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Information On The Genetic Nature of Obesity Can Reduce Perceived Weight Discrimination and Increase Willingness to Eat Healthier



sharma-obesity-doctor-kidContinuing the theme of harmful effects of weight bias, a paper by Janine Beekman and colleagues published in Psychology & Health, suggests that providing patients information on the strong genetic nature of obesity may not only reduce perceived weight bias but also increase willingness to eat a healthier diet.

In this study 201 women with overweight or obesity aged 20-50 were allowed to interact with a virtual physician in a simulated clinical primary care environment, which included physician-delivered information that emphasized either genomic or behavioral underpinnings of weight and weight loss.

This research builds on previous evidence that provision of genomic information in a primary care context can reduce patients’ perceived stigma because they feel less blamed for their weight.

As the authors note,

“This relates to attribution theory, which posits that causal attributions play an important role in determining reactions to stigmatizing information. The more overweight is attributed to controllable causes (like diet and exercise), the more negative one’s reactions are to it.”

All aspects of the virtual encounter were identical except for the type of information given: Participants who received genomic information were told that body weight has a sizeable heritable component, and this may be relevant to their personal situation. Participants who received behavioral information were given a parallel message that it may be harder for those who are already overweight to lose weight (but with no mention of the role of genomics). Both groups were reminded of the importance of health-promoting behaviours related to physical activity and nutrition.

After controlling for BMI and race, participants who received genomic information stated that they perceived less blame from the doctor than participants who received behavioral information. In a serial multiple mediation model, reduced perceived blame was significantly associated with less perceived discrimination, and in turn, lower willingness to eat unhealthy foods.

Thus,

“Providing patients with information about genomics and weight management reduced the extent to which they felt blamed for their weight, when compared to more traditional behavior-based information. Women who felt less blamed for their weight also felt less discriminated against based on their weight, and this reduced perceived discrimination was related to healthier eating and drinking cognitions”

These findings may not just have implications for clinical practice but also for public health messages about obesity:

“The proliferation of the “war on obesity” and social messages targeted at combating obesity are an attempt to tackle a public health problem by engaging stigma as a vehicle for social control, while stigmatizing individuals in the process. These messages, in turn, can lead self-perceived overweight women to, for example, consume more calories and feel more deflated about their prospects for weight loss. The present research provides another example of these ironic effects of stigmatizing weight – or, more specifically, the manifestation of that stigma as perceived blame and discrimination.”

Although the authors recognise that genomic information may in itself prove stigmatizing, in this context, they feel that the positive influence of genomic information provision in this context stems from its strong effect on reducing perceived blame.

Thus, for clinicians, the message may well be that acknowledging the importance of genetic factors (rather than simply diet and exercise) may positively influence interpersonal dynamics between patients and providers by reducing perceived blame and perceived discrimination. These improved dynamics, may in turn, positively influence health cognitions.

@DrSharma
Edmonton, AB

3 Comments

  1. Thank you for sharing this study. Once I got my 23nMe genetic results and could see I was at high risk for childhood obesity (I was obese from age 6-46 with periods of normal weight), I could forgive myself and others for the things that were said to me.

    Being an obese child in the 70’s- 80’s was tough. Knowing it wasn’t my fault helped me heal. It also helps me today be motivated to manage to keep my 70 pounds off and eat a food template that does not awaken my type 2 diabetes genetic risks.

    In a nutshell, knowing my genotype helps me immensely in the past and the present. Win-Win. Thank you Dr. Sharma!

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  2. This is a great study. Not only does it remind us that telling people, “You’re weak and a failure” is not exactly motivating, it flies in the face of the worst of the “I lost weight so I know everything about obesity” crowd, who firmly believe that bringing up genetics is just “making excuses.”

    Of course, most of these “people” aren’t able to understand the difference between having genes for something vs. how genetics actually can increase medical risk as well as be a part of a multi-environment cause. Your great-great-great-grandmother might have had the genes for obesity but that doesn’t mean that other factors got involved to see the obesity occur, anymore than her having the genes for breast cancer meaning that she certainly developed it.

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