This post was originally published on Allies for Health here: http://alliesforhealth.blogspot.com/2017/09/the-psychology-of-obesity-working.html
Our healthcare system is failing people with obesity. Yet rather than viewing the obesity epidemic as a failure of the system, failed weight loss interventions are too often attributed to failure of will. Sadly weight bias on the part of society as a whole, and health practitioners specifically, feeds into this stigma and prevents healthy psychological support for weight loss. For patients, this weight bias and stigma fuels a sense of self as a failure, and repeated perceived failures can lead to a belief that something is wrong with oneself as a person – shame. Shame isolates people from one another at a time when support could be beneficial. Depletion of energy from this sense of failure and shame creates a cycle that can interfere with healthy cognitive, emotional, and behavioral changes.
Mired in self-blame, shame, and humiliation, people with obesity often recount failed interventions and list the ways in which they are not strong enough, good enough, or determined enough to lose weight. The same people who run businesses, care for families, serve community organizations, and make our country’s policies, laws, and regulations believe they are failures because of the number on the scale. The belief that obesity is a failure of will can cause or exacerbate eating and mood struggles, interfering with health behavior change. The constant barrage of negative self-talk results in emotional and intellectual exhaustion. This is problematic because energy for behavior change is a finite resource. The more of it that is allocated to negative self-talk criticizing oneself for a “lack of self-control,” or berating oneself for “failing” the latest diet plan, the less energy available for self-care and maintenance of healthy lifestyle changes.
Shame also interferes with a person’s likelihood of accessing support. Weight management requires support from numerous disciplines (often medical, psychological, nutrition, and/or movement) as well as from loved ones, friends, families, and coworkers. Thoughts like, “I should lose weight before I go back to my doctor,” is just one example of how shame can interfere with a person accessing the very support that is most helpful. Shame can lead a person with obesity to believe that support is something reserved for others…those who are worthy of the support. Thus, reducing shame, identifying and disempowering the shame-based beliefs, and building a core sense of worthiness are all critical in helping individuals embrace autonomy and maintain energy for long term health behavior change.