Obesity and Stigma: The War Inside Your Head

The “War on Obesity” has claimed many victims, but made little progress against the disease itself. This  approach to obesity has done a fine job of setting up a war inside our own heads – self-stigma. “Weight stigma is widespread, damaging and difficult to eradicate,” writes Rebecca Puhl in the Washington Post. In fact, the bogus war on obesity often serves to promote self-stigma with counterproductive messages about “personal responsibility.”

A new paper in Qualitative Health Research describes how “personal responsibility” sets up this war:

“Our study highlights novel findings in that PWO struggle to recognize obesity as a disease due to the perception that they should be able to control themselves as they have agency with regards to body weight regulation. With this narrative and lack of options to treat their disease it is unsurprising many end up feeling trapped with no hope of ever finding resolution and ‘always at war with yourself.’”

In-Depth, Semi-Structured Interviews

This new study comes from Andrew Grannell, Carel le Roux, and Deirdre McGillicuddy. They are building on prior work to understand the lived experience with obesity. So they interviewed 23 patients in a tertiary care obesity clinic. What they discovered is a jumble of ideas about obesity setting up a conflict inside their own heads. On one hand they found an overall agreement that obesity is a disease.

But at the same time, they found that:

“A sense of personal responsibility appears to be a barrier to fully accepting obesity as a disease
which may negatively impact on seeking treatments and thus health outcomes.”

Understanding Obesity and a Better Sense of Self

So the war on obesity has put us at war with ourselves, promoting self-stigma along the way. Our biology is colliding with a hostile environment that promotes obesity. But the understanding of that biology and all of the environmental factors triggering it is quite incomplete.

One thing is clear. The war metaphor, paired with tropes about personal responsibility, is not helping. It’s hurting us all by promoting self-stigma.

Click here for the paper by Grannell, le Roux, and McGillicuddy. For more on the global harm of weight bias and self-stigma, click here.

In the Tavern, painting by Laszlo Mednyanszky / WikiArt

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September 30, 2021