We've Lost the Plot on Obesity

When avoiding hurt feelings trumps reality and leads away from an emphasis on personal responsibility, we all lose.

by Rebekah Wanic

We need to reinvigorate an interest in cultivating personal responsibility and holding individual’s accountable for behaviors and their consequences. This creates an empowering environment where individuals are primed to work toward self-improvement and bolstered in taking action toward their goals. In an earlier piece, I mentioned that “behaviors and outcomes that should be uncontroversially acknowledged as related to some aspects of individual behavior, such as obesity, are being touted as ‘not the result of individual responsibility.’”

This conclusion - that being overweight is disconnected from individual responsibility - is an absurd denial of reality, unless we assume that the majority of overweight individuals are being force fed against their will and kept sedentary under duress. Like so many things that began with a good intention – here helping to reduce weight-related stigma - the campaigns to reduce fat-shaming and promote body positivity have now morphed to cause great harm by fostering the promotion of ill-health.

While it is important to recognize the layered influences that affect choices surrounding diet and exercise, a renewed emphasize on the reality that excess weight as unhealthy and undesirable and under personal control is necessary. Obesity rates are astonishingly high and rising nearly everywhere, including the US, Canada, Latin America, Europe, Asia, and Africa. In a manner that is currently status quo, the alarm is sounded but the suggested causes and solutions move us away from reality, away from personal responsibility, and thus away from solutions.

The parasitic medical establishment is now recommending surgery and drugs for obese children. Why not recommend parental and child education classes that teach understanding of appropriate diet and physical activity instead? Why not put money into programming that promotes physical activity and accurate messaging about weight and personal self control? Perhaps because to do so would place the onus on individuals to control their behavior, something the victimhood narrative doesn’t allow for…and likely reduce medical profits. A child mutilated with surgery and hooked on drugs is likely to be a client for life.

Setting sinister motives aside, the argument of “healthy at any size” doesn’t hold up to scrutiny and results in almost comical side-stepping and word twisting to ensure impediments to saying what is true – that carrying around excessive weight is bad for your health. To acknowledge this is not to advocate, as many would have you believe, that there is no room for variation in body size, that only thin people have value, or that we should actively disparage those who might be struggling with the burden of extra pounds. It is rather to adopt a position that comports with reality, irrespective of whether it might hurt someone’s feelings, with an orientation toward improving health, promoting personal empowerment, and reducing societal costs. Perhaps the temporary unpleasantness associated with the truth will motivate people to take action.

Instead, however, the brigade that places feelings as paramount fights to perpetuate harm. For example, rather than discuss the importance of understanding medical science and focusing on dietary changes, a dietician is more concerned with the stigma fat people face, suppressing the fact study after study demonstrates that “healthy at any size” is a myth. Evidence of just how skewed general perception of weight has become can be seen in a recent article expressing outrage that a new ride at Universal Studios is designed only for “thin people” because those with a waist over 40 inches cannot ride. It would be more accurate to state that the ride is only for “not fat” people, as a 40 inch waist corresponds to abdominal obesity in both men and women and carries with it a substantially increased risk for excess weight-related health problems.

Furthermore, actions that can be taken to reduce one’s weight – controlling the amount of calories consumed and engaging in increased physical exercise – are often derogated rather than endorsed. For example, going to the gym with the goal of losing weight had been labeled fatphobic. In fact, some advocates even argue that widespread fatphobia might be more harmful to health than being obese, ignoring the reality that if one wasn’t overweight, they would face the risks of neither.   

Health is of course complicated and managing weight is difficult, but the issue is not unsolvable. For comparison, we can look at smoking. The public health measures adopted against smoking have been quite successful in reducing rates, and include a variety of different policies, such as limiting where it is allowed, adding taxes to make the habit more expensive and in some cases, even going so far as to legislate bans. Concerted efforts were also made to associate smoking no longer with “being cool” but with being unhealthy and disgusting. The evidence demonstrates clearly that people responded to the change in incentives.

While many have argued against such policies as an infringement on individual choice, they offer a useful contrast to obesity. (The parallels are not perfect, since smoking can directly harm those nearby who choose not to engage in the activity.) There are many who take no issue with regulation of smoking because of its association with increased health risks. However, only 6.3% of smokers are likely to get lung cancer. Admittedly, this is just one of the tobacco-associated diseases, however, obesity-related morality is almost twice that of tobacco. Further, the risk of weight-related health problems in those who are overweight is exceptionally high, with only 29% of overweight adults being deemed healthy in one study compared to 70% of normal weight Americans.

We must recognize the harm and societal costs, including $150 billion in healthcare costs in the US alone, associated with our unwillingness to confront the realities surrounding the problem of excess weight. A plethora of medical data suggests that being overweight and lack of physical activity are not good for physical or psychological well-being. But claims of fatphobia have led many to espouse the view that doctors or members of the public who advocate for losing weight or suggest that extra pounds may be a factor in health-related problems are demonstrating prejudicial and discriminatory behavior toward heavy patients. Such a position does nothing to help promote healthier outcomes. It shifts the onus for change on the doctor as discriminatory and the public as fat shaming rather than on the patient to take ownership of their behavior.

It is time we change the narrative. While it is important to adopt a nuanced understanding of the role that environmental variables, such as easy access to unhealthy foods combined with more discretionary income to spend on food, play in supporting weight gain, it is also important to reinforce a healthy understanding of how much one should reasonably consume and cultivate a cultural ethos that endorses occasional rather than constant over-indulgence. Maligning those who speak the truth about weight at the expense of hurt feelings is not kind, it’s harmful. Let’s put our efforts into helping cultivate healthier habits that begin and end with the individual and their choices, empowering them to take action toward improvement instead of supporting them in unhealthy ones.

Weight loss is hard, but it is made harder when those who should be providing help instead enable and actively undermine personal motivation. Placing the emphasis on weight control outside of personal responsibility does nothing to foster a “can-do” mindset in those who are struggling and impedes development of policy and interventions that might help support them in this goal. It is time to stop placing immediate feelings above long-term health and reinvigorate the empowering idea that weight loss is possible, and the source of change resides first and foremost with the individual.