Facts, Narratives, Stigma, and Food Addiction

In some circles, food addiction is a wildly popular idea. It’s useful for painting ultra-processed food and the food industry as villains in a narrative about obesity and why we have so much of it. Some people think that promoting narratives about food addiction might help to reduce the stigma attached to obesity. In fact, a new paper in Obesity Research and Clinical Practice seems to support this idea. But there’s a small problem with that.

Pesky facts keep getting in the way of those food addiction narratives. Telling an appealing story is a good start for any effort to move public attitudes. But at some point, facts really do matter.

A Study of Fitness Professionals

The latest study purported to support this idea examines the anti-fat attitudes of fitness professionals in New Zealand. Researchers recruited a sample of 249 of them and randomly assigned each of them to one of four experimental conditions. One group read a description of obesity as food addiction, for another the description framed it as a disease, and another used caloric imbalance to describe it. Then the fourth group was a control group that read unrelated material.

The researchers report anti-fat attitudes on three different subscales: dislike, fear of fat, and willpower. Comparing all four experimental groups they found no differences on those subscales, except for one. On the willpower subscale, professionals who read the addiction narrative registered less bias than those who read the disease narrative. But each of those groups were no different from the control group or the group who read the traditional caloric balance story.

On every other measure all four groups registered the same degree of bias across the board. In other words, for the most part, on most measures of bias, framing in this experiment made no difference.

Narratives Only Go So Far

Fiona Quigley is a PhD researcher working on weight-related communication in healthcare. She was not involved in this study and expressed some dismay at the premise of it:

“By framing obesity as food addiction it seems fitness professionals are less likely to show stigma versus framing obesity as a disease. Think about that for a minute – we change framing of something to fit with what people know more about (addiction) and that allows them to be less discriminatory.

“Nevermind that there is no real evidence or even agreed definition of  ‘food addiction.’ And we already know that there are multiple drivers for variations of higher and lower weights.

“But sure – never let evidence get in the way of a sellable narrative.”

She makes an excellent point. Narratives break down in the absence of solid facts to support them. Trying to frame obesity based upon what feels good to us simply won’t work in the face of facts that are more enduring than the story that seems popular in the moment.

Addiction may be some part of the story for the chronic disease of obesity for some people. But it doesn’t work as an overarching narrative because obesity etiologies are much more complex and they’re very different in different people.

Truth and facts matter.

Click here for the study in Obesity Science and Clinical Practice, then here, here, here, and here for further perspective.

Boy Reading Adventure Story, illustration by Norman Rockwell / WikiArt

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September 7, 2022