Obesity Is a Disease? Then I Give Up. Pass the Pie

New research suggests declaring obesity a disease seems to discourage healthy eating.
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(Photo: Iryna Melnyk/Shutterstock)

(Photo: Iryna Melnyk/Shutterstock)

Last June, the American Medical Association formally recognized obesity as a disease. Ignoring the recommendation of a committee charged with studying the issue, the AMA concluded such a label could reduce the stigma associated with excess weight, and encourage doctors to take the condition seriously.

Newly published research suggests the decision could backfire in a big way.

In three experiments, a research team led by University of Richmond psychologist Crystal Hoyt found obese people who were told their condition was a disease were less concerned about dieting, and more likely to choose unhealthy food items, than peers who were given standard weight-loss advice.

“The disease label encourages the perception that weight is unchangeable,” the researchers write in the journal Psychological Science. This belief makes efforts to control weight “seem futile and failure inevitable,” they add, “which results in feelings of hopelessness.”

For many people, the word "disease" implies a condition that is beyond our control. And if there's nothing we can do—well, why not have that chocolate fudge sundae?

An emotion that doesn't inspire many trips to the gym.

One of this new study’s experiments featured 185 participants (median age 27) recruited from Amazon’s Mechanical Turk. Each began by reading either the New York Times story discussing the AMA’s decision to classify obesity as a disease, or an “information-based control article,” in which “the author highlights standard tips and tools for managing weight.”

After reporting their height and weight, participants rated how concerned they were with watching their weight on a one-to-seven scale (“very unconcerned” to “very concerned”). They were also given a menu and asked which of five sandwiches they would be most likely to order. The offerings ranged from a 900-calorie sandwich featuring Italian meats to a 230-calorie vegetarian alternative.

The results: Obese participants who read about the disease labeling expressed significantly less concern about their weight, compared to those who read the article about weight-loss tips. They were also more likely to choose the less-healthy, higher-calorie sandwiches.

This dynamic was not found for normal-weight people, meaning the apparent backlash effect was exclusive to those who most needed to drop some pounds.

Another study focused on participants’ dissatisfaction with their bodies. The 360 participants (median age 29) read either the aforementioned New York Times story or a different article that “focused on the reasons that obesity should not be considered a disease.”

They then chose between the same sandwiches offered in the previous study. In addition, they were shown a series of nine drawings of body shapes and asked to note which one they most resembled, and which one they wish they most resembled.

The results suggest the AMA’s reasoning was sound on one point: Obese people told their condition is a disease “reported significantly lower levels of body dissatisfaction.” However, this contentedness lowered their motivation to lose weight, and made them more likely to choose the fattening sandwiches.

“We agree that the acceptance of diverse body sizes is laudable,” the researchers write, “as is the goal to increase medical treatment for obese individuals.”

But their research suggests this new way of defining obesity "alters crucial psychological processes underlying obese individuals' motivation to engage in healthy behaviors."

For many people, the word "disease" implies a condition that is beyond our control. And if there's nothing we can do—well, why not have that chocolate fudge sundae?

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