Obesophobia: Dealing With the Stigma of Being Overweight 

Dr. Christopher McGowan
September 6, 2022

According to the National Institutes for Health (NIH), more than 70% of American adults are either overweight or obese. Moreover, research continues to show that being overweight or obese is connected to numerous negative health outcomes and diseases like type 2 diabetes, heart disease, stroke, liver disease, and some types of cancer. Yet even as the prevalence of obesity continues to rise in this country and around the world, the aspect that most often motivates people to make a change is the stigma of being fat. This concern is familiar to many people, but in some cases it can grow into an obsession called obesophobia.  

What is Obesophobia?   

The term obesophobia (or sometimes pocrescophobia) generally refers to an anxiety disorder that is characterized by an intense fear of gaining weight or being overweight. Everyone has some aversion to gaining weight, of course, but a person with obesophobia is obsessed to the point of taking extreme measures like starving themselves or constantly exercising. Indeed, obesophobia is often associated with eating disorders like anorexia nervosa and bulimia nervosa. Even when these extreme measures lead to malnourishment and underweight, they will still be afraid of weight gain. 

Obesophobia is usually both irrational and inexplicable, especially because those who suffer with this condition are not actually obese or even overweight. In fact, one early sign of obesophobia is a hatred for people who appear to be obese; ridiculing others is often merely a way of covering over a deep inadequacy. In order to manage and cope with all of these feelings, obesophobes may use a variety of strategies: 

  • exercise excessively and vigorously 
  • bring their own food elsewhere so they can always control what they eat
  • eat only small portions or skip meals (anorexia nervosa)
  • binge eating and then purging (bulimia nervosa) 
  • regularly criticize themselves 
  • avoid social activities that involve eating
  • spend substantial amounts of time and money in order to look or feel thinner

Anxiety disorders like obesophobia involve irrational fears that probably seem silly to observers, but they are genuine emotions that can seriously impact a person’s quality of life. And because people who suffer from a phobia tend to avoid talking about it, it’s hard to say how many people are affected. However, the NIH estimates that about 12% of adults will experience a specific phobia at some point during their lives. Obesophobia itself is most common in teenage girls, but it can happen to anyone at any stage of life.    

What Causes Obesophobia?    

Like all phobic disorders, the cause of obesophobia is difficult to identify, and it usually looks slightly different for different people. There are, however, a number of factors that seem to be causative or contribute to the development of the phobia: 

  • Emotional trauma: One of the most commonly reported experiences associated with obesophobia is emotional trauma. This can include being teased or bullied during childhood for appearing heavier in relation to other kids. Sometimes even one specific incident can be disruptive and leave an emotional scar for years.    
  • Other anxiety disorders: Obesophobia is one type of anxiety disorder, but other types can be a precursor. Someone with social anxiety, for instance, may already be in great turmoil about being rejected by society in some way; fear of gaining weight can then add an additional layer of anxiety.  
  • Genetics: There is some research that suggests phobias may be partially based on genetics. So if a family member has obesophobia, you might be more likely to develop it as well.  
  • Stigma: In many cultures around the world (perhaps particularly in the U.S.), a great emphasis is placed on body image and being perceived as thin or athletic. These social pressures can come from peers, parents, teachers, or anyone else who has influence over us during our formative years. The strong urge to “fit in” and avoid criticism can be powerful and many people feel significant anxiety as a result.   

Symptoms of Obesophobia         

As noted earlier, there are a significant number of Americans who are overweight or obese, and this fact translates into a lot of people trying to lose weight; by some estimates, more than half of adults are trying to lose weight at any given time. But just because someone wants to lose weight doesn’t mean it has become a debilitating phobia. Beyond an obsession with weight loss, there are some other telling signs and symptoms of obesophobia: 

  • indigestion (dyspepsia) 
  • chills or trembling 
  • lightheaded or dizzy
  • nausea
  • heart palpitations
  • shortness of breath 
  • excessive sweating 

Conditions Related to Obesophobia  

Obesophobia is a term that describes the underlying fear of gaining weight, but that fear can then manifest in different ways. One of these ways is anorexia nervosa, an eating disorder that can be thought of as an escalation of obesophobia. Anorexia often involves having a distorted view of one’s body that drives a desire to highly restrict food intake. People with anorexia can get dangerously thin and still believe they need to lose more. In extreme cases, the lack of sufficient nutrition can lead to problems with multiple body systems and eventually organ failure or even death.  

Another common type of eating disorder is bulimia nervosa, a condition that is characterized by repetitive cycles of binge eating and then purging. People with bulimia tend to ravenously consume large quantities of food (usually in private) in short eating sessions; these are followed by a comparably aggressive purge session that can involve fasting, intense exercise, or forced vomiting. There is also a related condition called purging disorder, but it includes all the purging behaviors without any of the binging.    

Treatment for Obesophobia

Part of the stigma of being overweight is that the person is lazy or has no self-control; as a result, this kind of condition can sometimes be dismissed as not really a problem. Yet obesophobia and related eating disorders are serious conditions that can take a lot of time and patience to address. Most treatment options for obesophobia involve some form of psychological therapy: 

  • CBT: Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on the connection between thoughts, emotions, and behaviors. The goal is to help people replace negative thoughts about themselves with more constructive ones. Over time, this can promote a more positive and healthy relationship with food. 
  • Exposure therapy: The aim of exposure therapy is to help people gradually—and in a safe environment—confront their fears. For obesophobia, this might involve looking at photos of people at different weights or looking in the mirror. Eventually a person can learn to become desensitized to the fears that once dominated.  
  • Medication: Antidepressant or anti-anxiety medications can help reduce some of the symptoms related to obesophobia. Medications like this aren’t meant to be a cure, but they can be helpful when paired with talk therapy.   

Freedom is Waiting! 

For so many reasons, the relationship we have with our body weight can be a major challenge in life. Both the fear of obesity and obesity itself can feel like being trapped. That’s why at True You Weight Loss, we are passionate about providing weight loss solutions that can give you a new direction with new hope for long-term weight loss. Instead of fad diets or punishing exercise programs, we offer weight loss procedures like ESG that give you the help you need to make a change in your life. To learn more about True You and what we do, please contact us today to request a consultation

Dr. Christopher McGowan
Dr. Christopher McGowan

Dr. Christopher McGowan, MD, a leader in endobariatrics, specializes in non-surgical obesity treatments and is triple-board-certified in Internal Medicine, Gastroenterology, and Obesity Medicine. Renowned for pioneering endoscopic sleeve gastroplasty (ESG) with over 2,000 procedures, his global influence and research contributions define him as a top expert.

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