Ignorance of Causality Meets Fear of Body Positivity
The headlines are jolting. Body positivity causes people to think they aren’t obese, says Newsweek. It is a threat to public health, the reporting suggests. Unfortunately, many other publications came up with similar stories. A new study Friday in Obesity prompted this sensationalism. In her paper, Raya Muttarak does not make the claim of cause and effect outright. But she clearly suggests it in her conclusion:
The upward trend in under-assessment of overweight and obesity status in England is possibly a result of the normalization of overweight and obesity.
Inferring Causality from a Correlation
Muttarak found a correlation between size misperception and self-reported efforts to lose weight. She looked at people with BMI in the range of obesity or overweight. If they didn’t think of themselves as “too heavy,” then she labeled them as misperceiving their size. After further analysis, she found they were 85% less likely to say they were trying to lose weight.
The title of the study is revealing:
Normalization of Plus Size and the Danger of Unseen Overweight and Obesity in England
Right from the start, Muttarak lays out her thinking. In the introduction of her paper. She describes her belief that flattering fashions for larger people and body positivity can be harmful. That’s because they can undermine the recognition of being overweight. In press materials, she elaborated on her beliefs. Plus size fashion is a problem. She sees danger. And so, she put danger right up front in her article’s title.
A False Assumption
Alongside this study, Obesity published a dissenting commentary. Tiffany Stewart correctly identifies Muttarak’s false assumptions. Other research tells a very different story, she says. When people feel themselves labeled as “too heavy,” their health is worse, not better. Most important, their likelihood of persistent obesity is higher.
Frankly, all this worrying about body positivity is offensive. People shouldn’t feel good about themselves? Seriously? It’s hard not to think of this as a symptom of loathing for people with large bodies.
Such misplaced concern should go toward positive endeavors. Like encouraging healthy behaviors. We don’t need more scolding about weight. We need healthy attitudes and encouragement for healthy lives.
And, by the way, we also need scientists to be a bit more careful about cause and effect. Correlation is not proof of causality.
Click here for the study, here for the commentary, and here for the sensationalism from Newsweek.
Confident, photograph © Obesity Action Coalition / OAC Image Gallery
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June 25, 2018
June 25, 2018 at 7:43 am, Harry Minot said:
Thanks for this quite robust analysis. The article, by contrast, displays fragile thinking.
June 25, 2018 at 7:51 am, James said:
We did a 5 country study and among other things asked for height & weight to calculate BMI and we also asked about their assessments of self which we categorised as underweight, normal, overweight and obese. There were significant differences by country. In Spain, respondents were more likely to report themselves as obese when they were overweight. In the US and UK, respondents who were obese were more likely to report themselves as overweight or normal. From a marketing perspective you have to meet people where they are – so obesity as a term is a non-starter in US and UK.
June 25, 2018 at 10:01 am, Ted said:
Thanks for sharing this James. Have you published these findings?
June 25, 2018 at 4:55 pm, Karen Patte said:
We’ve also looked at weight perceptions. Yes, those who perceive themselves as overweight are more likely to report that they are trying to lose weight, regardless of their BMI (https://www.ncbi.nlm.nih.gov/pubmed/27561864). However, trying to lose weight cannot be assumed to be a positive finding. Perceptions of overweight are linked to unhealthy weight control behaviours, and in our study, when youth changed from perceiving themselves as ‘about the right weight’ to percptions of being overweight, they became LESS likely to engage in healthy behaviours (including eating and phsycial activity related) regardless of BMI (study: https://www.sciencedirect.com/science/article/pii/S2352827316301264).
In fact, one study found individual with overweight perceptions were more likely later have obesity.
June 25, 2018 at 5:01 pm, Ted said:
Well said, Karen.