Stigma, Shame and Obesity Rates
In a study published Tuesday, August 23, 2011, in BMC Public Health, researchers in Germany concluded that the stigmatization society puts on obesity perpetuates it. In a systematic review of the available literature, the study’s authors looked at three issues: how the lay public perceives people who are obese or overweight (stigmatizing attitudes), what the public attributes obesity to (causal attribution) and what types of interventions are supported by the public (prevention support).
In the past decade, only 2-3% of the population considered obesity to be one of the most important health issues, whereas now the majority recognizes the problem. However, as awareness of the problem grows, so does the level of stigmatization toward obese people, resulting in discrimination in areas such as interpersonal relationships, health care settings and employment opportunities. This discrimination is based on negative attributes, meaning obese people are seen as having negative character flaws.
The reason for this is the public’s association of causal beliefs and responsibility. Obese people are seen as having a disease that is under their control, and therefore have a greater responsibility for their status. This belief by the public leads to an emotional response, and discrimination is the result.
One of the reviews in the study found that obese people are consistently labeled as “lazy, unintelligent and unmotivated.” While these labels may seem obvious to many, what is not as obvious is the effect it has on public policy – which is less support of preventive and intervention measures. If the public were to become more supportive of measures that assist obese people, the burden that is currently on health care systems might be somewhat alleviated as financial investment increases. This support is critical to obviate a further rise in obesity prevalence rates.
Besides the lack of public support for help in combating obesity, the stigma placed on the obese has a major impact on their quality of life, including higher probabilities to engage in unhealthy eating and activity (82.4% attributed obesity to lack of activity; 72.85% listed overeating as the cause, and 65% cited lack of willpower). While this may seem logical to many, the result of feeling stigmatized is that the obese do not seek help and therefore decrease their chances of finding a successful path to weight loss.
The areas of public perception that were determined to show hope for future shaping of public policy and attitudes was in the area of external factors – 34.9% found heredity to be important, while 23.6% listed the lack of activity environments. Additionally, 53.8% agreed that a bad food environment could be one possible cause of obesity.
From the available literature (7 articles total were selected from an initial list of 1,042), it was determined that regulated prevention is supported by 42.4% of the population, while prevention of pediatric obesity has the highest approval rates, at 89.7%. Overall, until our culture addresses the shaming that occurs, change will be difficult.
The study concludes with two suggestions to decrease obesity rates – 1) information campaigns that increase the public’s awareness of the link between shame and recovery as a way to decrease prejudice, and 2) more effective coping strategies for the obese.
Sikorski, C. et al. 2011. The Stigma of Obesity in the General Public and its Implications for Public Health – a Systematic Review, BMC Public Health, 11:661.