Timi Gustafson, R.D.

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Stigmatization Makes It Harder to Overcome Obesity

May 16th, 2012 at Wed, 16th, 2012 at 11:46 am by timigustafson

Obesity rates may be on the rise worldwide, but thinness continues to be the standard for physical beauty and attractiveness. Conversely, obesity is often linked with poor body image and low self-esteem, which only adds to the struggle with weight and weight-related health problems.

“Modern Western culture emphasizes thinness, denigrates excess weight and stigmatizes obese individuals, making it likely that obese people internalize these messages and feel badly about their physical presence that brands them,” said Dr. Kelly D. Brownell and Dr. Marlene B. Schwartz of the Rudd Center for Food Policy and Obesity at Yale University in a study report on obesity and body image.

Prejudices against the overweight seem to develop early. One study found that children as young as three years of age believed fat people were “mean, stupid, ugly, and had few friends.” A majority of adults responded similarly, associating obesity with self-indulgence, laziness and lack of discipline. One poll conducted by Reuters found that over 60 percent of respondents believed the current obesity epidemic was caused by personal diet and lifestyle choices alone. Half supported the idea of charging obese patients higher health care premiums.

Views like these are also reflected in the job market, where obese candidates on average fare much poorer than their slender peers, according to a report on the subject by Reuters (5/11/2012). Statistically, obese workers receive lower wages, are more often passed over for promotions, and are less perceived to have leadership potential than their slimmer colleagues.

The effects of stigmatizing obesity have not yet received wide attention in our society. Unlike discrimination based on race, gender, religion or sexual orientation, exhibiting bias against the overweight is not illegal and would in any case be difficult to prove. One of the reasons for this discrepancy may be cultural. Many of us like to think that hard work leads to success and that failure results from weakness. The same applies to our standards of health and beauty. We each are responsible for our own well-being, so the thinking goes, and if we don’t manage, we have only ourselves to blame. So it shouldn’t come as a surprise that obesity, especially when it’s seen as a self-inflicted disorder, is judged so harshly, even in moral terms.

Fat people are increasingly becoming scapegoats for all sorts of cultural ills, said Dr. Linda Bacon, a nutrition researcher and author of “Health at Every Size: The Surprising Truth About Your Weight.” “There is an atmosphere now where it’s O.K. to blame everything on weight. We have this strong believe that it’s their fault, that it’s all about gluttony,” she said.

Even health care professionals are sometimes found to have prejudicial attitudes towards heavier patients, as studies have shown. In one survey, more than half of the interviewed doctors said obese people were “less likely to comply with treatment.” Consequently, they tend to spend less time with them and, as a result of feeling embarrassed and disrespected, the patients themselves avoid seeking the care they need.

In sharp contrast to many popular views on the causes of obesity, the Institute of Medicine (IOM) has recently published a report that identified the increasingly “obesogenic” environment we live in as the root of the crisis, rather than individual behavior.

Dr. Rebecca Puhl, a psychologist at Yale’s Rudd Center, agrees with the IOM’s conclusions, but she warns that “as long as we have this belief that obese people are lazy and lacking in discipline, it will be hard to get support for policies that change the environment, which are likely to have a much larger impact than trying to change individuals.”

People suffering from emotional distress in connection with weight problems are much less likely to succeed in their efforts to improve their health. Dissatisfaction with one’s size or body type can produce great amounts of stress. The results can be eating disorders like binge eating or bulimia, social isolation, depression and other psychological dysfunctions. Comprehensive counseling and support from family members, friends and people with similar experiences can be lifesaving. For our society in general, a shift in attitude would help as well.

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun”®, which is available on her blog, “Food and Health with Timi Gustafson R.D.” (http://www.timigustafson.com), and at amazon.com. You can follow Timi on Twitter and on Facebook.

Timi Gustafson, RD, LDN, FAND is a registered dietitian, health counselor, book author, syndicated newspaper columnist and blogger. She lectures on nutrition and healthy living to audiences worldwide. She is the founder and president of Solstice Publications LLC, a publishing company specializing in health and lifestyle education. Timi completed her Clinical Dietetic Internship at the University of California Medical Center, San Francisco. She is a Fellow of the Academy of Nutrition and Dietetics, an active member of the Washington State Dietetic Association, a member of the Diabetes Care and Education, Healthy Aging, Vegetarian Nutrition and the Sports, Cardiovascular and Wellness Nutrition practice groups. For more information, please visit http://www.timigustafson.com

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