Well-Meant, but Promoting Weight Bias and Discrimination
“We must support people living with obesity by educating them about healthy lifestyles.” This is #4 in a series of well-meant statements that promote weight bias and discrimination.
Such a statement purports to mean well. But there are so many problems with comments like this that it’s difficult to summarize them all in a short post.
A Simple Lack of Knowledge?
For one, this statement obviously implies that people living with obesity simply lack “knowledge” about what is healthy. Therefore they need to be told what to do or not to do.
This flies in the face of the many people living with obesity I’ve met who could probably write books about healthy eating and the benefits of exercise (not to mention those whose actual eating and activity habits are substantially better than mine).
This comment also assumes that an “unhealthy lifestyle” is the root cause of their problem. That providing people with “knowledge” will somehow “empower” them to change their behaviours, thereby solving their dilemma.
Thirdly, this comment ultimately puts the onus on the person living with obesity. “Now you have the “knowledge, it’s up to you to do it!”
More Than Lifestyle
I could go on. But the point is that such statements, although well intended, do little more than to perpetuate the notion that obesity is simply a “lifestyle” problem. That making people aware of their “misbehaviour” and providing them with “information” will make a difference.
The very same people making these statements would probably laugh at me if I were to declare that all people living with depression really need is for someone to finally explain to them the importance of being happy, being more motivated, and seeking out enjoyable activities.
This is not to say that people living with obesity will not benefit from learning about their disease (in the same manner that someone living with diabetes or depression needs to learn about their disease and how to manage it).
But suggesting that education regarding “healthy lifestyle” will be enough to solve their problem, is not only disingenuous. It is frankly insulting!
Thanks to Arya Sharma for today’s guest post and for his outstanding series on well-meant expressions of weight bias. You can find more from this series here, here, here, and here.
Whispering Eve, painting by William Gilbert Foster / WikiArt
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March 12, 2024
March 12, 2024 at 7:13 am, Michael Jones said:
Arya, good post. Thanks. While I agree, there are so many scattered and confused thoughts and ideas bombarding our patients who, as a result, often do not really know the better choices to make, they do need sound, consistent guidance as they endeavor to avoiding throwing more “gas” on the obesity “fire” that already exists separate from their choices.
March 12, 2024 at 7:29 am, Dara Clark said:
Amen! Many of us do all the things and still do not achieve the body composition that others do without lifestyle and education!
In fact I have lived long enough to see the “smug slender” find themselves facing obesity and it wasn’t pretty. They had no idea what to do with their excess weight and hadn’t spent a lifetime “learning” all the things like so many of us living with obesity.
March 12, 2024 at 8:59 am, Susannah Southern said:
This approach also leads to disillusioned clinical nutrition providers who have gone into healthcare with the notion of being able to help people by providing this “knowledge”. Their patients often continue to struggle with weight despite the “help”.
Even if clinical nutritionist/dietitians don’t specialize in obesity care, they are often asked to “educate” patients about achieving a healthy weight. I’ve seen a look of dread come over a college’s face when they are about to have this type of consult. It is often because they know that educating patients and families doesn’t magically lead to a healthy weight. It’s much less “effective” and satisfying than when dietitians are writing a new pediatric formula recipe, or going over a list of gluten containing foods with a patient in GI clinic.
Yes, there is benefit from seeing nutrition providers for obesity, but it is a supporting role and needs to be part of comprehensive obesity care. Nutrition students who are considering this specialization should be clear-eyed about this aspect of care.
March 12, 2024 at 9:24 am, David Brown said:
But what if people living with obesity are getting the wrong sort of dietary advice from officially-sanctioned sources? And what if the food supply itself is obesogenic? “Over the last half-century, the modern human food chain has emphasised omega-6 and diminished omega-3 intake, largely because of: (i) a shift from animal fats to vegetable oils, (ii) an increase in grain-fed meat and dairy, and (iii) a decline in full-fat dairy products from grass-fed livestock (an important source of omega-3). In the opinion of the current author and others, these diet trends are likely to be responsible for the increased incidence of obesity and other modern epidemics of chronic disease. https://pubmed.ncbi.nlm.nih.gov/33914036/
Hulbert The under-appreciated fats of life
March 12, 2024 at 3:36 pm, MONICA BHAGWAN said:
Can the framing be around, here is how you navigate a culture and commercial environment that doesn’t prioritize your wellbeing and health? I think that is potentially much more useful and truly empowering. I.e. marketing misleads us so we must become more savvy about marketing and media, food manufacturers create products that override our ability to judge our own intake so we may want to be more aware about food formulations, our culture taxes our bodies which leads to a metabolism altering stress response so we need to protect our nervous system, and our food environment capitalizes on this stress response. Its a different tone that lays the onus where it belongs but allows people to live in a way that combats this.