Is It “Lack of Willpower” or Something Else? Reframing How We Talk About Obesity
“Just eat less.”
“Move more.”
“You just need more discipline.”
These are the types of comments people living with obesity often have to face.
Over time, these comments can change the way we think about weight. Not just the way we think about weight as a whole, but the way we think about weight as individuals.
The implication is obvious: if weight is not being managed, then something must be wrong.
But the reality is, weight is just not like that.
Where the “willpower” idea comes from
The idea that weight is something we can control is deeply ingrained.
This can be seen in:
- Everyday conversations
- Media
- Healthcare
The idea is that weight is something we can control because we have control over the decisions we make regarding our weight. Decisions like what we eat, how we exercise, or whether we can follow through on our weight loss plans.
Choices don’t happen in a vacuum; they’re shaped by biology, environment, access, stress, and a range of factors that aren’t always visible from the outside.
The impact of weight stigma
When weight is framed as a personal failing, it doesn’t just influence opinions. It affects how people are treated.
This means that weight stigma can include:
- Assumptions about laziness or lack of motivation
- Different treatment in healthcare
- Social judgement or prejudice
But what we can’t forget is that for so many people, weight stigma is something that can lead to something else: internalised stigma.
Eventually, the person might even begin to apply the same judgments to their own life. This can impact their confidence levels, mental well-being, and the support they might need.
In some instances, it can even delay or prevent them from receiving the support they need in the first place.
What current guidance says
In recent times, the way obesity is perceived in the medical community has undergone significant changes.
Organisations such as the World Health Organization and the NHS have started to refer to obesity as a complex health condition that is likely the result of a combination of the following:
- Biological factors
- Environmental factors
- Behavioral factors
This is not necessarily dismissing the role of lifestyle in obesity; it is more about understanding it in the context of the bigger picture.
This is because it recognises the following:
- Appetite is regulated by hormones
- Weight is regulated by genetics
- Environment affects the options available
Most importantly, it recognises that these options interplay with one another.
Why blame-based narratives don’t help
Understanding obesity in the context of willpower can seem quite simple; however, it is not necessarily helpful in practice.
This is because if we consider obesity in the context of willpower:
- We overlook the influences around the individual
- We overlook the support provided
- We overlook the fact that the individual might feel like they have failed if the desired results are not obtained
This can create the situation where the individual is in a cycle of trying, failing, and then trying again.
This is not because the individual is not committed enough; it is simply because the system is not recognising the bigger picture.
A more constructive way to approach it
Changing the way we think about obesity is not necessarily about removing the element of blame; it is about recognising the element of blame in the context of the bigger picture.
This is because:
- We recognise the influences around the individual
- We recognise the support provided
- We recognise the fact that the individual is not necessarily failing; it is more about the system not recognising the bigger picture.
In the context of healthcare, this might mean more personalised care. Discussions must delve deeper to identify the causes, without making assumptions.
The role of compassionate, structured care
For those who have experienced judgment and/or frustration with respect to their weight, it can make all the difference.
The feeling of being heard, understood, and taken seriously can make a big difference in how someone responds to care.
That is, in part, why structured care, including clinical research, places such importance on how care is provided, as well as on how care results in outcomes.
In any clinical trial for weight loss, as well as any clinical trial for obesity, there is often:
- Clear assessment processes
- Ongoing monitoring
- Opportunities to ask questions and raise concerns
This is an environment intended to support someone, rather than placing all burden on them as an individual.
Changing the conversation
The conversation we have with respect to any problem is an important factor in how we approach it, as well as how we find resolution.
If we consider an individual’s weight to be an easily solved matter of willpower, then we tend to continue to talk about it at an individual level.
If, however, we consider it to be more complicated than that, then we can begin to explore other avenues of support, as well as other expectations, and often, more successful outcomes.
For many, this can be an important factor in and of itself.
It doesn’t change everything immediately, but it changes where the conversation starts.
Disclaimers
Not medical advice: This article is educational and not a substitute for professional medical advice. Consult a qualified healthcare professional before making health decisions or starting/stopping any medication.
Conflicts / affiliations: Panthera Clinic conducts and supports clinical trials, including trials that may relate to obesity and weight management. This information is provided for general education. If you are considering trial participation, discuss suitability and risks with your clinician and the study team.
