Fatphobia, or prejudice against people with obesity, is all over the place in America. Have you ever seen it on TV, heard it from a friend, or thought it yourself? (Be honest.) Someone with obesity enters the room or crosses the street, and the comment made — or thought — is, why don’t they just stop eating?
This judgment comes out of the notion that overeating causes obesity. And we blame overeating on a person’s lack of self-control. When we see a person with excess weight, we draw the conclusion that they lack the stamina, strength, and motivation that everyone else has, with little to no effort.
We look down on them. We judge them. And, if we ourselves become obese, we turn all that fatphobia on ourselves.
Fatphobia & Myths About Obesity
But all of these conclusions and judgments are based on myths (or fatphobia), not facts. Recent science has found through a variety of studies that people suffer from obesity not from personal failings, but for built-in, biological reasons.
We spoke with board-certified obesity medicine specialist Catherine Varney, DO, to help us understand the truth and undo the fatphobia our culture cultivates.
You’re Wrong if You Think People With Obesity
…Lack Self Control
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It's not lack of will power. It's lack of normal levels of hunger hormones and neurochemicals that those without obesity have naturally.
Want proof? Varney points out how, “there are many people without obesity who do not choose highly nutritious food or exercise daily, yet they do not gain weight.”
…Should Lose Weight Faster
If you don’t have obesity, but you do sometimes add on unwanted pounds, what do you do? You go on a diet for a few weeks or months. You hit the gym. It’s not fun, but the effort and time required to get 5 to 10 pounds off is doable.
We tend to judge others based on our own experience, compared to what’s true for us. In this case, what works for people without obesity does not work at all for those with obesity.
For those who have a small amount of weight to lose, it's often possible to lose weight quickly through a combination of diet and exercise, Varney explains. “For those with obesity, losing weight at such a rapid pace is not only difficult but can be unhealthy. This is because the body has a hard time adjusting to rapid weight loss.
Trying to lose a lot of weight too quickly could lead to:
- Muscle loss
- Intense fatigue
- Hair loss
- Other health issues
…Can Lose Weight With Mind Over Matter
People can’t will themselves to lose weight. Positive thinking doesn’t dispose of fat.
When you have obesity, it affects your hormones. These are the chemicals in the body that regulate how hungry you feel, what foods you crave, and how your body uses energy.
If you have obesity, your hormones may:
- Slow down your metabolism, making it harder to burn calories
- Have a hard time regulating your appetite
…Need to Exercise
Conventional wisdom tells us a person can exercise off their extra weight. Hundreds of get-fit programs out there, from Jane Fonda to P90X, have been selling the idea that you can sweat off your weight.
For people diagnosed with obesity, aerobic activity is only one small part of weight loss.
“It’s no secret and well known in the medical literature that while exercise is of utmost importance for your heart, lungs, mind, and weight maintenance, it does little for weight loss compared to other more powerful tools,” Varney explains.
So What Does Work?
More recent treatment is directed at correcting your body’s abnormal response and levels of hormones through anti-obesity medications. These treatments are finally getting to the underlying physical dysfunction that we see in patients with obesity that make weight gain so easy and weight loss so difficult.
Losing weight for people with obesity is very different from losing a small amount of weight. Comparing losing 10-15 pounds to 50, 100, or more is like comparing a sunburn to a third-degree burn. You can usually care for a sunburn on your own at home. But you need specialized medical care and often more than one medical intervention to treat a severe burn.
Replacing Fatphobia With Supportive Healthcare
Treating obesity is a long-term process that requires a combination of physical, psychological, and emotional support. It’s important to remember that weight loss success is not determined by the number on the scale, but rather by the overall improvement in health and quality of life.
If you or someone you know is struggling with obesity, it's important to seek help from an American Board of Obesity Medicine physician or other healthcare professional with additional obesity medicine certification. These doctors have a whole toolbox of interventions that can help. They cover 4 areas called the 4 Ms:
- Meals - your diet
- Movement - activity and exercise
- Mind - your mental health
- Medication - anti-obesity medicines
With interventions from these 4 areas, a doctor can help you make a personalized plan for weight loss and maintenance.