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Susan Cowden, MS

A Ridiculous Idea: Using Shame to Curb Obesity

By January 25, 2013

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This month, The Hastings Center Report published a paper entitled "Obesity: Chasing an Elusive Epidemic" by bioethicist Daniel Callahan.  In his paper, Callahan details the the American obesity 'epidemic' and strategies for controlling this issue.  He calls for social pressure and stigmatization to be applied to those people who are overweight and/or obese.  He encourages professionals to ask the following questions of their clients and patients:

  • If you are overweight or obese, are you pleased with the way you look?
  • Are you pleased when your obese children are called "fatty" or otherwise teased at school?
  • Fair or not, do you know that many people look down upon those excessively overweight or obese, often in fact discriminating against them and making fun of them or calling them lazy or lacking in self-control?

It appears to me that Callahan has never spent anytime with people who have been shamed and ridiculed for the way that they look.  Nor does he understand the effects of shame.  Shame does not encourage change or the taking of responsibility.  Shame is something that causes people to turn away from and hide from their struggles.  It tells them that they, as individuals are bad or unworthy and when people believe that they are unworthy, they are unlikely to change.  In fact, I would argue that shaming someone only ingrains the problems they are struggling with.

According to Rebecca Puhl, PhD, Director of Research and Weight Stigma Initiatives at the Yale Rudd Center, "Considerable research shows that when individuals are exposed to weight stigmatization, they are at heightened risk for depression, anxiety, low-self esteem, and even suicidal behaviors, as well as unhealthy eating behaviors, binge eating, increased calorie consumption, and avoidance of physical activity, which can reinforce weight gain and impair weight loss efforts."

Callahan also actually proposes that we should encourage "the majority of the population to do what a minority already do: working to stay thin in the first place and to lose weight early on if excess weight begins to emerge." Really?  Does he know that up to 11 million people in the United States alone suffer from anorexia or bulimia?  Or that 45% of American women and 25% of American men are on a diet?  Diets, by the way, don't work and only lead to gaining more weight and increasing both obesity and eating disorders.  Dieting and shaming people are definitely not the answer.

What are your thoughts on this article?  What do you think will happen if people actually take Callahan's advice?

Sources:

Callahan, D. (2013), Obesity: Chasing an Elusive Epidemic. Hastings Center Report, 43: 34-40.

Rudd Radar (January 24, 2013). Stigmatizing Obese Individuals is the Wrong Way to Address Obesity. http://www.yaleruddcenter.org/stigmatizing-obese-individuals-is-the-wrong-way-to-address-obesity

Tribole, E. & Resch, E.(2012). Intuitive eating: A revolutionary program that works. New York, NY: St. Martin's Griffin.

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Comments
January 25, 2013 at 7:44 pm
(1) lou says:

fact: medical obesity( a real medical condition) accoaccounts for less than 5% of the population worldwide! Dietary and Lifestyle Obesity are linked to poor diet, ie; junk food and sugar laced drinks and food, little or no exercise. Obesity is a late 20th Century problem in the affluent nations of the world. Stop ignoring these fact and employing political correctness to justify bad choices, laziness and a propensity for excess.

January 26, 2013 at 3:02 am
(2) Chris Hugh says:

Ha. I did an image search on Daniel Callahan and I would ask,

1 Are you pleased with how you look?

2. Does it please you to know that you have insulted people better than you? How would you compare your personal accomplishments against those of, for example, Winston Churchill?

3. Fair or not, do you realize that many people consider you cruel, unscientific and, given your own appearance, rather lacking in self awareness?

January 30, 2013 at 8:32 pm
(3) Jessica Setnick says:

Regardless of the ethics of the shame-based approach, it is definitely not effective on a large scale. This is not a new idea, and it certainly hasn’t worked yet. 15 years ago when I first read an article suggesting this method of weight control I read a response calling it, memorably, like using shame about teen pregnancy as a method of birth control. In other words the cat is already out of the bag. The scarlett letter didn’t work either. The harangue by the doctor can lead to weight loss at any cost, which we know is usually more harmful than the weight itself. Worse than that, if an individual is fighting a shame-based eating disorder, more shame = more eating = more weight to be shamed about. This ultimately leads to fear of speaking up, and even of going to the doctor for routine health care – so shame about weight ends up causing more health problems in the end. So sad that someone out there uses his platform to spread this cruel and misinformed idea.

February 19, 2013 at 9:34 am
(4) kulls says:

This is a good article on using shame to decrease obesity.
Shame only makes one to overeat. Shame does not help in any way.
It should not be used anyhow anywhere to curb down over eating or obesity. Rather encouragement on little success should be done.

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