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Some Evidence Against Shame and Stigma as Weight Loss Motivators

[Content note: weight/size stigma and discrimination]

It is considered self-evident by plenty of people that shaming fat people for being fat gets them to stop being fat. That’s why a common reaction to body/fat positivity campaigns is that they’re going to make people think it’s “okay” to be fat. As opposed to…not okay.

However, even if we begin with the presumption that it’s a net good for fat people to stop being fat, research evidence is rapidly piling up that suggests that shaming and stigmatizing them won’t work. In fact, it may have exactly the opposite effect.

In a paper recently accepted for publication in the Journal of Experimental Social Psychology, the authors provide this overview of research on this topic:

Media attention to obesity has increased dramatically (Saguy & Almeling, 2008), as has discrimination against overweight and obese individuals (Andreyeva, Puhl, & Brownell, 2008). Overweight individuals are often portrayed in the media as lazy, weak willed, and self-indulgent (Puhl & Heuer, 2009), and as a drain on the nation’s resources (Begley, 2012). Because stigma can be a potent source of social control (Phelan, Link, & Dovidio, 2008), some authors have suggested that stigmatizing obesity may encourage people to lose weight (Bayer, 2008, Callahan, 2013 and Heinberg et al., 2001), and policies that utilize potentially stigmatizing elements (e.g., BMI report cards) are becoming more prevalent (Vogel, 2011). Little evidence exists, however, that stigmatizing obesity promotes weight loss. In fact, among overweight individuals, experiencing weight-stigmatization is associated with greater reports of maladaptive eating behaviors (e.g., Haines et al., 2006 and Puhl and Brownell, 2006), increased motivation to avoid exercise (Vartanian & Novak, 2008; Vartanian & Shaprow, 2010), and poorer weight loss outcomes among adults in a weight-loss program (Wott & Carels, 2010; but see Latner, Wilson, Jackson, & Stunkard, 2009). Furthermore, experimentally activating weight stereotypes decreased overweight women’s self-efficacy for exercise and dietary control (Seacat & Mickelson, 2009). Collectively, these findings suggest that stigmatizing obesity has negative behavioral consequences that may increase, rather than decrease the weight of overweight individuals.

The paper also reviews research suggesting that the reason this happens is because of something called identity threat. When an individual has an identity that they know is stigmatized and something happens that triggers their awareness of that (such as a joke about the identity or a person who invokes negative stereotypes about it), the individual may experience negative effects. Some of these are physical, such as increased physiological stress response. Some are psychological, such as feelings of shame or anxiety. The person may try to act in ways that “compensate” for the flaws others may perceive in them or avoid situations in which people might think poorly of them (for an overweight person, this may include eating with people or going to the gym).

In theory, all this stress, anxiety, and effort depletes cognitive resources available for other activities that require what is known as executive function–mental tasks such as regulating emotions, setting goals, using short-term memory, and so on. Research has shown that when people of various stigmatized categories are reminded of those stigmas and stereotypes, their cognitive performance on a variety of tasks worsens.

The researchers in this study hypothesized that feeling identity threat would decrease participants’ ability to subsequently regulate their food intake. Specifically, they tested whether or not exposure to news articles about weight stigma would actually increase the amount of calories participants consumed. They believed that the participants who would be most affected would be those who believe themselves to be overweight, regardless of their actual weight, because they would be the ones who would feel identity threat when reminded that weight stigma exists.

The participants were 93 female college students (45% White, 24% Latina, 18% Asian/Pacific Islander, 3% African American, 10% other races). Prior to the study, they had filled out a survey that included a few questions about weight (the rest were just there to hide the purpose of the survey). When they arrived at the study, they were told that the purpose was “to examine correspondence among verbal, nonverbal, and physiological signals.”

They were randomly assigned to one of two conditions. In the test condition, they read an article called “Lose Weight or Lose Your Job,” which was compiled from actual news stories and described the discrimination that overweight people may face in the workplace. In the control condition, the participants read a nearly-identical article that was about smoking rather than weight.

Afterward, they were led to another room and asked to wait for the experimenter to return. The rooms had bowls of snacks that had been weighed prior to the study, and the participants had the opportunity to eat some of the snacks while they waited for 10 minutes. They were then asked to return to the previous room to complete a final questionnaire.

One of the measures on the questionnaire was called “self-efficacy for dietary control.” Self-efficacy refers to one’s sense of having the ability to do something and control one’s outcomes in that domain. This particular measure assessed the extent to which participants felt they could control their eating, avoid unhealthy foods, and so on. Various studies suggest that having a sense of self-efficacy is more important in terms of actual behavior than other factors, such as believing that the behavior is healthy or important. (For instance, here’s an example involving elderly people and exercise.)

