The Madness of Fear

Daunting Medical Words – Like Obesity

Cancer is not just exuberant cell growth. Nor is depression simply a matter of feeling sad. Likewise obesity is not a simple matter of living in a larger body. But cancer, depression, and obesity are medical words that can be daunting and also misused. And each of them can bring stigma to complicate any efforts to overcome the health impact of the diagnosis.

Increasingly, we hear from folks teaching in public health and nutrition that they are having difficulty teaching about the health implications of obesity. Some people are advancing the idea that obesity is a bad word. Sharing the experiences of colleagues, a distinguished professor recently told us:

“They cannot even say the ‘O-word’ for fear of being canceled. If they are, they are sure that their universities will not back them up.”

But avoiding the medical reality by banishing the word does not solve either problem – neither the medical problem nor the problem of stigma.

Health Stigma Complicates Many Diseases

Perhaps we should get some comfort from knowing that health stigma is not a problem confined to obesity. It’s a serious problem for mental health. Just as it does for obesity care, it gets in the way of mental health care. It becomes a barrier that limits access to care. With stigma, the outcomes get worse for persons coping with a mental health diagnosis.

Even with cancer, stigma is a problem that complicates life for the people who are dealing with it. For example, cancer stigma has a link to job discrimination and loss for cancer survivors. It’s hard to think of a clearer example of adding insult to injury.

If We Don’t Talk About It . . . the Problem Remains

Health stigma does not go away when we avoid talking about difficult diagnoses. In fact, when a subject becomes forbidden, stigma and isolation increase. So pretending that stigma related to obesity or cancer or depression will be fade if we just don’t use these daunting medical words is absurd.

More Respect and Care, Less Hype and Catastrophe

If we want health stigma to fade, we all need to work for better awareness of the subtle ways of implicit bias. When zealous advocates catastrophize obesity, they add to implicit bias. They make the problem seem more daunting than ever, while disrespecting the individuals who are coping with it.

But health problems become less stigmatized when they are more manageable. Leper colonies faded away when leprosy became curable. HIV stigma faded when the infection became manageable. Instead of hyping the problem of obesity, we need more emphasis on opening doors to solutions.

For obesity, the options for dealing with it are multiplying. So we have the opportunity to take the edge off this daunting word. In this way, opening the doors for better access to care can play a role in tamping down the stigma of obesity.

Click here for more perspective on health stigma.

The Madness of Fear, painting by Francisco Goya / WikiArt

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May 10, 2022