Obesity is “not a choice” and fat shaming does not help, says British Psychological Society

Obesity is “not a choice” and making people feel ashamed of their weight only leaves them feeling worse about themselves, according to a new report from the British Psychological Society (BPS). The BPS recommends that healthcare professionals should be trained to discuss weight loss in a more supportive way.

The report calls for changes in how people regard obesity, suggesting that less reference is made to “obese people” and that people are instead discussed as  “people with obesity” or “people living with obesity.”

Experts behind the study also suggest that the obesity epidemic should be approached in a similar way to how smoking has been approached.

Obesity is a complex condition

The report states:

"Whilst obesity is caused by behavior, those behaviors do not always involve ‘choice’ or ‘personal responsibility'. This cannot be explained by a sudden loss of motivation across the four nations of the UK. The increase in obesity can, in part, be attributed to changes in the food supply and physical activity environment."

The report explains that people become overweight or obese as a result of a complex combination of factors such as childhood stress, genetics, poor food choices and sedentary lifestyles.

Between 2015 and 2017, the prevalence of obesity increased by 18% in England and by a similar percentage in Scotland, Wales, and Northern Ireland.

Today, just over one-quarter of the UK adult population is obese and two-thirds are either overweight or obese.

However, these increases cannot simply be explained by a lack of motivation and will power, says the BPS. The report concludes that the situation is far more complicated than what the negative stereotypes suggest.

Changes should be informed by psychology

Angel Chater, a chartered psychologist at the University of Bedfordshire and one of the report’s authors, says that to address the problem, we need to understand how weight management and behavior changes for obesity prevention are informed by psychology.

The report says that the people who are most likely to be an unhealthy weight are those with an increased genetic risk for developing obesity and those whose lives are also shaped by work, school and social environments that promote overeating and inactivity:

"People who live in deprived areas often experience high levels of stress, including major life challenges and trauma, often their neighborhoods offer few opportunities and incentives for physical activity and options for accessing affordable healthy food are limited."

Psychological experiences also play an important role, says the report, with as many as half of the adults who attend specialist obesity services having experienced difficulties during childhood.

In addition, those living with major life challenges and traumas may be less incentivized to be physically active.

The report also discusses the phenomenon of “emotional eating,” and how people who diet a lot may be more inclined to overeat once they are feeling especially vulnerable.

'Fat-shaming' only makes the situation worse

According to the authors, the stress caused by fat-shaming in public health campaigns and by doctors, nurses and policymakers often leads to more eating and more weight gain.

Recently speaking out against a call for the return of fat-shaming, comedian James Corden said: "If making fun of fat people made them lose weight, there'd be no fat kids in schools."

Chater suggests that psychologists use their expertise to help train healthcare professionals to improve how they communicate about obesity. She and her and colleagues have also called on ministers to ensure that any initiative aiming to promote healthy weight is informed by psychological evidence:

To address obesity, we need an understanding of all its causes, biological, psychological and social, and use approaches to behavior change for prevention and weight management that are informed by psychology."

A similar approach to tackling smoking is needed

The report suggests the government should tackle obesity using the same approach it used towards smoking.

It has taken action at all levels for decades, from government policy to helping individual smokers, but we are now seeing significant reductions in the level of smoking and the health problems it causes.”

Sarb Bajwa, Chief Executive, BPS

The government acknowledged that obesity was a threat to the health of the nation back in 1991, says Bajwa, yet the problem has only continued to worsen: “We need a similar effort on obesity to the one we have seen on smoking.”

Like Chater, Bajwa thinks that psychologists have the science and clinical experience to help the health service do the same for obesity: "We can help, not just by devising ways of helping individuals, but also by advising on public policy which will help create an environment in which people find it easier not to become obese in the first place."

The psychologists do not support the idea of obesity being classed as a "disease," since this could shift the focus away from behavioral changes that would otherwise succeed.

Obesity not caused by lack of willpower – psychologists. BBC News. September 24, 2019.