I decided to write a post on fat shaming because I feel it became quite prevalent in our society. Many blame persons with overweight or obesity for their condition and spontaneously assign them other negative qualities such as poor motivation, lack of control and willpower or ever stupidity. But what is obesity and where can we look for its causes? And why is weight stigma a big issue?
Obesity is characterized by excessive accumulation of body fat and is currently becoming such a big issue that it has replaced malnutrition as the most prevalent dietary contributor to poor health worldwide. It is also putting people at risk for many cancers, it contributes substantially to deaths from cardiovascular disease and is tied to hypertension, Type II diabetes, atherosclerosis, and heart failure. It is the chief cause of disability. Furthermore, people with excessive abdominal weight (that is, weight centered on the stomach) are more psychologically and physiologically reactive to stress. This means that stress puts them in a poor mental shape as well as increases their heart rate, nervousness, or shakiness. The problem of obesity is most severe in the United States and will soon account for more diseases and deaths in the US than smoking. But why have we become so heavy?
It is no secret that soda consumption has skyrocketed, daily calorie intake rose substantially, snacking and portion sizes have increased over the past 50 years. However, obesity is far more complicated than that - it's not a simple product of little or no exercise and a poor diet. There are so many other factors that influence a person’s weight. The factors may range from daily emotions, such as anger, sadness, emptiness or happiness, to stress, patterns of sleeping, social engagement and/or a fulfilling life. It’s important to remember that your worth is never determined by your weight. Overweight doesn't necessarily mean unhealthy and skinny doesn't necessarily mean healthy. A thin person could also have low weight as a result of excessive smoking, sleep deprivation, unhealthy food patterns or lack of exercise.
When trying to understand food patterns and obesity, it is mandatory to understand the role of protein leptin. This protein is secreted by fat cells and signals whether the body has sufficient energy stores or if it needs additional energy. In case our body needs additional energy, a brain structure called hypothalamus sends a message that we recognize as hunger. Leptin is important as it activates neurons that suppress appetite and thus informs us when we’re full. Many people with obesity have a leptin deficiency and therefore, never get the signals that they are full and should stop eating. That’s why they seem to be always hungry and never fully satisfied. Up to date, there is no definite cure of leptin deficiency.
Dieting contributes to the propensity for obesity. Repetitive cycles of dieting and weight gain, called yo-yo dieting, lower the metabolic rate and result in unhealthy eating patterns. Dieting has many risks. For example, low-carbohydrate or low-fat diets help people lose weight initially, but these diets are the hardest to maintain and as a result, people commonly revert to their old habits.
Moreover, dieting might actually increase stress and elevate levels of stress hormone (cortisol). This can cause weight gain and that leads to the paradoxical effect of dieting. Instead of the intended outcome of weight loss, it results in gaining weight. Therefore, dieting seems to harm both psychological well-being and biological functioning.
There are without doubt genetic contributors to obesity. However, genetics commonly interact with a vigorous feeding style that is learned early in life and sedentary activities, involving television, video games and the internet. Genes also influence the number and size of an individual’s fat cells. Among moderately obese people, fat cells are typically large, but there is not an unusual number of them whereas among severely obese, the number of fat cells and the fat cells themselves are exceptionally large. Many persons with overweight or obesity have high basal insulin levels, which are genetically predisposed and promote overeating due to increased hunger.
Another relevant thing to mention is the set point theory of weight, which encompasses an idea that each individual has an ideal biological weight that cannot be greatly modified. A person eats when his or her weight gets too low and stops eating as the weight reaches its ideal point. Some people have a higher set point than others do, leading to the risk of obesity. This theory can also explain why dieting doesn't work: when dieting you come below your ideal weight so it's your body responding when you subsequently overeat. It's the body's attempt to get you back at your genetically predisposed weight.
Stress affects eating but in different ways for different people. Some may eat more when under stress and some might eat less. For adults with overweight or obesity, stress and anxiety usually result in greater food consumption, therefore removing self-control that usually guards against eating. Moreover, stress also influences what food is consumed. People eating in response to stress usually choose more salty low-calorie foods. People who eat in response to negative emotions show a preference for sweet and high-fat foods.
On a long term, a stressful job or difficult living conditions often lead to unhealthy choice of foods. If constantly under stress, you’re more likely to eat comfort foods on a daily basis therefore bringing unhealthier patterns into your diet. Furthermore, stress might influence exercise or sleeping patterns, which is my next point.
Sleep is another factor that can have an effect on your weight or shape of your body. Sleep deprivation can result in muscle loss (read more about sleep deprivation here). Some obese people have an altered sleep pattern, whereby they work when others are sleeping. This is especially common for professions that require working in shifts and can adversely influence food consumption and eating patterns (for example, doctors, nurses and security guards). It messes with our biological circadian rhythms and consequently, changes our health habits.
Weight stigma is discrimination or stereotyping based on a person’s weight. Obesity is stigmatized in our society and fat shaming is not an unusual occurrence. Social consequences also contribute to stigmatization of obesity. Such are, for example, that an obese person may have to pay for two seats on an airplane, have difficulty finding clothes or have to endure rude comments. People commonly blame people with obesity for their condition. Even health providers may hold these stereotypes. Studies have shown that as a consequence, persons with overweight or obesity are less informed about treatment options, are thought to have no willpower, no self-control, and are believed to have difficulty sticking to healthy lifestyle. If everybody in the environment holds these prejudices, obese people are more likely to believe them as well. Repeated exposure to others’ judgements about their weight commonly results in low self-esteem and social alienation.
Obesity and mental health
Despite the stereotype of people with overweight being “jolly”, research suggests that obesity is more commonly related to psychiatric conditions, especially depression, anxiety and disordered eating. People who are depressed are more likely to gain weight, and people who are obese or overweight are more likely to be depressed. Because of weight stigma, obesity often negatively influences a person’s self-esteem and sense of worth. It can be damaging to self-concepts or even cause a poor relationship with food. An unhealthy relationship with food is associated with fear and guilt around food. People with obesity might often feel guilty if they enjoy a bar of chocolate or some chips or even feel anxious before meals. This more often than not leads to restrictions and restrictions are psychologically linked to binging. If you’re not allowed to eat something, you will very likely want it even more. This commonly results in binging on foods high in sugar or fat, the “forbidden foods”. Binging can be an early indicator of disordered eating and can soon become a serious psychological problem or disorder.
What can be done in the future?
Positive media portrayals of overweight people can help mitigate the stigma. A few years ago, no overweight or obese people would ever appear in movies, TV shows, or advertisements. Normalizing all body shapes and sizes is the first step to eliminating weight stigma.
To sum up, concluding that people with obesity or overweight don’t exercise enough or have unhealthy eating habits is far too simplistic. There are so many more factors that influence an individual’s weight, and shape of body, including sleeping patterns, stress, living conditions and well-being. Please, don’t laugh at people with overweight eating snacks or judge them for eating foods high in sugar or fat. That’s straight up mean. You don’t know what they ate earlier that day, you don’t know what they might be going through, you don’t know anything about their health habits or their lifestyle. Let’s be kind to one another.
If dieting does not work, what will? Lifestyle change. Rather than restricting calories, changing one’s diet permanently in a way that involves more fruits and vegetables, less starch and smaller portions, coupled with regular exercise will more likely lead to sustainable weight loss. Lifestyle change also involves a shift to optimism, forming and maintaining meaningful relationships and finding joy and interest in everyday activities. Changes in health habits should be gradual and sustainable. Let’s aim to live a healthy and fulfilling life!