How many times have you heard ‘just eat less and move more’ as an answer to the escalating obesity crisis? Yet this kind of strategy advocates willpower and individual responsibility when all the research suggests that this is a far more complex issue; a powerful combination of biological, genetic and psychological components. A little shame is seen as a motivating factor to change one’s lifestyle as if people with a weight issue don’t already blame themselves.
Yet blaming and shaming is harmful to health and actually has the reverse effect as many people end up bingeing as a coping mechanism which only adds to their emotional distress. The advent of Covid-19 has only heightened weight shaming as excess weight is seen as a major risk factor for the virus. The message implies that it is your fault if you become ill or die.
The science indicates that weight stigma can activate physical and behavioural changes associated with increased weight gain. In a laboratory situation, participants who were subjected to weight shaming, experienced increased appetite and cortisol levels – a hormone associated with stress and weight gain. This was particularly prevalent in those who were or thought that they were overweight. These results have been replicated in several long-term studies; weight shaming leads to weight gain and a higher likelihood of obesity, irrespective of the participants' weight at the outset.
If losing weight and keeping it off was so easy then why is not a single country on track to reverse spiralling obesity rates?
Stacey had lost a lot of weight was complimented on her appearance by a male associate. She was totally appalled when she heard that when she used to come into the office her colleagues would laughingly mention that ‘Stacey has just rolled in’. This kind of discrimination is commonplace and blatantly implies that her previous weight was socially unacceptable. Often, discrimination can be far more subtle. Family and friends often don't intend any hurt, but even the wrong remark or look can intensify people’s guilt about their weight. Mary described the way her mother said her name every time she reached for a second helping was enough to shame her about her body shape and size. She had spent so many years struggling with her weight that to feel condemnation and blame on top, really impacted her emotional well-being. As a result, she would go home and binge in secret.
Often it is not until one loses weight that you realise the full extent of the discrimination. Unfortunately, most people will regain the weight and end up feeling even worse knowing how differently they were treated when they were slimmer.
Weight stigma has been particularly prevalent in a health setting. Health professionals often attribute blame and trivialise peoples’ weight concerns – "all you need to do is stop eating junk food and exercise more". This kind of bias has led to harmful health consequences. For example, higher BMI adults were found to be given less time and treated with less respect than those with a ‘normal’ BMI by their doctors. As a result, patients became more reluctant to seek appropriate treatment - whatever their ailment.
Too many weight loss interventions neglect the underlying psychological causes of emotional eating. The initiatives can be counterproductive as they reinforce body dissatisfaction and feeling bad about yourself is more likely to lead to comfort eating and weight gain.
Research has shown that a key source of weight stigma is in the community - either through peoples’ body language or negative verbal interactions. For example, strangers' insults in the street using unacceptable stereotypes such as ‘fat’ or ‘lazy’ or being treated as worthless in shops. Often it was the judgmental looks which created a feeling of discomfort.
As long as the general consensus remains that excess weight is a matter of personal responsibility, weight stigma will be allowed to flourish and obesity levels will continue to rise. However, this predominant message does not reflect the real picture as aside from the contributing factors already mentioned, we are living in an obesogenic environment. Tempting foods are readily available, portion sizes have doubled and we move less due to technological advances.
The Government proposes ‘A call to action’ to take steps to move towards a healthier weight. Yet by failing to address the social stigma of weight shaming they are ignoring the importance of psychological well-being – a fundamental step in helping people with weight issues. We should be focusing on good health for everybody and not on achieving an ideal weight. We need to be aware of how our behaviour and language may impact on other people and offer support and understanding rather than judgment.
