By Madeleine Ortiz
The term “weight bias” refers to negative attitudes towards people living in larger bodies – for example, many people incorrectly assume that people with obesity are lazy and lack willpower. One of the consequences of the weight bias that exists in our society is that many people living with obesity turn that negativity on themselves, and believe that the stereotypes are true, and that they are lazy, lacking in willpower, etc.
This is called internalized weight bias (or negative attitudes about one’s own weight), which is the most common type of weight bias, with over half of people living with obesity believing that they deserve to be viewed negatively by others and to receive subpar treatment. The authors of the guidelines warn that this type of “tough love” is dangerous – and can negatively impact our weight more than what we eat or how we move.
Here are five reasons why negative self-talk is terrible for our health and the scale – and what the guidelines suggest doing instead.
1. Negative self-talk commonly leads to binge eating.
Binge eating is consuming large amounts of food without feeling like you have the ability to stop – even if you feel full. It can happen when you’re feeling stressed and overwhelmed, when you’re mindlessly eating in front of the TV or even when you least expect it. It often leads to feelings embarrassment, guilt and shame. And for many people, the default reaction to these feelings is negative self-talk. The bad news is that beating yourself up about overeating, or any “off track” eating experience, is closely linked to binge eating and other unhealthy behaviors. The guidelines suggest that that’s because negative self-talk prevents learning.
Instead of being harsh with yourself after a setback or slip-up, obesity experts recommend reflecting on the situation. Approach incidents of binge eating or overindulging like a detective. Without judgment, think about how you were feeling before you started eating and what made you feel that way. Jot down how you felt afterwards and brainstorm some strategies to avoid using food as a coping tool the next time you find yourself in a similar situation. A food journal is a great tool to help make these notes and observations. Replacing punishment with learning is a great way to evolve and make healthier choices in the future.
2. Those living with depression and anxiety are 2.5x more likely to have obesity.
When you’re constantly calling yourself lazy or a failure, it’s not giving you the “push in the right direction” you’re probably hoping it will. Instead the Canadian Obesity Clinical Practice Guidelines state that the constant barrage of harsh words will likely lead to negative mental health outcomes like chronic stress, anxiety and depression. One of the main side effects of dealing with these issues is weight gain, which in turn can actually lead to more internalized weight bias, creating an unhealthy cycle that’s difficult to break.
For many people the best way to combat depression, anxiety and other forms of mental distress is by seeking help from a therapist, counselor or other healthcare professional. A healthcare professional can help you “identify the lies” in your thinking patterns, introduce proven tools like CBT and ACT and sometimes even prescribe medications that can help you get to a healthier place. When your mindset starts to shift, reaching a healthier weight actually becomes easier and more manageable. A win-win.
3. Internalized weight bias can deter participation in healthy behaviors.
When you experience internalized weight bias, you probably find yourself feeling unworthy. And when it comes to healthy habits, internalized weight bias can have you saying things like “What’s the point?” or “That will never work for me.” According to the Obesity Guidelines, having thoughts like this can prevent you from doing things like eating nutritiously, exercising (especially in public) or reaching out for support. When you feel out of place or unworthy, you’re less likely to engage in behaviors that are good for you, the authors of the guidelines state. Forgoing these healthy behaviors because of internalized weight bias can lead to additional weight gain and more feelings of sadness or defeat. This can turn into a dangerous pattern that can be hard to escape.
As cliche as it may sound, “fake it ‘till you make it,” can be a great approach when it comes to internalized weight bias. Treat yourself like you would a good friend, says Dr. Sean Wharton, one of the authors of the guidelines. Tell yourself you deserve to do things like eat well, spend money on healthy food or take a fun exercise class. If convincing yourself that you’re worthy feels impossible, ask a good friend to be your cheerleader. When you feel upset with yourself, send them a text or phone call and let them know so they can be your support until you’re ready to do it for yourself. This will help you feel comfortable creating a foundation of healthy habits – and the more healthy behaviors you engage in, the easier it will be to build upon your success.
4. Self-stigmatizing makes patients less likely to receive quality healthcare.
The doctor’s office can be an intimidating place for anyone, but especially for those living with excess weight and obesity. According to Obesity Canada, most people living with overweight and obesity believe their weight is their fault… and their sole responsibility. This is a dangerous mindset, the authors of the guidelines say, because it prevents people from seeking the support they need.
According to the guidelines, the best way to combat these untrue thoughts about your right to healthcare is to understand that obesity is a complex and chronic medical condition. And just like other chronic medical conditions, the causes have less to do with personal choice and responsibility than you might think. Many people who have obesity experience genetic, metabolic and environmental barriers in addition to behavioral ones. The more you understand the science about what really causes obesity, the more able you’ll be to stop the self-blame and reach out for the support you deserve.
5. Assumptions about treatment can hinder results.
Even if you’ve decided to seek medical help for obesity, your negative self-talk and internalized weight bias can prevent you from seeing the results you seek. A majority of patients that have internalized weight bias have experienced a less effective treatment. Authors of the guidelines hypothesize that this is because patients who don’t believe in themselves or their worthiness of good health are less likely to be stick with a treatment. And even those who stay compliant with a treatment are more likely to blame themselves and never seek a follow-up appointment if a treatment isn’t working.
One thing everyone needs to understand about obesity is that, like many other chronic medical conditions, successful treatment is going to be different for everyone. Many people will require a combination of tools and treatments, and sometimes a few rounds of trial and error, before seeing significant long-term results. It’s important to set aside guilt or pride during the treatment process and talk with your doctor about any barriers you encounter or anticipate.
Yes, you hold the key to reaching a healthier weight, but not in the way that you (and much of society) thinks you do. Managing obesity involves recognizing distorted thinking and internalized bias, and then doing the difficult work of educating yourself on the science of obesity, retraining your thoughts and practicing self-compassion. Only then will you be able to seek out the treatment that exists…. and you deserve.
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