Happier and Heavier: Benefits and Costs of Labeling Obesity as a Disease


Obese individuals are less likely to reduce calorie intake when presented with a disease-based message of obesity.

Being fat in America comes with more costs than your health. Fat people are discriminated against, stigmatized and often perceived as lazy or unwilling to take control and responsibility of their lives. Due to society’s perception of what it means to be fat, obese individuals often face dissatisfaction with their bodies and personal blame. In June 2013, however, the American Medical Association officially labeled obesity as a disease. One intended result of doing so was to reduce the personal blame that obese Americans tend to experience. Curious about how the new public health approach would affect obese individuals, researchers from the University of Richmond and University of Minnesota conducted a study to investigate potential costs the disease-based public health messaging may have.

As was predicted, the study, which was recently published in Psychological Science, found that obese individuals have a more positive self-image when they were presented with information about how obesity is a disease than when  presented with no such information or information about why it is not. The researchers labeled this as a decreased concern for weight, which they then predicted would cause individuals to make unhealthier food choices. In fact, participants chose sandwiches that were higher in calories after being told about why obesity is a disease, even when presented with additional information about the importance of exercise and healthy eating. The researchers claim that that while they fully recognize the benefits of labeling obesity as a disease, the new public health messaging might not help reduce caloric intake.

So the question appears to be, is it more important for obese individuals to have a positive body image or to be motivated to lose weight? Before jumping to a conclusion, it would be beneficial to investigate whether the answer has to be so black and white. Indeed, I would argue that the study’s measurements for healthy behavior might not actually be entirely valid. First, the use of caloric intake in sandwiches seems outdated.  While calorie intake certainly correlates with weight, it is not the definitive factor of what classifies a food item as  healthy or unhealthy. What’s more, the study emphasizes dieting, which previous studies have shown to be only a temporary solution to weight management and can actually cause more harm than good, such as a decreased self-esteem. On the contrary, a positive self-image likely correlates with positive self-esteem, which could lead to healthier habits in the long run.

The researchers claim that while they recognize the benefits of the new approach,  labeling obesity as a disease has “weakened the importance placed on health-focused dieting and reduced concern about weight among obese individuals—the very people whom such public-health messages are targeting.” However, perhaps the obese individuals are not the primary, or at least only, people the message should be targeting. Instead, reducing stigma amongst the entire population, fat and thin, may producer greater positive outcomes for the obese individuals and matter more in the long run. The point is, scaring the individuals out of their obesity by motivating them through negative emotions may lead to greater weight management temporarily, but the long term effects cannot yet be determined. While the findings may be beneficial for making future decisions, they should be taken with caution.

Hoyt, C.L., Burnette, J.L., & Auster-Gussman, L. (2014). “Obesity is a disease”: Examining the self-regulatory impact of this public health message. Psychological Science, 25(4): 997-1002. DOI: 10.1177/0956797613516981

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