A few days ago, as I was walking my (admittedly) pudgy long-hair dachshund, two women, both relatively thin, walked by me laughing and one said, “Your dog is so fat!” Their remark was so surprising, I was flummoxed, wholly unprepared to respond. And by the time I thought of what I wanted to say (i.e., “You are rude!” “You don’t understand! The dog just has a thick coat!” etc.), they were gone.

Their remark upset me because of what it implied: I obviously feed the dog too much; I don’t exercise the dog enough; and I don’t care about his health. They had no way of knowing that for the past three years my dog has become almost entirely blind due to a genetic trait in his line. Nor do they care that his blindness reduces the speed of his walking, so the scents his long nose, like a white cane, detects in front of him have him moving slowly. These critics have no idea that that I carry him up and down stairs, up and down curbs, and in any area new to him, like a store. That he no longer runs because that means running blind, as well as that as a 14 year-old dog, he sleeps most of the day. And finally, that I feed him small portions of food. Sure he gained weight; it was almost inevitable due to his significant decrease in activity. But according to his vet, he is extremely healthy, pudgy or not.

We look upon obese individuals the same way these women looked at my dog and blame them for their size. “Look at her/him,” we think, “Look at how big he/she is!”  And we assume that the individual could easily be thin if only he/she had some self-discipline, will power, and control. 

Anyone who has struggled with weight knows how simplistic and irrelevant these attitudes are. People don’t choose to alter their body size, and often as a consequence their lifestyle, health, personal relationships, and sometimes employment are impacted simply because they like food more than someone of normal weight. There is always a reason for the overeating—sometimes many reasons—but don’t expect these reasons to be shared with the onlooker who is commenting, albeit silently, about your excess weight.

As a weight-loss consultant, I rarely spent more than two or three sessions talking about dieting and exercise; that was the easy part. My goal was to try to find out what caused the weight gain, and develop strategies to stop these causes from preventing weight re-gain after the diet was over. But often the reasons for gaining weight were almost unmovable (like my dog when he does not want to walk). I remember the hospice worker client who often put in 12-14 hours a day, and ate most of her meals in her car driving from home to home. There was the young woman whose 350 pound weight gain was caused by the many psychotropic drugs she took for years of mental illness and whose chronic back and knee pain, a result of her obesity, made it impossible for her to move. I recall the mother of three, the sole wage earner after her husband was laid off, who faced daily abuse from her sadistic boss but did not dare quit. An executive chef related how he ate his way through his job because the demands of managing a large food service, in addition to food preparation, left him mentally and physically exhausted. And, of course, there was the young law associate who ate candy from the vending machine when she had to remain in the office until 10 or 11pm each night to finish her impossible workload.

Yes, they were obese but no, they were not obese simply because they liked to eat.

Our attitudes toward obese individuals are formed to some extent by promoters of weight-loss programs, diet books, magazine and news articles in tabloid magazines about celebrities who have gained weight. These sources imply that all that prevents an obese person from turning into a skinny one (“I lost 40 pounds in 60 days on ____ diet!”) is the diet itself. It’s all so simple. Just eat less, or take this magic supplement, or buy this expensive piece of exercise equipment, and Voila! the transformation will occur.

Obesity, to borrow a phrase, has many mothers. Thus weight loss, to be successful, must go beyond diet and exercise to deal with the many causes for the weight gain. If there were an operation to restore my dog’s sight, he would lose weight. If there were drugs that helped mental illness without substantial weight gain, many would not face obesity as a side effect of their treatment. If employees were not abused by sick bosses or overwork, if sick relatives or friends did not drain our emotional strength and energy, if financial worries were vanquished? Many who are now obese would be thin. If people who eat to subdue emotional pain were freed from their distress, they would not face a life of obesity.

My pudgy dog is healthy, and I struggle to make sure he does not gain any more weight by controlling his food intake and taking him on walks, often to his dismay (he would rather sleep). Will he ever return to the sleek shape of his puppy-hood? Maybe in the canine world to come. His weight gain was the result of a situation beyond his control. So too, the weight gain of many who are obese may be due to situations that they are unable to control, and/or resolve, and/or accept. Their weight is the visible manifestation of these situations; the emotional pain is hidden.

Empathize; do not criticize. And if possible, help.

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