The Athlete's Way

Sweat and the biology of bliss

Will Labeling Obesity as a Disease Backfire?

Labeling obesity as a disease demotivates some obese people to lose weight.

In June of 2013 the American Medical Association reclassified obesity as a disease. That June, I wrote a Psychology Today blog post questioning the decision titled, "Should Obesity Be Labeled As a Disease?"

At the time, I had concerns about the potential dual-edged sword of labeling obesity a disease and suspected that the decision to classify “obesity-as-disease” could backfire. Unfortunately, a new study has found that labeling obesity as a disease does in fact have an unexpected psychological backlash among some obese individuals.

The findings of the new study titled “'Obesity Is a Disease.' Examining the Self-Regulatory Impact of This Public-Health Message” were published on January 28, 2014 in Psychological Science, a journal of the Association for Psychological Science.

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The researchers found that obese individuals who were told that obesity is a disease actually made less effort to make healthy diet choices and reported less motivation to change their weight. When obesity is viewed as a disease, people who already view themselves as obese seemed to psychologically throw in the towel and make unhealthier food choices.

Labeling Obesity as a Disease Increases Body Acceptance but Decreases Motivation to Lose Weight

The authors of the study, Crystal Hoyt and Jeni Burnette of the University of Richmond and Lisa Auster-Gussman of the University of Minnesota, are psychological scientists interested in exploring the effects of health and diet messaging.

Hoyt and her colleagues had a hunch that labeling obesity as a disease might create a misperception that changing your weight once you are obese is out of an individual’s control. When obesity is labeled a disease, it made attempts at weight management seem futile, especially among obese individuals. Ironically, the AMA’s public-health messages may actually be sabotaging motivation to lose weight in the very people the message is designed to benefit.

Hoyt explains, “Considering that obesity is a crucial public-health issue, a more nuanced understanding of the impact of an ‘obesity is a disease’ message has significant implications for patient-level and policy-level outcomes. Experts have been debating the merits of, and problems with, the AMA policy—we wanted to contribute to the conversation by bringing data rather than speculation and by focusing on the psychological repercussions.”

For this study the researchers recruited over 700 participants to take part in an online survey across three different studies. Participants read an article related to health and weight and then answered various questions. Some participants read an article that described obesity as a disease, some read a standard public-health message about weight, and others read an article specifically stating that obesity is not a disease.

In an unfortunate psychological twist, obese participants who read the “obesity is a disease” article placed less importance on health-focused dieting and reported less concern for weight relative to obese participants who read the other two articles. They also chose higher-calorie options when asked to pick a sandwich from a provided menu. Interestingly, these participants did report greater body satisfaction, which, in turn, also predicted higher-calorie food choices.

Conclusion: How Obesity Is Described Has a Dramatic Effect on Behavior, but More Research Is Needed

The results of this study show that when obesity is framed as a disease—or not a disease—it has a dramatic impact on an obese persons attitudes towards health, diet, and weight. Hoyt concludes, “Together, these findings suggest that the messages individuals hear about the nature of obesity have self-regulatory consequences.”

The researchers point out that there are probably some benefits to framing obesity as a disease, such as decreasing shame about obesity and promoting a greater acceptance of diverse body shapes and sizes. Labeling obesity as a disease also appears to reduce stigma, which may help some obese individuals engage with health and weight-related goals.

The researchers believe that their findings indicate that there may be some hidden costs to the “obesity is a disease” message, including less motivation to eat healthy. Hoyt and colleagues caution that more research is needed to gain a clearer understanding of both the costs and benefits of such health-related messaging before the findings can be put into practice.

“In our ongoing work, we hope to gain a greater understanding of how the ‘obesity is a disease’ message influences beliefs about the controllability of weight,” says Hoyt. “In addition, we are also interested in investigating the role of this message in reducing stigma against the obese.” The researchers hope that their work “sparks further discussion and inquiry by researchers and practitioners alike.”

If you'd like to read more on this topic, check out my Psychology Today blog posts:

Follow me on Twitter @ckbergland for updates on The Athlete's Way blog posts. 

Christopher Bergland is a world-class endurance athlete, coach, author, and political activist.

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