Should we accept obese people for who they are or encourage them to get in better shape? This question can and should be explored both biologically and socially. We need to look at science and what it can tell us about obesity—specifically how much control does one have over it and how harmful it is to our well-being. Since the question involves a "should," we also need to explore the question from a social perspective and consider some of the more subjective issues about which science doesn't have much to say. There is no universal answer to this question that can be applied to all people in all situations, but there is a reasoning process based partly on scientific knowledge that can help shape our attitudes towards those who are obese, and help us to help others without offending, blaming, or contributing what has become known as "fat-shaming."
According to the National Institute of Health, obesity is different from being overweight. Overweight means weighing too much whereas obesity specifically means having too much body fat. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. What is healthy? Although these numbers are based on averages and can fluctuate based on updated research, you can find the definition of obesity as it relates to weight at http://www.cdc.gov/obesity/adult/defining.html.
There are many physical, mental, societal, and social problems associated with obesity. As for the physical, being obese increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers (“Obesity,” n.d.). As for the mental, research consistently supports the finding that obesity is associated with cognitive deficits, especially in executive function, in children, adolescents and adults (Smith, Hay, Campbell, & Trollor, 2011). Indirectly, obesity is generally associated with less physical activity or exercise, which has serious measurable short-term and long-term effects on the brain (for an excellent science-based book on cognitive performance and exercise, I highly recommend Spark: The Revolutionary New Science of Exercise and the Brain by John Ratey, M.D.). As for the societal problems, obesity-related medical treatment costs between $147 and $210 billion a year (Finkelstein, Trogdon, Cohen, & Dietz, 2009), decreases worker productivity and increases absenteeism (Cawley, Rizzo, & Haas, 2007), and results in higher workers' compensation claims (Burton, Chen, Schultz, & Edington, 1998). As for the social problems associated with obesity, these are a result of the attitudes we hold about those who are obese—a stereotype we create based on commonly-known facts about obesity. For example, we know that obesity is caused by overeating, eating high-fat foods, and not being physically active. These are seen as negative characteristics of people who lack self-control, motivation, and because of the clear dangers associated with obesity—self-preservation. However, like all stereotypes, judging individuals based on generic information often leads to inaccurate conclusions.
According to new guidelines from the American Heart Association, obesity should be treated as a disease (Jensen et al., 2013). This view of obesity puts more focus on the genetic and other biological factors that contribute to obesity that are often ignored by most people, helping to chip away at the social stigma attached to obesity. Of course, the obese person is not always to blame for the environmental factors either. Those who are unaware of the seriousness of the health risks associated with obesity are less likely to find the motivation necessary to maintain a healthy weight. In America, high-fat, high-calorie food is cheap and highly available whereas food high in nutritional value and low in calories is harder to come by and far more expensive—a social pressure that unconsciously and greatly influences our collective behavior that leads to obesity. Just because we lack any genetic predisposition to obesity, have no biological conditions or physical ailments that promote obesity, and have the money to buy healthy foods, does not mean that others have the same luxuries, and we must acknowledge this. Although most individuals are believed to have a significant amount of control over their weight, this level of control varies greatly from person to person for reasons outside their control.
In regards to the stereotypes of the obese, if we look closer we will see that there are far from perfect correlations between behavior and body fat. For example, many people are highly athletic (i.e., not at all lazy) but still take in more calories than they consume due to their love of food. Many people are extremely motivated in non-physical domains (e.g., devote all free time to charitable causes at the expense of their health) and still lack the motivation and desire to maintain a healthy weight. And when it comes to self-control or willpower, some obese people may have tremendous willpower that they use in other domains and there is nothing left when it comes to their diet (Baumeister, Bratslavsky, Muraven, & Tice, 1998). The point is looks can be, and often are, very deceiving when attempting to judge the character of a person based on their weight.
The first part of the question, "should we accept obese people for who they are" implies that obesity is a major part of who the person is. Unless you are a Chris Farley who was known as "that really funny fat guy," the chances are, your weight is just one of your many characteristics—a characteristic that would in no reasonable sense change "who you are" if your weight was at a more healthy level. The full question also can be seen as a false dilemma, where it appears that we must choose one of the two choices (i.e., to accept the person or encourage them). Of course, we can do both. We can accept people for who they are and appreciate and celebrate their strengths, at the same time, recognize them as imperfect humans who, like most of us, are interested in self-improvement. "I like who I am" is often used as an excuse to take the easy path of least resistance. The solution to this all too common problem is to be the kind of person dedicated to constant self-improvement and like that quality most about yourself.
No matter what one's view on freewill is, or how much control one may believe one has over their weight, most people can agree that influence can play a significant role in one's weight. Many years ago, when I guy I already didn't like very much told me I was getting fat, I realized that he was right, and I needed to do something about it. That spark of motivation or inspiration is often the result of another person. Technically, there is no such thing is "self-help." When you pick up a "self-help" book, you are being helped by the author through her writing. What motivated you to pick up the book? Some external factor, often another person who directly or indirectly inspired you. The point is, we are social beings who rely on each other to make positive changes in our lives. However, the inspiration we offer is not always accepted or appreciated.
When talking about weight problems and the obesity epidemic, one must be careful—perhaps overly careful. If the message comes across as offensive, it can have the opposite of the intended effect. We can accuse people of being "too politically correct" all we want, but that won't help us in our end goal of contributing to the problem's solution. For this, we need diplomacy.
How. Is your message or comment likely to be interpreted more like an insult that would undoubtedly solicit a defensive and negative reaction rather than a factual statement expressing sincere concern that is more likely to solicit an appreciative and positive response? Put yourself in the shoes of an obese person and think about how you would react to the message. Don't just think about the message, but think about how you choose to share the message and under what circumstances. The age old advice is praise in public but criticize in private. As this relates to discussing someone's weight problem, it's good advice.
Why. If you feel the need to comment on someone's weight, ask yourself why. Helping someone make positive changes in their lives is a win-win situation, so there's nothing wrong with desiring that good feeling that comes from helping another person. However, often comments about another's weight are made only with self-interest in mind. These are the comments that are best never shared.
To some, words of encouragement with the intention to motivate a person to lead a healthier and happier life is akin to making fun of a blind kid in a wheelchair. This reaction is not completely unjustified since there are people who "comment" on other people's weight with less than good intentions, often as a way to feel better about themselves. However, loaded language such as "fat-shaming" and "bullying" tends to be overused and used incorrectly, which contributes to fewer people willing to encourage others to say something to those people in their lives secretly struggling with obesity but unable to fight the disease on their own. Some people conflate weight with beauty, so saying that someone is obese, or even overweight might get you accused of saying that they are not beautiful or even attractive. Still others in the "everyone gets a trophy" camp will insist that everyone is "perfect" and how dare you for suggesting otherwise. Like Felix Unger in the opening credits of the Odd Couple who gets purse-slapped by an elderly woman he tried to help across the street, when it comes to the issue of obesity, your well-meaning gestures will most likely be met by some with fury.
We can't pretend that everyone is perfect as they are while we watch people we love suffer and die from preventable diseases and conditions. Nor can we take extremist views on obesity where we see it as a personal choice or a disease we can do nothing about. The fact is, we can provide the inspiration those who suffer from obesity need but currently lack, and we can do this in a respectful and diplomatic way that recognizes the challenges the person faces. We should accept all people for who they are, but this doesn't mean we still can't encourage them to make lifestyle changes that will demonstrably lead to greater well-being.
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