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A surprsing verdict over weight loss ‘shaming’?

A recent study into obesity has found that “fat-shaming” is an ineffective, in fact, a counter-effective, method of encouraging weight loss. The investigation, conducted by researchers at University College London, spanned the day-to-day experiences of 2,944 participants over four years. 5% of these reported weight-based discrimination, of whom 1% were categorically of “normal weight”, and 36% morbidly obese. Those who had experienced shaming tended to gain weight – on average 0.95kg – whereas those who had not reported success in their attempts to lose weight. The findings led researchers to this apparently ground-breaking conclusion: that exacerbating a patient’s self-esteem issues, in order to help them combat a problem which is itself a reaction to lack of self-esteem, is an unwise approach.

This information was personally unsurprising, as it no doubt is to anyone with at least a gram of human compassion. Also unsurprising is the day-to-day discrimination faced by participants, in our image-obsessed society. Far too many of us are at best insensitive, at worst cruel and simply rude, where physical appearance is concerned.

The truly shocking revelation is the fact that “fat-shaming” is such common practice among health professionals. On a purely emotional level, bullying someone into action when that person, in all likelihood, suffers from extremely low self-esteem and motivation, is counter-intuitive. Humans are creatures of habit, and changing habits is a daunting task when they have evolved into deeply entrenched coping mechanisms.

“Psychological harm should be avoided with the same care as physical harm”

Logically this ought to be common sense, the phrase “adding fuel to the fire”, comes to mind, not to mention the fact that anywhere connected with health care ought to be a safe environment. Psychological harm should be avoided with the same awareness as physical harm, and yet it would seem that our health service is still operating under the archaic notion that the mind and body are unconnected. It is difficult to accept that one’s lifestyle must radically be changed; that one has entered into a destructive and compromising spiral.

Simple compassion, however, is clearly not reason enough for many health professionals to avoid the shaming method, which points to an industrial bias. Dr Sarah Jackson of UCL reported that “stress responses to discrimination can increase appetite.” In a nutshell, this occurs because the neurological systems which regulate stress and eating behaviour are connected. A person’s appetite is likely, therefore, to increase according to the level of stress they are experiencing; and since discrimination causes stress responses, it follows that “fat- shaming” will not aid weight loss. This is also evident for cognitive reasons. Jackson stated that people reported “comfort eating”, and “feeling less confident about physical activity”, when they have experienced shaming.

“No-one ought to be forced into action which concerns their own body”

So what is the best approach to helping people lead a beneficial lifestyle? This will never be an easy issue to approach, given that the meaning of a “beneficial lifestyle” will change from person to person. No- one ought to be forced into any kind of action which concerns their own body; government and health authorities, in conjunction with education services, should make lifestyle information clear, concise and readily available. Positive support and encouragement should be provided for those who seek it, and are ready to take autonomous action. The idea of punishing a person for a genuine psychological issue with which they struggle is repulsive.

30/09/2014

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