INB Obesity ad campaignAlthough many public health experts consider obesity to be among the most serious health challenges in the U.S. and a decade of public health campaigns have tried to address the problem, obesity rates remain unmoved. Bioethicist David Callahan argues that overweight people hear the message about the dangers of obesity, but don’t apply it to themselves. He and others believe shame-based “education” programs are the solution for getting at-risk individuals off the sofa. Callahan, for example, encourages Americans to scrutinize their bodies for signs of unattractive fat.

In a 2010 article in the American Journal of Public Health, however, psychologist Rebecca Puhl and her colleagues show that these campaigns don’t work. For one thing, obese people already feel ashamed. In their article, “Obesity Stigma: Important Considerations for Public Health,” the authors report that family members, medical providers, and peers regularly shame obese individuals, while negative stereotypes limit access to employment and educational opportunities. But the more people feel ashamed of their size, the less likely they were to exercise and the more likely they were to binge on food. Furthermore, even the most dedicated participants in weight loss interventions faced difficulties conforming to cultural expectations about size.

Sociologists Bruce Link and Jo Phelan, in the Annual Review of Sociology (2001), have offered a more general theory about internalizing stigma that can help illuminate Puhl’s findings. One who feels intense shame about a part of himself also internalizes related negative stereotypes, Link and Phelan write. Obese people who feel bad about their body size also believe cultural stereotypes that associate fatness with gluttony, laziness, and lack of self-control. These ideas can affect their lives far beyond body size.

Sociological perspectives urge us to move away from obesity shaming and the associated archetype of the “lazy fat person.” Some large people are already side-stepping fat shame to become triathletes, ballroom dancers, and cyclists. Maybe 300-plus pound Olympic weight lifter Holley Mangold, who told ABC News, “I’m a big girl and I’m comfortable with who I am,” can show Callahan a thing or two about the power of pride.

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