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.

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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.

Fatism and Going to Extremes

Discrimination against fat people is a problem. People who are overweight are often judged to be less competent, less intelligent, and more lazy–not to mention less attractive–than people who are of a “normal” weight. They face discrimination in the workplace, and there are some jobs for which they are unlikely to ever be hired at all.

It’s only natural, then, that a movement has sprung up to combat “fatism”–and that’s awesome. What bothers me, however, is the tendency of anti-fatism activists to deny the fact that being severely overweight has negative effects on one’s health. I hear a lot of “weight has nothing to do with health” arguments these days, and this sort of denialism is simply dangerous. Obesity is a problem in America, and it does put you at increased risk for a lot of health problems, such as:

  • high blood pressure
  • heart disease
  • stroke
  • type 2 diabetes
  • sleep apnea
  • breast and colon cancer
  • osteoarthritis
Given that heart disease is the leading cause of death in the United States, I feel like its prevention is something that should be taken seriously.

Regardless, denying these health problems does not help anyone, and admitting that being obese is unhealthy is not tantamount to justifying discrimination against obese individuals. After all, one’s health is one’s own business, and not taking care of your body shouldn’t result in being discriminated against.

It worries me when social movements respond to a problem in society (such as fatism) by taking the extreme opposite view. This happens a lot with progressives. For instance, noticing that our society has pervasive and restrictive gender roles, some claim that gender is entirely socially constructed and has no basis in biology whatsoever. (Apparently these people never noticed that men and women do actually have at least one very noticeable biological difference.) Some note that homophobia is rampant in society, so they insist that heterosexuality is actually constructed and unnatural, and that same-sex relations are the only “genuine” ones. Similarly, some people think that because discrimination against fat people exists and discrimination is wrong, therefore, there is nothing whatsoever bad or unhealthy or in any way undesirable about being overweight.

But being fat isn’t the same as being part of other marginalized groups, such as being a woman, being gay, being transgender, or being Black. No reputable scientific study has ever found that being gay or transgender is in any way unhealthy or abnormal (except, of course, in the statistical sense). No reputable scientific study has ever found that women or African Americans are inferior in any way to men or Caucasians. But our entire body of medical evidence shows that being severely overweight comes with significant hazards to your health. This is something that is simply true. Regardless of whether you think BMI is a good measure of obesity, and regardless of how easy or difficult it is for you to lose weight, being obese is unhealthy. Does this mean that discrimination against fat people is okay? Hell no. But it does mean that obesity is something that should be discouraged.

Incidentally, some of the things that anti-fatism activists consider discrimination simply aren’t. For instance, when airlines ask obese people to buy two seats, guess what–it’s not because they just don’t like obese people. It’s because if your body requires more than one seat, then you should have more than one seat–in which case, it follows that you should pay for more than one seat, because it wouldn’t be fair to give some people a second seat for free. Furthermore, it would be unfair for a person who paid for a seat to effectively receive only half a seat because the person sitting next to them clearly requires part of theirs. Does it suck to have to pay more to fly if you’re fat? Yes. But in that case, lobby for airlines to make seats bigger, not to give you permission to use half of another customer’s seat.

Also, companies that provide incentives for their employees to exercise/get down to a healthy weight/whatever are not being fatist. They’re doing two things: 1) encouraging their employees to be healthier, and 2) saving themselves money by reducing lost productivity due to medical problems and by reducing the amount they have to pay as insurance. Fact: being healthier and not obese reduces medical expenditures. Similarly, doctors who recommend that their obese patients lose weight are not being fatist. They are being doctors. I am terrified of the day when doctors are prevented from dispensing sound, evidence-based medical advice for fear of offending someone.

Regardless, it is, in fact, quite possible to discourage obesity without promoting eating disorders, obsessive dieting and exercising, and holding oneself to an impossible standard of beauty, as the mass media does. Conflating  efforts to discourage obesity with efforts to promote unhealthy behaviors or stigmatize fat people is intellectually lazy. There is, for every issue, a solution that is healthy, reasonable, and benefits the greatest possible number of people. Just because that solution is extremely hard to find doesn’t mean it doesn’t exist. It’s there, and I can guarantee that it is almost never at one extreme or the other. It’s usually somewhere in the middle.