The weight-gain double standard—and why it needs to change
Ever wonder why, when a person loses weight rapidly, they’re sent for a battery of tests by their doctor, but when they gain weight they’re told to eat less and exercise more?
So did I. In fact, the decision to wind down my family practice and found Your Body Evolution—a clinic devoted solely to helping patients lose weight and achieve overall wellness—was prompted by a couple of key observations around that common physician reaction.
The first was that more of my patients were showing symptoms of weight-related conditions such as diabetes, hypertension and heart disease. The second was that many of my colleagues—indeed, the medical community in general—seemed to be laying the blame for that weight gain strictly on the lifestyle habits of overweight individuals. These patients weren’t unhealthy or didn’t have underlying medical issues that needed examining, many of my colleagues argued. They ate too much and didn’t exercise enough. They were lazy and slovenly. Want to know why our annual health care expenditure is increasing dramatically? Look no further than these folks, so many of them claimed.
But I knew that wasn’t the full story. We acknowledge that almost everyone can use our guidance and help on the nutrition and exercise front, but that doesn’t explain why, when a patient loses weight unexpectedly, a physician investigates it aggressively—rapid weight-loss could be a sign of the onset of a disease such as cancer, for example. When they gain weight, however, it’s usually written off as a result of poor lifestyle choices. I recognized this was a complete double standard and that obesity really is a socially-condoned prejudice.
Empirical studies support my view. According to a 2012 report by the Yale Rudd Center for Food Policy and Obesity citing previous U.S.-based studies, the prevalence of weight-related discrimination increased to 12 per cent of American adults in 2004-06, up from 7 per cent a decade earlier. Furthermore, the report notes a trend I’ve seen emerge anecdotally through interaction with my patients over the years: over-weight people not only to bear the burden of their condition in the form of physical challenges and lower self-esteem, but also in career limitations. That means lower maximum incomes compared to non-overweight people over the course of their careers, fewer promotions and a general perception of laziness and lacklustre self-discipline on the part of their colleagues and managers. Citing a 1982 study of 400 doctors in the U.S., the report notes that a whopping one-third of physician respondents admitted that obesity was ‘a condition to which they respond negatively.’ If even doctors carry a clear prejudice towards their overweight patients, it’s no wonder the entire medical community has spent decades pursuing non-solutions to this growing epidemic.
So, what does cause obesity?
Let’s be clear: overweight people don’t necessarily eat more. Obesity is not only about indulgence and a lack of willpower. It emerges from a combination of factors including genetics, lifestyle, environment and nutrition. There is no single magic causal factor that makes a person overweight. I learned over time and through clinical research that obesity is a sign that something is wrong with the body, which is a highly-complex piece of machinery with unlimited ways to say ‘ouch.’ Weight gain is just one of them.
The focus need not be on laying blame, but on finding out why these patients gain weight in the first place.
Perhaps more importantly, I found that as patients become healthier, they lose weight quicker—which is the basis for the Your Body Evolution system and the reason why we’ve managed to help thousands of Canadians lose weight and keep it off for good. Another important lesson I learned: weight-loss needs to be managed by a doctor who understands the metabolic processes that lead to weight gain. Otherwise, that complex process is left to the patient to manage on their own—and as we know from the poor success rates of most diets, weight-loss results typically fall far short of expectations.
This is the time to overcome our societal double standards regarding weight gain, and finally treat it as a curable medical condition. Only then will we start putting the brakes on the obesity epidemic and reverse years of inefficient and ineffective weight-loss advice.
In my next post, I’ll offer five simple diet preparation tips to help maximize your weight-loss results. Until then, stay well and keep enjoying your body evolution.
Dr. Jeffrey Brown, Medical Director
Your Body Evolution
Weight Loss Through Wellness