The results were pronounced. In the weight stigma condition, women who perceived themselves to be overweight ate significantly more calories than those who did not perceive themselves as overweight. In the control condition, there was no significant difference:

The interaction between perceived weight and article type.

The interaction between perceived weight and article type.

Furthermore, women who perceived themselves as overweight had significantly lower self-efficacy for dietary control in the weight stigma condition than in the control condition, while women who did not perceive themselves as overweight actually had higher self-efficacy in the weight stigma condition than in the control condition.

This means that, within the context of this experiment, women who perceive themselves as overweight increase their food intake in response to hearing about stigma against overweight people and feel less capable of controlling their food intake. The very people being targeted by this information in ways many people think are helpful are actually being harmed by it, not only in the obvious emotional sense but even in their ability to control what they eat.

One really notable finding in this study is that actual weight did not correlate with either calories consumed or self-efficacy in either condition. Perceived weight was the relevant variable. I’ve often heard people argue against the body positivity movement because but if fat people don’t think they’re fat then how will they ever stop being fat?! Ironically, the women who did not perceive themselves as overweight had higher self-efficacy in the weight stigma condition than in the control condition.

One weakness of this study is that it is unclear whether or not the participants who increased their food intake did so consciously–or deliberately. If it was unconscious and not deliberate, then this finding may fit with previous findings about identity threat. If not, it’s still an important finding, but it’s probably easier to get people to change mental processes that are conscious and deliberate as opposed to those that are subconscious and unintentional. It’s also possible (though probably unlikely) that the women in the weight stigma condition purposefully ate more as a sort of symbolic protest. Oh, you’re going to fire me because of what I do with my own body? Well, fuck you, I’ll eat as much as I want.

Another limitation is that the type of stigmatization invoked in this experiment isn’t quite what overweight people might actually experience in their day-to-day lives. While articles like the one used in the study are common, the idea behind stigmatizing people so that they lose weight is usually more direct: for instance, telling them they need to lose weight, penalizing them for being overweight, and so on. Telling a study participant that they’re fat and ugly and need to lose weight would probably never pass an IRB review, but it would be a more naturalistic scenario, unfortunately.

While the sample used in this study is more racially diverse than many other samples in psychology studies, that really isn’t saying much. The researchers did not discuss any racial disparities in the data, but that would be an interesting direction for future studies. Also, all of the participants were young women, so it’s unclear how well this generalizes to older women and men of all ages.

With research like this, it’s important to remember that the findings should be interpreted much in the way that the statement “consent is sexy” should be interpreted. Namely, you should get consent because it’s the right thing to do, not because it’s “sexy.” Likewise, you should refrain from shaming and stigmatizing fat people because it’s the right thing to do, not because shaming and stigmatizing them doesn’t work anyway. Activists rightly criticize research like this for suggesting the implication that we should stop shaming fat people because it doesn’t get them to lose weight, rather than because it’s a shitty thing to do. That said, I don’t think that’s an implication that the researchers mean to give. We should conduct, support, and read research about how human motivation works (and how everything else works) because it’s important to know. This is just one piece of that puzzle.

It is my hope, though, that studies like this will work where “don’t be an asshole” won’t. The most important thing to me is for people to stop stigmatizing and discriminating against fat people, whatever the reason they stop doing it, because it’s harmful and needs to stop. Then maybe we can make these people understand why they were wrong to do it.

However, this research also opens up a lot of tricky questions. If shaming people who are overweight did actually help them lose weight, would more people think that this is an okay thing to do? If shaming people who do things that most of us would consider Definitely Bad, like rape or theft or even saying racist things, worked, would that be okay to do? Many would probably say yes to the latter but no to the former.

