Is stigma stopping exercise in obese people?

Posted by Dave on October 15, 2013 | 1 Comment

I’ve struggled to maintain a healthy weight my entire adult life. For me the most humiliating moment came about 13 years ago when I was visiting an allergist about a skin condition and noticed that he had written “moderately obese” on my chart. At that point, I weighed 245 pounds with a BMI 32.3, well above the standard definition of obesity.

I increased my exercise and started dieting, but my BMI remained stubbornly above the “overweight” threshold of 25. It wasn’t until two years ago that I finally lost enough weight to be considered “normal.” I am quite sure that the reason I succeeded was social support: I joined groups of people with similar goals. I hooked up with a running group locally; these people were instrumental in ensuring I got up every morning to run. And I signed up with a weight loss / fitness web site (myfitnesspal) for online support.

Despite the amazing support I received from these communities, I’ve also noticed that many people in similar circumstances are self-conscious about exercising. Locally, I’ve heard from lots of folks who don’t want to join our running group because it is “too intimidating.” On the myfitnesspal message boards, there are dozens of stories every day from overweight / obese people who won’t go outside to run, or who are uncomfortable going to the gym, because they are worried that others will mock them.

Could it be that the same powerful social forces that helped me get in shape are, paradoxically, preventing many others from participating in exercise? Surprisingly, I haven’t been able to find much research on this question. A 2012 review article entitled Overweight and obese adolescents: what turns them off physical activity? summarizes the state of research on obese adolescents and exercise, but doesn’t touch on adults.

The research shows that obese adolescents are definitely self-conscious about exercise. They avoid gym class because of the skimpy clothes they must wear, or because girls are concerned about messing up their makeup and hair and getting taunted for that. They are worried about getting teased for being overweight and unfit — even when teasing doesn’t actually occur. It isn’t so much that they don’t enjoy PE; they don’t like being “visible” in PE class. They are concerned about how others perceive them much more than their own experience engaging in PE activities.

In a 2008 study led by Margaret Schneider, researchers tried to address these issues by enrolling unfit, sedentary teenage girls in an exercise program. In one school girls recruited for the program were tested and enrolled in a special PE class designed to improve fitness. In another school the participants were tested at the beginning and end of the school year but weren’t enrolled in a special class. The special class included increased physical activity compared to regular PE classes, and also had extra instruction about the benefits of physical activity.

Unfortunately, Schneider’s team found that there was no overall improvement in self-image for the girls who had enrolled in the special class. Perhaps related to this, overall, there wasn’t a significant improvement in fitness, despite the increased activity. In fact, when the researchers broke down the girls into one group that had improved fitness and another group that had not, the improved-fitness group did have an improved self-image and body-image. In other words, once they started seeing results, their attitudes about their bodies improved.

This certainly seems to match my experiences interacting with the myfitnesspal community. New members of the community who haven’t seen improvements due to exercise are intimidated by exercising. But if and when they do improve, their attitude improves substantially. What neither my experience nor the research yet supports, however, is whether it’s possible for large numbers of people to improve their attitudes about fitness and actually permanently change their lifestyles and become healthier.

Maybe the “success stories,” the folks who sustain these communities of fit and healthy people, are simply the lucky few who are capable of staying healthy in today’s sedentary world, saturated by drive-through restaurants, monster-sized soda cups, and jumbo bags of potato chips.

What’s clear to me, however, is that one of the major hurdles a sedentary person must first overcome in order to get fitter is a social one. Maybe it’s even the most important hurdle.

Stankov I., Olds T. & Cargo M. (2012). Overweight and obese adolescents: what turns them off physical activity?, The international journal of behavioral nutrition and physical activity, PMID:

Schneider M., Dunton G.F. & Cooper D.M. (2008). Physical activity and physical self-concept among sedentary adolescent females: An intervention study, Psychology of Sport and Exercise, 9 (1) 1-14. DOI:

Comments

One Response to “Is stigma stopping exercise in obese people?”

  1. Michael Vance
    October 15th, 2013 @ 12:16 pm

    Well said! In our planning upcoming beginner training groups, we’ve heard stories of program participants at other stores sitting in their car for an entire session, because of their perception that they would be the largest person out there, and subject to ridicule or judgement. It’s definitely a hard feeling to shake, and unfortunately many fitness companies reinforce those feelings by always using models that are thin and fit, rather than showing that “regular” people use their products as well.

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