In a future where the public will be paying for health care, the patience for preventable diseases, like those related to smoking and overeating, is dwindling.
But current weight loss messages and the stereotyping in the media - that characterize overweight individuals as lazy, weak-willed, self-indulgent and contributing to rising health care costs — may be tipping the scales in the wrong direction. Designed to encourage weight loss, they may actually have the opposite effect, according to U.C. Santa Barbara psychology professor Brenda Major.
It works in some circumstances. Shortly after Jennifer Love Hewitt and Christina Aguilera said they loved their 'curves' that were discussed so much in the media, they lost all that weight. Alyssa Milano was recently ridiculed by a fellow actor for her weight and may simply dig in her heels. And those are for people whose careers and identities involve public perception.
When it comes to people in the normal world, Major finds that women who perceive themselves as overweight are exposed to weight-stigmatizing news articles, they are less able to control their eating afterward than are women who don't perceive themselves that way. They eat to overcome the depression they feel for being called fat.
Using college students (naturally, it's psychology, though younger women are more prone to weight stigma, say psychologists), the researchers asked half of the participants to read a mock article from The New York Times titled "Lose Weight or Lose Your Job." The other half read a similar article, "Quit Smoking or Lose Your Job." After reading the articles, participants were asked to describe them via video camera to someone who was unfamiliar with the content. A 10-minute break followed, during which the women were ushered into another room and asked to wait for the next phase of the experiment to begin. Available to them in that room were a variety of snacks, including M&Ms and Goldfish crackers.
The snacks were pre-weighed, and every participant was offered the same type and amount, and remained in the room for the same amount of time.
In the final phase of the experiment, each participant was asked a number of questions, including how capable she felt of exercising control over her food intake. "People might think the overweight women who read the weight-stigmatizing article would eat less than the others," Major said, "but they didn't. As we predicted, they actually ate significantly more than the other women in the study. And afterward, they acknowledged feeling significantly less able to control their eating.
"Many people who are overweight feel helpless to control their weight," she continued. "Our study illustrates that articles and ads about the obesity epidemic that imply it's just a matter of self-control can make overweight people feel even more helpless and out of control of their eating."
Major's current study builds on her earlier research demonstrating the negative effects overweight women experience when they are put into situations in which they fear being stigmatized because of their weight. In that study, each participant was asked to give a talk — which she believed was either audiotaped or videotaped — on the qualities that make her a good date. Major and her colleagues found that the overweight women who thought they were being videotaped had greater increases in blood pressure and performed more poorly than the others on a subsequent cognitive measure of self-control than did others in the study.
"Our first study showed that being worried about being stigmatized because of your weight can decrease your self-control and increase stress," Major said. "And two big contributors to overeating are stress and feeling out of control. Thus, we predicted that exposing people who think they are overweight to messages emphasizing the stigma overweight people experience could actually cause them to eat more rather than less. And this is just what we found."
One finding in the current study that surprised her, however, was that women who didn't perceive themselves as overweight and who read the "Lose Weight or Lose Your Job" article subsequently reported feeling significantly more in control of their food intake afterward. "This may partly explain why some people who've never had an issue with weight and feel in control of their eating think that weight stigmatizing messages ought to cause people to eat less," Major said. "For them, these messages have that effect. But for people who don't feel in control of their eating, these messages have the opposite effect."
She suggested that messages related to weight loss would be more effective if they focused on good health and exercise rather than on weight and body mass index (BMI). "There is good evidence that BMI at very high levels is unhealthy. But people who are in the slightly overweight category actually live longer," said Major. "A recent paper published by the Centers for Disease Control that summarized the results of many studies reaffirmed the idea that people who are slightly overweight tend to live longer than those who are thin or in the 'normal' weight category. That information doesn't get much publicity, though."
Focusing on weight and BMI can do a tremendous disservice to people who are in a constant battle with their scales. "More than 90 percent of individuals who lose weight gain it back in two years," Major said. "There's so much biology involved and so many metabolic factors that it's difficult for almost everyone to lose weight and keep it off. Once people become heavy, their metabolism changes and the reward centers in the brain function differently."
Major argued that the stigma attached to being overweight is devastatingly unhealthy at a psychological level. "People are literally dying to be thin," she said. "When you have such a focus on weight and people saying they'd take 10 years off their lives in exchange for being thin, or young women saying they'd rather lose an arm than gain weight, it shows an incredible amount of fear."