Alice in Wonderland

How Are We Feeling About Ambiguity, Facts, and Obesity?

Many of us are struggling to hold onto a quaint belief in facts. But we’re also learning to deal with ambiguity. Simply because we don’t have all the facts. So we all, to varying degrees, rely on feelings to guide us. Welcome to the world of obesity, where we cope with an imperfect knowledge of this complex, chronic condition. New research at ObesityWeek suggests that feelings about obesity are changing.

The research suggests that Americans are thinking of obesity more as a medical condition and less as a personal fault. People are feeling less inclined to discriminate against people with obesity.

Pathologizing Fatness?

In the Presidential Plenary on the opening day, Lee Kaplan laid out a very clear description of the chronic disease of obesity. It is not a disease because we deem it to be one, he said. But rather, it is a disease because it results from abnormal physiology. It causes further pathology, and it diminishes health. So healthcare professionals need to deal with it as they would any other disease.

However, all this talk about pathology and disease leaves many folks uncomfortable. “He’s pathological” is a casual insult. And when most people understand obesity as simply a matter of body size (it’s not), they really don’t like the concept that obesity is a disease. An average person is very uncomfortable with word obesity. Roxane Gay, who received a presidential medal in that same session, captured this feeling in a tweet.

Blame, Care, and Getting on with Life

So we have many different ways of thinking about obesity. But the research presented at ObesityWeek by Ted Kyle and colleagues suggests that Americans are moving away from feelings blame and guilt. We seem to be moving toward embracing the need for medical care in this condition.

Comparing attitudes of U.S. Adults in 2020 to 2017, they found increasing agreement that we need more care and less blame. They also found less agreement with discriminating against people with obesity in employment.

Feelings about obesity are complicated. Some people will never let go of the idea that they can “sculpt” their bodies to be whatever they like. As much as obesity influences someone’s appearance, though, appearance is quite irrelevant to this medical condition. Obesity is all about how and where the body is storing fat tissue. When it goes into the liver and other vital organs, it harms health.

This is a fact of physiology. It’s has nothing to do with appearance, feelings, or virtue. And yet, there’s much we don’t know about obesity. So we have to live with ambiguity, help people make the best personal choices they can, and get on with our lives.

Hopefully, with the passage of time, the ambiguity will diminish. That’s the real point of obesity research.

Click here for the abstract and presentation by Kyle et al and here for further information.

Alice in Wonderland, public domain screenshot from the 1951 film trailer / Wikimedia Commons

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November 4, 2020