Obesity and the blame game

'The Good Life' with Gemma Good.

I grew up during a time when we would “call a spade a spade”, which means saying it like it is, without the hearts and flowers. It’s certainly an old-style way of thinking, but is it right? The phrase came to mind when I was reading an article about how some doctors and nurses are weight-shaming patients. The results were de-motivation among patients and it also caused anxiety, depression, self-blame and ultimately caused people to skip appointments. People should not be made feel bad about themselves when they are already trying to make a positive change. But is there such a thing as being cruel to be kind?

For one, a few months back we all praised the work of healthcare professionals and even clapped for them in our sitting rooms or at the front door. Now we blame them for causing people to skip appointments. I think today we are stuck between body positivity, embracing ourselves for who we are and also realising that our habits might also be affecting our health. This creates a most unpredictable battlefield for the professionals tasked with fighting the obesity epidemic Ireland is currently facing and the 1,800 patients presenting to them per year with eating disorders.

One way patients have felt shamed is when professionals judge them for being unable to stick to low calorie diets with increased exercise. This regime is clearly goal orientated and, despite all the waffle we hear about the importance of goal setting, I have started to think otherwise. I have finally gotten around to reading James Clear’s Atomic Habits, which has been recommended by many and has been sitting on my shelf since it came out in 2018.

While I haven’t quite finished it yet, one message that has really stood out to me so far is the importance of building systems rather than setting goals. Clear states: 'Goals are about the results you want to achieve. Systems are about the processes that lead to those results.'

The problem often is the system does not match the person attempting to implement it, so in terms of sustainability, it’s not going to work. Sure, you might meet some weight goals and feel great for a while but, without a proper system in place that works for you, old habits will catch up. Achieving goals like this allow you to treat the symptom without addressing the cause, a momentary change that Clear speaks about.

The principles in his book can be applied to all aspects of life, I am really enjoying it so far. Other ways patients have felt shamed is by the nurse's reaction to having to find a different scale to weigh them. A study at the University College London found that some healthcare professionals believed their patients to be lazy with a lack self-control, they overindulge, are hostile, dishonest, have poor hygiene and don't follow the guidance given to them. In these cases, I think a career change might be needed.

The article continues that obesity is so common in today’s society that medical students need to be taught that excess weight is almost guaranteed and is not the fault of the individual, with the results of medical professionals treating patients with more sensitivity. I think this completely de-motivates one to make a change and I do not agree. I do not think blaming external forces is the answer as people would feel helpless to take responsibility and implement a system for change. I mean, why bother if society is destined otherwise? It continues that students should also be taught the correct terminology when speaking to patients, i.e. it is a person with obesity not an obese patient, or somebody is managing their weight as opposed to struggling with their weight. To be honest, I think it would be more beneficial to help a person make a change to their small daily habits rather than getting caught up on word ethics. I think the news is hard to hear, no matter how softly it is delivered. According to the World Health Organisation, out of 53 European countries, Ireland ranks ninth for obesity. One quarter of Irish adults are obese. No country in Europe is on track to meet the goal of curbing obesity by 2025. Also in Ireland, we have just three dedicated beds for treating adults with eating disorders and waiting lists the length of your arm. So, what do we do? Does society aim to curb the obesity epidemic or help those with an alarmingly low weight and severe body dysmorphia? Do students need to know endless synonyms or actually learn about how they can care for their patients? And, for the person in the situation themselves, who can they blame? Society, their environment, the professional or themselves? Addressing the issue at hand would be more beneficial for everybody involved.

Change is hard no matter what the situation. For those who search for somebody or something to blame, I can't see the logic in that or what can be achieved by pointing fingers.