What is clear, though, is that human motivation (and reasoning in general) often works in ways that seem counterintuitive. You might think that people would respond to the stimulus of “being overweight can cost you your job” with “well I’d better stop being overweight, then!” But that’s not necessarily the case.

~~~

Major, B., Hunger, J.M., Bunyan, D.P., Miller, C.T. (2014). The ironic effects of weight stigma. Journal of Experimental Social Psychology, 51: 74-80.

Comments

  1. Azkyroth Drinked the Grammar Too :) says

    If shaming people who are overweight did actually help them lose weight, would more people think that this is an okay thing to do? If shaming people who do things that most of us would consider Definitely Bad, like rape or theft or even saying racist things, worked, would that be okay to do? Many would probably say yes to the latter but no to the former.

    Rape, theft, etc. harm others. This is an apples-to-orangutans comparison.

    • says

      That’s true, and that’s why I’d generally say yes to the latter but no to the former. But some people would still argue that neither of those is okay and that shaming/stigmatizing behavior that we want to stop is always bad.

      I’ve struggled with this a lot myself, because I want people to not do things that harm others (i.e. say racist things), but I also worry about the negative consequences of using shame and stigma to get them to stop doing it. I wrote about this a few months ago: http://freethoughtblogs.com/brutereason/2013/05/05/blogathon-does-anyone-deserve-to-be-stigmatized/

      (Though, I should note that I wrote that post as part of a blogathon so it’s not as well-written or thought out as most of my other posts, so I should probably keep thinking about this and rewrite it eventually.)

  2. badgersdaughter says

    Shaming and stressing overweight people is directly counterproductive because of the role of stress on body chemistry. Stress itself can make and keep you fat.

    Making someone feel defensive and stressed sends threat signals to their body that make the body feel like it needs more energy to flee or fight, causing the sympathetic nervous system to release insulin to stimulate cells to take up blood sugar. After the extra blood sugar has been metabolized, the stressed person will seek to being blood sugar back up by eating. But in the absence of an actual physical need for more food or more blood glucose, insulin helps turn it to fat. Repeated cycling of unnecessary insulin release and blood sugar rises can eventually give way to “insulin resistance” and type 2 diabetes, conditions that usually make it terribly difficult to lose weight or to have the energy to exercise. http://www.britannica.com/nobelprize/article-9042512 High levels of cortisol due to stress cause storage of deep abdominal fat, which can lead to dangerous obesity.

    Elevated cortisol has been linked to high blood pressure, high fasting blood glucose, and high blood lipids, all of which are risks for obesity, diabetes, cardiovascular disease, and other metabolic disorders.

    Knowing this won’t stop people from harassing fat people. Knowing that their harassment might have actually caused deaths from heart attacks and strokes won’t stop people from being mean. But at least enlightened people at risk can at least get the facts on these matters and try to minimize the level of stress in their own lives.

    • badgersdaughter says

      Messed up that paragraph break due to WordPress log-in being a you-know-what, but I think you all get my drift. :)

  3. Glenn Charles says

    The experiment reminds me of a couple of rather infamous ones (the Stanford experiment for instance) and had far too small a test base. However, it would be hard to not suffer PTSD if one were suffering peer (read media) pressure because of one’s weight. I also strongly object to the modern practice of equating what amounts to closeness with causation (especially since free will is in fact ultimately arguable, which means that on any “thread” of causation you end up desperately searching backwards for a first cause.

    There is an obvious and evident need among modern Americans for those to discriminate against, in my opinion, with that being the root problem.

  4. gecko says

    If shaming people who are overweight did actually help them lose weight, would more people think that this is an okay thing to do? If shaming people who do things that most of us would consider Definitely Bad, like rape or theft or even saying racist things, worked, would that be okay to do? Many would probably say yes to the latter but no to the former.

    Actually this concerns me for the opposite reason. What if the same sort of effect happens for things that are Definitely Bad, ie, shaming people for Definitely Bad things causes them to do the Definitely Bad things more often? It also makes me think of how any sort of attention is often reinforcing in operant conditioning paradigms and how punishment has the effect of causing fear, avoidance, and resentment of the punisher. Yeah, I am very wary of shaming in any case because I worry that it will cause the exact opposite effect than intended.

    • says

      What if the same sort of effect happens for things that are Definitely Bad, ie, shaming people for Definitely Bad things causes them to do the Definitely Bad things more often?

      Then you apply guilt instead of shame. I wrote a blog post earlier this year on that topic– apparently shame applied for Definitely Bad things does cause people to do Definitely Bad things more often, or at least can be a contributing factor, because shaming someone tends to cement their identity in their own mind as a Person Who Does Bad Things. And once you’re a PWDBT, what is there to do but….more bad things?

      Guilt, on the other hand, does not have this effect. Guilt says “You did a bad thing” without saying anything about whether you’re a good person or a bad person. In order to demonstrate that you’re a good person, guilt encourages you to undo the bad thing you did, or at least try to make amends for it.

      • gecko says

        Guilt, on the other hand, does not have this effect.

        Do we know whether that is true though? It may depend on the person being guilted/shamed and possibly whether they have a stable or unstable locus of control and other personality traits like agreeableness. (I know for myself, even if I’m being guilted for something not tied to my identity, I tend to react in a spiteful manner because I find the strategy of persuasion manipulative and therefore threatening.) I’m also skeptical that guilt encourages people to undo the bad they’ve done – it will make people feel bad about something that they’ve done, but this doesn’t necessarily motivate one to do anything about it. The problem with punishment is that it tells you what NOT to do, but does nothing to say what to do. In some cases this is all that’s needed, but in others it puts people in a state of anxious immobility – and I think it’s this that leads people to developing a sort of “if I can’t do anything right, why bother?” attitude about whatever they’re being guilted/shamed for.

