Telling someone to lose weight makes it harder to do so

Not only is it counterproductive to point out that someone should lose some weight, it’s harmful to her health as well.

A study in the journal Obesity says people who feel stigmatized because they carry too many pounds suffer a form of stress that can increase health risks. It’s a two-part problem, experts say.

“Stemming in part from oversimplified and inaccurate beliefs about weight and obesity, weight stigma leads to societal devaluation, discrimination, and rejection of individuals with obesity and excess weight,” wrote editorialists in Obesity. “In addition to damaging consequences for the mental health of those targeted, weight stigma adds insult to the direct injury of obesity, causing physiological stress, weight gain, disordered eating, and other maladaptive behaviors, and may increase mortality.”

In other words, not only is it demotivating to “fat shame” someone, but it can lead to direct physical injury.

Many studies have explored the connection between obesity and “fat shaming,” said Dale Veith, Psy.D., at Providence Medical Group-Seaside. He said he’s seen many patients who have felt shamed and demotivated by what they see in the media and hear from their own health care providers.

“If I were king, I’d ban scales, and I’d ban BMI,” said Dr. Veith, referring to body mass index, a commonly used measure to determine whether a person is overweight for his height. He said BMI misses people who trade 5 pounds of fat for 5 pounds of muscle, but contributes to a sensitivity about weight. As a result, a person may feel discouraged about his weight when he shouldn’t.

Similarly a scale can tell you how much an object weighs, but it can tell you nothing about the composition of the object. A scale can’t measure the transformation of fat to muscle.

“The media presents obesity as if that’s the issue,” Dr. Veith said. “It’s not. The issue is fitness.”

Losing weight is hard

It’s not easy to take pounds off considering all the ways we’re discouraged by our surroundings, said Sandy Miller, director of Health Education, Diabetes and Fitness Services at Providence Health & Services in Oregon.

“Our environment – fast food, the marketing and advertising of unhealthy foods and sugary drinks, screen time, neighborhoods with no sidewalks or bike paths – make it challenging to maintain a healthy weight,” she said.

Making things worse, for some, is that many health care providers “aren’t really great about talking to patients about weight,” Miller said. Some overweight people who are ambivalent about losing weight won’t take the initiative to do so because they are fearful of being shamed, she said. “Our health care system is not always warm and welcoming.”

When psychological impediments are placed in the way of people who should lose weight, Dr. Veith said, it “makes them really reluctant to go out and do it.”

Dr. Veith and Miller are part of a team at Providence that will launch a pilot program in medical weight management. It will involve specialists from various disciplines, including psychology and nutrition.

Doing damage by standing still

Miller and Dr. Veith want to foster healthier habits in the workplace. Miller presided over a Providence transition away from sugary drinks; Dr. Veith wishes treadmill desks and recumbent bikes would become more common.

Inactivity is damaging, he said.

“Five and a half hours of prolonged inactivity does as much damage as smoking a pack and a half of cigarettes,” he said, adding, “And no amount of exercise is going to undo it.”

But for a person to stand, walk and seek regular movement during the course of a work day, he must be motivated to make some healthy changes. And fat-shaming works against that.

“Shaming makes people not want to engage,” said Dr. Veith.

The study in Obesity adds to the growing pool of research showing the relationship between weight stigma and poor physical outcomes, the authors wrote. And, it contradicts “a persistent argument that stigma motivates behavior change and improves health.”

In other words, it’s counterproductive to point out that a person is carrying an unhealthy amount of weight. It’s more likely to discourage them than motivate them to make changes.

“The whole shift should be to ‘How fit are you?’” said Dr. Veith. “We should get people to go out and play. Do it because it’s fun.”