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Obesity has been said to have reached "epidemic" proportions. Interestingly, obesity doesn't fit the true definition of this word from the dictionary:
ep·i·dem·ic/ˌepiˈdemik/
A widespread occurrence of an infectious disease in a community at a particular time: "a flu epidemic".
Media reports say that obesity is the cause of numerous health conditions and costs the health care system millions of dollars a year. Statistics show that 65% of Americans are either overweight or obese. Even health care professionals report difficulty in working with obese individuals.
What none of this addresses is how statistics, the media and the health care professional's attitudes as well as society in general promote stigmatization of obese individuals. Bullying of children about their weight is at an all time high.Research studies show that obese individuals seeking bariatric surgery have high rates of depression, suicidal thoughts and suicide attempts directly related to experiences of weight stigma. Obese and overweight individuals in our culture are thought to be lazy, disgusting, not intelligent and may experience bias in the workplace and in many other areas of their lives. These beliefs are often internalized in those with obesity. Experiences of weight stigma can lead to an increase in binge eating and overeating as a coping mechanism.
Physician surveys have shown weight stigma in treating the obese:
A survey involving a nationally representative sample of primary care physicians revealed that, not only did more than half of respondents think that patients who are obese were awkward and unattractive, but more than 50 percent believed that they would be noncompliant with treatment. One-third thought of them as "weak-willed" and "lazy." Another study found that as patients' weight increased, physicians reported having less patience, less faith in patients' ability to comply with treatment, and less desire to help them. (1,2)
The current focus on childhood obesity is yet another example of how weight stigma is being played out in the media. The Georgia campaign against childhood obesity uses demeaning messages along with pictures of overweight children. Messages include: "Warning: It's hard to be a little girl, if you're fat." "Warning: Fat prevention begins at home. And the buffet line." While raising awareness is important, we currently have no proven way to help children or adults lose weight. Beyond that, a preponderence of research shows that it is not the number on the scale that is the cause of health problems—it is lack of healthy behaviors. You can be overweight or obese and be healthier than a thin person who is sedentary. The Health at Every Size movement promotes a more realistic approach which is the health is the result of a dynamic interplay involving lifestyle, activity and should not be determined by a set of graphs or the number on the scale. Research proves that weight stigma makes a person LESS likely to go to the gym or attend an exercise class so it is indeed counter-productive.
The media portrayal of obese individuals makes matters even worse. Studies on this show that obese individuals are usually portrayed in the worst possible light. Their bodies are often photographed without showing their face (dehumanizing), at an angle that is the least flattering to their size (biased). Popular TV shows that portray obese people usually show them as comedic and lonely people or as wierd freaks. The Biggest Loser promotes the idea that if you just work out an enormous number of hours and diet, you, too can be thin and happy.
Obesity is not a problem of willpower, despite our society's best efforts to convince us of this notion. Obesity is not about what you eat. Despite all the hype on the evils of sugar, fat and carbs in various diet crazes, the rates of obesity have continued to climb and experts now admit that fat, for example does not make you fat.
Obesity, like many public health problems (smoking, drug and alcohol addiction) and like many chronic medical conditions (diabetes, heart disease, high blood pressure, etc.) is a long-term, complicated issue that cannot be addressed with a simple prescription of "eat this, don't eat that." It involves a mix between genetic factors, emotional factors, beliefs and behavior patterns. The sooner we address the red herring of focusing on the number on the scale rather than focusing on what the evidence shows, the more likely we will help people deal with this issue. The help should come not in condemnation or shaming, but in full acceptance and the promotion of health, no matter what your size is.
- Foster GD, Wadden TA, Makris AP, et al. Primary care physicians' attitudes about obesity and its treatment. Obes Res. 2003;11(10):1168-1177.
- Hebl MR, Xu J. Weighing the care: physicians' reactions to the size of a patient. Int J Obes Relat Metab Disord. 2001;25(8):1246-1252.