  5. sathyalacey says

    Thanks for posting this. Interesting study.

    Thanks for also pointing out the weaknesses (the overuse of college students in psych studies is starting to make me wonder if we as a society should make mandatory participation in psych studies a thing for the general population, or maybe something softer, like tax credits) in the study, as well as cautions against over-interpreting the results.

    As an aside, as I was reading this, and the comments, I started getting -seriously- hungry. Kind of weird to think that maybe reading about how reading about fat-shaming makes people hungry made me hungry, as I’m getting hungry, possibly due to the thing I’m reading, wondering if thinking about how reading the article could make me crave food, and that thinking about that effect might make me crave food more, ala “don’t think of an elephant”.

    Or maybe I was just hungry.

  6. smrnda says

    Something worth noting is that anybody who is overweight, or even just *not thin enough* is being hit with fat shaming and body shaming messages all day, every day. If I walk into a normal grocery store, and overwhelming number of magazines focus on weight loss, or else shaming celebrities who are *not thin enough* and praising those who have made their weight loss quota. Getting explicitly shames has to be irritating since the person deemed overweight is being told ‘you’re fat’ all day, every day, almost everywhere they go.

    I am, personally, very skeptical of weight/BMI approaches to health and fitness, just since I think these are the wrong metrics to look at and just get people to focus and obsess over calories, body image and weight. Even people who succeed at losing weight or getting the body they want can then start feeling insecure about their weight and appearance again.

    Another issue is I’m not sure obesity really is the result of bad choices. If you’re working several relatively sedentary jobs, have to eat on the go a lot, don’t have money to join a gym you’re not really in a position to change much.

    Contrasting fat shaming to bigotry shaming – I think a difference is that fat shaming is already going on, whereas our society *still* is fairly racist, homophobic and sexist. The fat person is being shamed daily, whereas the bigot isn’t getting shamed in the same way. Whether this is effective, I don’t know, and I would really hesitate to make up a general rule since it probably depends a lot on the person. There’s also the danger that the shaming can just lead bigots to form their own parallel culture where they can mutually reinforce their misogyny, racism, homophobia, transphobia or whatever, all while pretending that they’re being horribly rejected by this cruel society.

  7. says

    Being in the military, which not only institutionalizes fat shaming via punitive measures for being overweight and is positively marinating in the idea that being fat is the worst sin a person can commit and is completely due to lack of discipline, I can relate. I have rarely been within “acceptable” weight standards even though I usually pass the infamous tape test (I tend to vary between 17-23% within any given month). I get crapped on pretty constantly due to this even though I do work out three times a day and eat like a bird most of the time. There are times, like when I got denied the chance for promotion because I was almost too fat that I just lost the will to keep up the grueling workouts and diet and just pigged out, so I can see how this kind of thing would be ineffective.

    • smrnda says

      Another problem is that we keep cycling through some means of *objectively* deciding if someone is too fat. I know that heigh/weight charts are out, but I did see one at the doctor’s office once, which doesn’t make me feel good. I heard the military switched to BMI, but (as you mentioned) they use the tape/measurement means these days I guess?

      All said, wouldn’t it make more sense to measure fitness in the military exclusively by performance standards? I know that size matters in some areas: pilots have to fit in planes, but the obsession with weight seems absurd.

      Just wanted to add, it has to suck for this to be made such a huge deal.

      • says

        They use the weight charts for “screening purposes” now, and I’m always over on that. The tape test also has a good amount of research which suggests it’s wildly inaccurate, often giving a higher BMI, sometimes as much as 6%. Of course, having a high BMI does point to a higher risk of medical issues… which likely wouldn’t show up until the end of your career… but I can see why the military would be kind of concerned about it. Still, they don’t treat it as a strictly medical concern. They treat it as a punishable offense and something you can be drummed out of the service with. That’s really the absurd part.

        • Glenn Charles says

          The military really had to do it because of higher-ranked “non-commisioned officers”–enlisted–who were more than a tad overweight and in fact gloried in it. Since they couldn’t run, they couldn’t fight and if in the Navy they were literally unable to make the “Abandon Ship” drill (five minutes to deck, period). That was a problem in the 60s. The problem with the military is that they are utterly inept at best in making personnel solutions (the job of a psychiatrist in the Army is to “Fix the tool” and I got that straight from the horse’s ass–sorry, mouth [he was pretending to treat me as a veteran, an obligatory treatment no less]). At worst they are like being forced to sit through one of the movies you walked out on…in the first five minutes.

  8. Aliasalpha says

    Hang on, making people feel like shit doesn’t help them? So all those people who hurl abuse at me as they drive by (despite the fact I’m stronger than they’ll ever be) all those girls in high school who pretended to like me so they could laugh in my face, all those fleeting but obvious looks of disapproval and disgust I see from practically everyone I’ve ever met… those weren’t trying to help?

    Surely if that was all true I should be filled with a black bitter hatred of pretty much all of humanity…

    Oh hang on, turns out the gauge on my hatred tank broke when it got to 120%, I should have listened to Scotty when he said the instruments cannae take it…