Whom Shall We Blame for Obesity?

Whom Shall We Blame for Obesity?

Affixing blame is an ancient human ritual. Affixing blame helps people make sense of a situation and move on to solving a problem. In the ancient scripture of Leviticus, the community places its sins upon a goat and casts the goat into the desert. It’s the original scapegoat. With sins removed, everyone can get on with their lives. And so it is that we need someone or something to blame for obesity.

Too Many Suspects

But we have just one tiny problem: too many suspects. Obesity is not a single, simple condition, it is a collection of conditions with a common feature – an accumulation of unhealthy excess fat tissue. It starts with an inherited susceptibility. That accounts for most of an individual’s risk. Blame your parents.

Acting upon those risks are triggers in a person’s life: traumatic stress, a toxic food environment, a virus, a sedentary lifestyle, and the list goes on.

Finally comes the response to the challenge of obesity. The dominant thinking – though it’s at odds with the facts – has long been that obesity is largely a matter of personal choice. Have you made good choices that give you a healthy weight? Have you recognized a problem of excess weight and mustered the resolve to overcome it?

But the truth is that obesity is a chronic disease that can’t be dismissed simply through willpower. Study after study has shown that willpower doesn’t cure obesity any better than it cures hypertension. Some treatments help keep it under control. Sometimes you can put it into remission. Still, even with bariatric surgery, obesity can come back at you.

Public Theories About Obesity

Unfortunately, most of the public dialogue about obesity dismisses all of that complexity and comes back to the question of blame. In a new paper, Paul Thibodeau and Stephen Flusberg have newly published a review of popular theories about obesity. They describe how different ways of thinking about it lead to support for different policies to address it.

Naming a corporate villain builds support for regulating food and its marketing. Blaming the individual builds support for exhorting people to make better choices. But the real villain is the disease itself.

It’s about time to stop looking elsewhere for a scapegoat. We need to confront this disease that we still don’t fully understand. We need to use the evidence-based solutions we have – even though we have no miracle cures.

But most importantly, we need to commit to ambitious research that will lead to better solutions. With a better understanding of this disease, maybe we can stop chasing scapegoats.

Click here for the review by Thibodeau and Flusberg. For another perspective on beliefs about obesity and links to public policies, read this paper in BMJ Open.

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April 4, 2017