Comedian and talk show host Bill Maher recently commented on the obesity epidemic and its role in the dysfunction of the American health care system. He suggests the solution to lowering health care costs is to motivate people to lose weight by body-shaming, or fat-shaming, them. The segment also included many common misconceptions about obesity.

“As much as Bill Maher and others in society want to suggest there's an easy solution to the obesity epidemic, it is a complex social, physiological and medical issue,” says Leslie Pristas, DO, medical director, Center for Bariatric Surgery. “It’s important to understand that weight is affected by more than just calories and exercise. This is not to say that these things don’t matter, of course they do.”

An effective option for weight loss is a comprehensive program that provides people with the right tools to change their lifestyle. The Center for Bariatric Surgery uses an approach that assesses each person’s medical, social and mental health history and develops an individual weight loss plan based on those factors. Patients undergo dietary counseling and education about food, food choices and portions as the major focus. The program also requires patients to start an exercise regimen.

As medical director of the Center for Bariatric Surgery, Leslie Pristas, DO, counsels patients on all the factors that cause obesity and educates them on successful long-term tools needed to maintain a healthy weight.

According to the World Health Organization, obesity rates have more than tripled over the past 40 years. As obesity rates climb, U.S. weight loss market is seeing a record growth in profits.

“The obesity epidemic hasn’t gotten this bad for lack of trying. Statistically, we know diet and exercise have a success rate of five to 10 percent at best,” Pristas said. “It's not for lack of willpower either. If diets or fat-shaming worked there would be no obesity.”

Here, she addresses some misinformation about fat-shaming “benefits”, explains the complex causes of obesity and provides advice on how to cope with shame and body insecurity.

Shame isn't motivational

Fat shaming involves criticizing and harassing overweight people about their weight or eating habits. Counter to what Maher suggests, embarrassing someone is counterproductive as a motivational factor to lose weight. Multiple studies have shown that weight discrimination causes stress and leads overweight people to eat more calories. In fact, a 2019 study published in Pediatric Obesity found that teasing kids about their weight is linked to increased weight gain well into adulthood — and the more teasing that kids and teens experience, the more weight they may gain.

Another study of 93 women showed exposure to weight-stigmatizing information made those who were overweight eat more calories and feel less in control of their eating. Research has also shown that the stigma associated with being overweight contributes to increased body dissatisfaction, which may lead to unhealthy coping mechanisms like binge eating – creating a toxic cycle.

“Experiencing the shame and stress that comes with weight stigma can trigger biological processes that actually make you gain more weight. Which in turn puts you at-risk for experiencing more weight stigma,” Pristas said. “Shame leads to increased levels of the stress hormone cortisol, which can stimulate appetite, and increase risk for depression and anxiety — both of which contribute to unhealthy eating habits.”

Obesity can be predetermined at birth

The claim that “nobody is born overweight” implies that obesity is solely based upon personal choices. That is a common misconception that has a lot of negative repercussions.  

“Many factors can contribute to obesity. Ignoring the fact that genetics, socioeconomics, physiologic factors and countless others additionally doesn’t do anyone any favors. All of these factors must be taken into account in order to attain real, long-lasting, weight loss,” Pristas explained.  

For example, having overweight parents classifies children as at-risk for being affected by excess weight or obesity later in life. Additionally, there is a 70 percent chance that an overweight adolescent will remain overweight or obese as an adult.

Children from low-income communities are also more likely to face obesity than their higher income peers.

“I meet people every day who struggle with their weight. They each have a unique background, experience and story. A person’s upbringing, family health history and family income can’t be controlled but have a huge impact on health,” said Pristas. “Instead of trying to embarrass someone, the solution is to support people, educate them, increase access to surgery, medical care and healthy affordable foods.”

Breaking the toxic cycle of shame

Weight discrimination — including fat shaming — is also linked to depression, eating disorders and low self-esteem. 

If you feel ashamed of your weight, seek out and create a strong support system of family and friends or find a body-positive community on Facebook or online. Focus on your overall well-being by practicing healthy behaviors, regardless of your weight. This should include your mental health.

“Social media can add to the toxic cycle of shame, but if we are deliberate about seeking out positive spaces, it can offer a supportive environment. The Center for Bariatric Surgery created a weight loss surgery Facebook group to foster a community of support and encouragement and the feedback has been extremely positive,” Pristas said.

Another good way to start building body acceptance is to focus on building an environment of acceptance in your home.

Pristas suggests putting the scale away and only bringing it out once a week to weigh yourself. It’s important to feel confident at any shape. Find clothes you like and feel good in at the size you are now. Don't put off buying things or doing things until you lose weight.

"You deserve to live the life you want to live now. Don’t subconsciously punish yourself by holding off on activities or events until you are at your goal weight," she said.

St. Vincent Charity Medical Center has been helping people lose weight for more than twenty years. The first nationally accredited Center of Excellence in Bariatric Surgery in northeast Ohio, St. Vincent Charity has helped 8,000 people achieve healthier lives through weight loss. To schedule a consultation with Dr. Pristas or one of our other highly-skilled weight loss surgeons, complete the consultation form here or call 216.592.2801.