Obesity revisited- It’s time to reframe, not blame

In two recent posts (links below) I introduced the medical topic of obesity because-

It is a major concern in the medical community

it is covered extensively in the media

many people are interested in it

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One  reader’s comment caused  me to pause, reflect and realize I need to make a clarification right up front. His comment stated,

“I know this topic is important but it seems society has resorted to fat-shaming while idolizing anorexic-looking people. What do you think?” 

Unfortunately, I do agree. People who are overweight have been the subject of jokes, sitcoms, movies. Obese children and teens may be the victims of bullying and ridicule. The fashion world tends to market chiefly to normal or even thin people, especially women’s clothes.

Even the medical community has been guilty of assuming that obesity results merely from lack of will power, motivation and valid attempts to lose weight. In an editorial in The American Journal of Medicine titled “A Candid Discussion of Obesity”, Dr. Robert Doroghazi wrote,

“Sir or Madam, it’s not OK to be obese. Obesity is bad. You are overweight because you eat too much. You also need to exercise more. Your obesity cannot be blamed on ..anything else. You weight too much because you eat too much. Your health and your weight are your responsibility.”   ( 2014.09.24)

The rest of Dr. Doroghazi’s editorial was equally blunt, and he does make some valid points. These include

  • Little progress has been made in the fight against obesity.
  • The work of obesity advocacy groups has helped to destigmatize obesity.
  • The various “causations” of obesity keep shifting focus- fast food, soda, television, computers, government, society in general.
  • We need new ideas and directions about solving this problem.

One conclusion he mentions more than once is probably most important- a person’s health and weight ( but not limited to their weight I would add) is one’s personal responsibility. But that  should be true for any medical condition- whether one seeks out the care of a healthcare professional or not, ultimately it is each of our responsibility to get what we need to treat illness and stay healthy.

Telling someone they need to eat less is a start. But the next step is to explore the reasons why that person eats more than they need; not to assign blame, but to reverse the factors that perpetuate the unhealthy behavior. The same goes for exercise; identify what are the barriers to exercise, or what can create an environment more conducive to physical activity.

At a recent national forum on obesity, family physicians advocated for better ways of addressing obesity with patients, and recommended avoiding blaming.

“We don’t do it with other conditions,” Kahan said. “We don’t call people with cancer ‘cancerous’ or call people with depression ‘depressives.’ We should refer to ‘a patient with obesity’ rather than saying ‘he is obese.'”

Patients who struggle with their weight should be treated as someone in need of medical attention, not someone who made bad choices, observed another panelist.

“Obesity is not a sign of weakness or a lack of willpower,” said Don Bradley, M.D., M.H.S.-C.L., from the Duke University Department of Community and Family Medicine. “It is a condition.”

 

I’ll be posting content reviewing obesity management, what works, what doesn’t and what may be used in the future. Here are the previous posts in case you missed them.

What is obesity and why it matters

Waist size matters

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