Exploring the sense and nonsense of food and health

The Bias Against Obesity


English: Obese man early 20th century

English: Obese man early 20th century (Photo credit: Wikipedia)

The recent emphasis on our obesity “epidemic” has in my opinion,  added to the bias that exists by the public as well as many heath care professionals that all obese people are gluttonous individuals and never leave the comfort of the couch. Obese people are often the subject of ridicule in our society.

With more people becoming obese, it would stand to reason attitudes toward obese people should be getting more tolerant, but that doesn’t seem to be happening.  When Yale University scientists searched through medical studies on weight bias published between January 2000 and May 2008 they found the following:

When 620 doctors were surveyed, more than half viewed obese patients as “awkward,” “unattractive,” “ugly” and “non-compliant.” A third described the obese as weak-willed, sloppy and lazy. Even dietitians and personal trainers showed fat phobia.

College students were shown pictures that represented hypothetical sexual partners.  The pictures included an obese partner, a person missing an arm and another who supposedly had a history of sexually transmitted diseases. They chose the obese partner as least desirable compared to the others.

In a survey of almost 3,000 individuals, obese respondents were 37 times more likely than normal-weight to report employment discrimination.  Obese employees were considered less conscientious, “less agreeable” and less emotionally stable than “normal weight” worker

Since obesity remains a stigma for many people in all areas of their lives, it’s important to be aware of the many complex mechanisms that the body employs to control our body weight for survival and to maintain the body weight we are genetically programmed to protect.  Obesity is more than likely an interaction between nature (genetics) and nurture (environment).  But the first problem to address is nature.

The first place to look is the genetics of obesity. Everyone has seen what we call “fat families” – either in public or in photos and everyone has seen the opposite thin slender parents and their thin children.  There are two possibilities: one that the children inherited the genetic tendency to be fat or that the parents encouraged bad eating and/or exercise habits.

Albert J. Stunkard, M.D. wanted to answer this question so in the early 1980’s, he began his study of genetics and obesity.  He looked at the weights and heights from a previous database of 540 adults over 40 years of age who were adopted by the 1st year of life.  The study was published in 1986 in the New England Journal of Medicine.  The results showed that the adoptees were as fat as their biological parents and fatness had no relationship to the adoptive parents.

Stunkard then examined twins in 1990.  He looked at 93 pairs of identical twins that were reared apart; 154 pairs of identical twins reared together; 218 fraternal twins reared apart; and 208 fraternal twins reared together.

The results?  The identical twins had nearly identical body mass indexes whether they were reared apart or together.  But there were more variations in the BMI’s of the fraternal twins (who share some genes, but not all).  The conclusion was that the variation in BMI’s might be accounted for by inheritance.

This does not mean that we are helpless to control our weights – but those predisposed to gaining weight need to constantly battle against genetics to maintain a lower weight especially when living in our current food-laden environment, i.e. food is everywhere. A predisposing genetic trait is expressed when the right environmental trigger  exists.

These studies also provide support for the set-point theory (that there is a comfortable weight range for all of us).  This range may span 10-20 pounds.  So going much below or above your set-point is difficult because the body resists by increasing or decreasing appetites, metabolic rates and other more complex mechanisms.

Jeffrey Friedman, MD, PhD at Rockefeller University discovered the hormone leptin and his work in molecular genetics has led us to a greater understanding of its role in the regulation of human obesity.  He says:  “Obesity is not a personal failing.  In trying to lose weight, the obese are fighting a difficult battle- a battle against biology, a battle that only the intrepid take on in which a few prevail.”  This helps to explain why so many people gain weight and so few maintain that weight loss.  These concepts are at odds with the popular conception to simply eat less and exercise more.

For more current information on genetics and obesity, CLICK HERE.

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2 thoughts on “The Bias Against Obesity

  1. Enjoyed your blog! I am a Miami University grad as well!
    Look forward to following


  2. I really like your approach here. For those struggling with obesity, it is a battle for them, but society more often looks at it as a character flaw. That being said, just yesterday I published a blog ( on the effect of obesity on our daytime performance and it does indeed appear to be related to poorer academic success and an increase in daytime sleepiness. I have most certainly seen “fat phobia” (as you put it) influence employee hiring. But if there really is a performance difference, can we really blame an employer for it?


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