Fat Stigma Fading? Fewer See Obesity As Problem Of Bad Personal Choices, Survey Says

Are public perceptions and stereotypes around obesity beginning to shift?


New research presented this week in Boston suggests that the general public and health care providers are starting to view obesity more as a "community problem of shared risks" as opposed to a personal problem stemming from "bad choices."

These findings were presented as part of The Obesity Society's Annual Meeting.

Americans' view on fat has been evolving for some time, spurred by a robust "fat acceptance movement" and a decision last year by the American Medical Association to officially recognize obesity as a disease.  Also, a wave of media and advocacy revolving around healthier eating and lifestyles, from Michelle Obama's Let's Move campaign to the film Fed Up, has focused the national attention on the nitty gritty of food and weight.

The Obesity Society
The Obesity Society

The latest research shows that bias against fat people may also be evolving.

Here's more from the Obesity Society news release:

...For adults in the United States, perception has moved away from seeing obesity as a personal problem resulting from bad choices. Healthcare professionals were already less likely than the public to view obesity as a personal problem of bad choices.

“Despite the high prevalence of obesity in the U.S. and worldwide, weight bias and stigma continue to complicate clinical and policy approaches to obesity treatment,” said study author Ted Kyle, RPh, MBA, of ConscienHealth in Pittsburgh, PA. “The goal of our study was to measure any shifts that might affect or result from public policy changes.”

Kyle and his colleagues Diana Thomas, PhD, professor at Montclair State University, and Adam Tsai, MD, an obesity medicine expert at Kaiser Permanente of Colorado, conducted an online survey of a representative sample of 54,111 U.S. adults (POP) and 5,024 healthcare professionals (HCP), who were asked whether they viewed obesity primarily as a personal problem of bad choices, a community problem of bad food and inactivity, or a medical problem. Responses were collected in five different time periods: Feb 2013, Mar 2013, Aug 2013, and May 2014. The HCP sample included registered nurses, physicians, dietitians and nutritionists, and healthcare policy/management professionals. Researchers analyzed how demographic variables (age, gender, income, region, urban density) were associated with the changing views of the public and HCPs.

“Our results show a significant shift in perceptions of obesity in 2014, with the percent of Americans seeing obesity as a community problem increasing as much as 13% and the percent of healthcare professionals increasing 18%,” said Kyle. “Surprisingly, the healthcare professionals who view obesity primarily as a medical problem actually decreased between 2013 and 2014. This trend bears watching.”

Data also show differences among various demographic groups. In 2014, younger and higher income respondents more likely view obesity as a community problem. Older respondents more likely view it as a medical problem. Male and rural respondents more likely view obesity as a personal problem of bad choices.

The researchers observed little evidence of impact from the 2013 decision of American Medical Association to classify obesity as a chronic disease, but concluded that substantial news and social media attention for the documentary film Fed Up may have influenced perceptions of obesity.

“Obesity is one of the most complex, chronic medical conditions and successful treatment often requires the support and care of healthcare professionals,” said Rebecca Puhl, PhD, Deputy Director at Yale University’s Rudd Center for Food Policy & Obesity speaking on behalf of The Obesity Society. “These trends are encouraging because they suggest a shift away from simplistic, biased views that focus on personal blame. The more that people recognize shared risks for obesity, the more likely they are to support evidence-based approaches to reducing obesity’s impact.”

In May 2013, TOS launched the Treat Obesity Seriously campaign with the goal of encouraging the treatment of obesity as more than a personal problem – a disease that warrants serious, evidence-based medical care. The effort is intended to help healthcare professionals better understand obesity, its causes, effects and treatments. During ObesityWeek, attendees will be given the opportunity to support the treatment of obesity as a disease by signing the Obesity Pledge and sending a letter to their members of Congress in support of the Treat and Reduce Obesity Act.

“Addressing weight bias is essential in efforts to effectively prevent and treat obesity, and will bring us one step closer to improving the quality of life for people affected by obesity,” said Dr. Puhl.

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Rachel Zimmerman Reporter
Rachel Zimmerman previously reported on health and the intersection of health and business for WBUR. She is working on a memoir about rebuilding her family after her husband’s suicide. 



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