If someone tells you, “Don’t think about a blue unicorn,” what is the first thing that comes to mind? Likely as not, it will be a strangely colored mythical creature. As silly as this example is, it illustrates a concept that is applied in far more consequential ways—that negative motivations or suggestions often produce the opposite of the intended result.
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.
It turns out that, contrary to popular sentiment, social cues that tell people to “not be fat” turn out to work the same way. An increasing number of studies are showing that fat shaming—a blanket term for many types of stigmatizing language and behavior, negative motivations, social pressures, and messages designed to make people feel bad about being fat—can actually contribute to people gaining weight rather than losing it.
What is Fat Shaming?
Fat shaming is a term that covers many different types of behavior and messaging directed at people of high body mass index, or BMI. These individuals fall in a category that has historically been defined as either overweight or obese based on their body composition and a calculation based on the relationship of their weight and height.
Fat shaming can take many forms. It can be well-intended comments from family members trying to pressure an individual into losing weight. It may come in the indirect form of social media or traditional media messaging filled with pictures of “ideal” body types that in reality only represent a small slice of the population. Fat shaming can also occur in medical contexts where physicians incorrectly or summarily assume high body weight is the cause of a patient’s symptoms rather than conducting a more thorough examination to determine the underlying cause of symptoms.
People who are subjected to fat shaming are more likely to experience a range of negative physical and psychological effects including:
- low self-esteem
- eating disorders
- chronic stress
- anxiety
- weight gain
That last bullet may surprise some people, but the link between fat shaming and weight gain is more straightforward than it may seem to people who have never struggled with the challenges of excess body weight.
There is ultimately a difference between fat shaming and helping people find the tools and techniques to achieve lasting weight loss. The former, rooted in weight stigma, is often comprised of negative reinforcement, shame, critique, and condemnation. The latter is focused on providing positive frameworks, reinforcements, and motivations to help people achieve positive results and come to understand what is healthy for their body rather than merely fitting a social norm.
Why Fat Shaming Doesn’t Work
Being exposed to negative images, stereotypes, and messaging about your body size can have serious effects on a person’s mental and physical well being. This extends from teasing and bullying in childhood to even more serious challenges like workplace discrimination later in life.
The stress of fat shaming can trigger drops in self esteem which can, in turn, lead to eating disorders such as overeating or binge eating resulting in further weight gain. Stigmatizing messaging from family members, social media, and even health care professionals have been shown to result in increased stress, anxiety, and even further weight gain.
One of the ways negative pressure on people with larger bodies can bring about weight gain instead of loss is in unproductive and unhealthy weight loss practices. Trying to lose too much weight too fast often carries a component of severe caloric restriction that can deprive your body of nutrients it needs to stay healthy. What is more, unstable dieting can lead to rebound weight gain, as well as a host of other health issues brought on by large, repeated fluctuations in body weight over time.
Body Shaming and the Causes of Obesity
Understanding why fat shaming doesn’t work requires a look at the root causes of obesity. It is often incorrectly assumed that people who have a higher BMI are simply lazy or stupid, implying they have chosen to be the weight they are. This thinking denies many important realities such as the web of links between poverty, ethnic background, availability of quality food, and access to recreation.
When these conditions are present in childhood, as is the case in lower-income urban areas, increased body weight through the adolescent years can be more common. This weight is often carried through the rest of life, meaning many people are starting out fighting an uphill battle against their weight independent of their decisions later in life.
Psychological factors can also play a role in long-term weight gain. Attempts to achieve or maintain dangerously low body weight associated with conditions like bulimia or anorexia are somewhat well known, but these diseases are not the only forms of mental health conditions that can affect a person’s weight. Compulsive eating or binge eating are just two examples of conditions that result in excessive caloric intake.
Where these conditions link to fat shaming is in what triggers unhealthy eating behavior. Body shaming creates psychological stresses associated with low self-esteem and social isolation. This can be enough to cause someone with an eating disorder to either engage in unhealthy dieting or eating behavior (which may lead to rebound weight gain later), or to turn to food as a source of comfort.
Obesity and Medical Care
When talking about weight gain, or even using terms like obesity, it is incredibly important to make a clear distinction between potentially harmful social norms and the medical reality of increased chances of cancer, heart disease, type 2 diabetes, and other diseases that correlate strongly with a high body mass index.
Talking about fatness can be an area of difficulty for both patients and medical professionals. Health care providers are often responsible for communicating hard medical facts about health issues, but body weight is not the only potential challenge obese people might face. Many people in larger bodies report avoiding or delaying medical care as a result of physician attitudes toward body weight that result in body shaming.
It is not uncommon for people who maintain a high BMI to report medical professionals dismissing symptoms or failing to prescribe appropriate diagnostic techniques until patients lose weight. In many of these cases, physicians will attribute pain or other symptoms to excess weight, dismissing patients and requesting they lose weight before further treatment is undertaken.
In a culture of increasingly vocal weight bias, body shaming can increase intense stress and anxiety. This chronic stress of feeling pressure about body size can contribute to a high allostatic load, a measure of the amount of cortisol and epinephrine in your body as a result of your natural “fight or flight” stress response. Higher stress loads can also lead to trouble sleeping, which is also linked to weight gain. This is all part of the complex picture research has shown on the links between stress and weight gain.
Finding Freedom from Excess Body Weight … the Healthy Way
Being shamed into losing weight is not healthy, but maintaining a high amount of body fat can also negatively affect your long-term health, and could even threaten your life. For many people, losing weight could improve their health and wellbeing if it can be done in a way that is not psychologically or physically damaging.
One of the first steps to achieving and maintaining a healthy weight for you is knowing how to evaluate your overall health. Using body weight alone as the metric for health success is a mistake for many people. Looking at eating habits, body composition, cholesterol levels, blood pressure, and other health markers can give a better picture of someone’s actual state of health rather than simply checking the number on the scale.
Getting a handle on your health, and finding healthcare professionals who can care for you in a positive manner, has never been more important. For the last several years, there has been increasing attention in traditional media coverage and social media of the American obesity epidemic. This has only increased during the COVID-19 pandemic as preliminary research shows links between body weight and health outcomes for people hospitalized with the novel coronavirus.
Recent data from the CDC and others highlights the importance of clearing the air about when body weight affects health outcomes and when it doesn’t. Individuals who maintain a higher BMI are sometimes at increased risk of certain serious medical conditions, but they must trust that their physician is making clear distinctions between these scenarios and those when body weight is not a contributing factor.
At True You Weight Loss, we understand what works and what doesn’t about finding freedom from excess body weight. Every person’s journey with their body size is different, and the goals, motivations, diets, and outcomes someone should consider are unique to them. That is why we work hard at helping people understand where they are starting from and what they can achieve in their weight loss journey.
If you are looking to explore your weight loss options in an environment that places a high value on positive outcomes, request a consultation today with True You Weight Loss.
