or facility might work.

"It may not be that people need an obesity clinic, it might be a wellness clinic or exercise credits to use elsewhere," she said. Yet while the obesity problem rises in Bermuda it is unclear if the Ministry of Health has plans to tackle it. Questions to the department over six weeks ago remain unanswered.