OW2020: Challenging Popular Thoughts About Obesity

The Obesity Journal Symposium at ObesityWeek is a reliable source of new insights. This year’s edition was yesterday and it did not disappoint. Four new papers covered a diverse range of topics with excellence. But two of them are especially notable for challenging some popular thoughts about obesity. First, Emma Stinson et al tells us that adherence to diets is not a unique problem for people with obesity. Then in addition, Michelle Cardel et al give us reason to think harder about obesity and social status.

Everyone Sucks at Dieting

You’ve seen it – the smugness of someone telling you about a wonderfully healthy diet they’re following. The social signal here is quite clear. Look at me. I have the answer to good health. And then the assumption that follows is that when a person has a higher weight, they must have a hard time following a healthy diet.

Stinson et al told us that this thinking is simply wrong. She assigned people with obesity and people with leaner bodies to follow specific diets. All of the lean subjects and half of the subjects with obesity received the directions for a weight maintenance diet. The other half of the obesity group received a calorie-restricted diet.

No surprise, the calorie-restricted group lost the most weight. But the real surprise is that nobody was especially good at following the diet. Lean people were no better than those with obesity at following the maintenance diet. People with obesity, when asked to follow a diet with fewer calories, had no more (or less) difficulty following that prescription than either group following a maintenance diet. No difference in any of the groups.

This flies in the face of the popular bias – prevalent with healthcare professionals – that people with obesity are generally noncompliant. It just isn’t so.

Social Status and Eating Behaviors

One of the particularly noxious, albeit unspoken, popular thoughts about obesity is that the people who have it should have lower social status. This is the very essence of weight bias and stigma – discounting people with obesity.

However, Cardel asks us to flip that script. By experimentally messing with a the social status a person feels, she and her colleagues show that you can have an effect on eating patterns. In Hispanic teens they showed that females tended to eat more of a lunch when pushed into a lower status. Males responded in the opposite direction. They ate less of the lunch when experiencing a low social status.

Perhaps low social status is a source of obesity just as much as obesity is a source of low social status.

In fact, both of these new studies tell us to question popular thoughts about obesity. Such flawed thinking is a source of bias that does considerable harm.

Click here for the Stinson paper and here for the Cardel paper.

Flying Thoughts, photograph © Marco Nürnberger / flickr

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November 6, 2020