Though people can all agree that obesity poses problems for many individuals (though many others remain overweight and in perfect health), the approaches to addressing it vary. There are people who consider obesity a disease. But, there are just as many who argue against that notion and declare obesity a personal responsibility.

If this is a debate that feels very familiar, it may be because you are accustomed to it in the context of alcohol addiction and other substance abuse disorders. Initially, drug and alcohol addiction were considered moral failings and people who suffered were expected to muster the willpower needed to fight their urges. In contemporary medicine, addiction it considered a disease and approached as one when it is treated.

It is possible that the obesity controversy will follow a similar pattern and will at some later point be considered a disease by experts. However, as things stand now the personal responsibility approach is stigmatizing severely overweight people and compromising their health, creating health disparities, and interfering with effective intervention efforts. It’s time to stop with the stigma and begin considering obesity a social justice issue.

What Is a Stigma?

A stigma is mark of dishonor linked to a quality, person, or circumstance. For example, there are stigmas against people who have done prison time and people with mental illness. A stigma causes people to disapprove and serves to separate those stigmatized from the greater society and its norms.

What Is the Stigma Against the Obese?

North American society is riddled with negative attitudes about the obese. People believe obese individuals to be weak-willed, lazy, unsuccessful, lacking in self-discipline, unintelligent, and uncooperative with weight loss treatment. Because of these harmful attitudes, obese people face not only stigma but also prejudice and discrimination—rates of which match those of racial discrimination in America.

Why Does the Stigma Continue?

People who blame obese people for their weight problems believe the stigma can be justified, or may even be necessary, because it can serve as the motivation that the obese need to begin living more healthily. So ingrained is this belief that weight stigma rarely, if ever, receives the same intervention or recognition in public health that other disease stigmas are afforded.

Studies show that conditions that are believed to have low personal responsibility, like Alzheimer’s disease, elicit pity and efforts to help from others. But, people with stigmatizing conditions believed to involve high personal responsibility, like obesity and drug addiction, elicit little pity, evoke anger, and have low ratings of aims to help.

Does the Stigma Motivate People to Lose Weight?

The general attitude is that people will change their actions to dodge being out of step with social standards and the ensuing stigmatization. But, there has been little evidence to show this is the case with obesity. If this were the case, then the increase in stigmatization over the past several decades should mirror a decrease in obesity, but the reverse is true; rates of obesity continue to rise alarmingly.

Studies also indicate that people who experience stigmatization of their weight are more likely to participate in unhealthy eating behaviors and to perform lower levels of physical activity. For example, some obese people who are teased engage in binge eating and extreme weight control practices, often for years after suffering the taunts. Similarly, studies demonstrate those who internalize a weight stigma are more likely to refuse to diet and avoid exercise.

How Does Stigmatization of Weight Affect Physical and Psychological Health?

Not only does stigmatization reinforce negative behaviors such as engaging in drug addiction, it is a substantial threat to physical and psychological health. To counter this problem, one must go through rehabbing, or addiction treatment for instance.

There is a body of evidence that links it with increased psychological stress, which leads to poor physical health consequences. Stigmatization is a documented risk factor for low self-esteem, depression, and body dissatisfaction.

How Does Stigmatization of Obesity Affect Quality Health Care?

Unfortunately, health care settings are a substantial source of weight stigma, and this undermines the opportunity of obese people to receive successful medical care. Research indicates health care providers spend considerably less time in their appointments with obese patients than they do with those who are thinner and they provide them with less health education.

Obese patients often feel disrespected by health care providers, observe they will not be taken seriously because they are obese, state their weight is treated as the cause of all of their problems, and are reluctant to address their weight issues with health care professionals. These factors contribute to substandard health care events for these people.

What Does This Mean?

Ultimately, stigmatization of obesity is only serving to make the problem worse. When the problem is placed upon the back of the obese person and treated as a burden they alone invited and can control, important environmental and societal causes of the condition are ignored. Currently, the treatment of obese people is one of victim blaming.

Comprehensive obesity prevention strategies cannot be put in place until weight-based discrimination and stigma are reduced. It is vital that obesity interventions include anti-stigma messages. For example, efforts to motivate should focus on health as the desired outcome and not on an ideal weight, which can perpetuate stereotypes of obesity and punish obese individuals. All people should be discouraged from unhealthy eating behaviors, not just overweight people.

It may be controversial, but it is time to shift the way that obese people are treated and to make productive efforts to combat the condition.

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Maria C. Lopez is a health and wellness blogger that writes about addiction. Visit https://www.addictions.com to know more about addiction and treatment.