Blame, Nuance, and the Fallacy of Choice

The largest one of the group

Psychologist Chris Crandall of the University of Kansas has noticed that the fundamental American values of individual choice and self-determination have a dark side:

We blame people for everything that happens to them – being poor, being obese. It’s the ‘just world’ idea that people get what they deserve.

According to this doctrine, failure occurs when a person does not work hard enough or practice enough self-discipline, and what could illustrate the allegation more visibly and publicly than an overweight body? A 2012 Reuters/Ipsos poll showed that 61 percent of the respondents blamed the obesity epidemic  on “personal choices about eating and exercising,” and 49 percent thought obese people should pay higher health insurance premiums.

Many critics object to the term “fat-shaming” because it implies that overweight people have chosen to do something of which they should rightfully feel ashamed. A study discovered that even children as young as 3 have been instilled with the idea that “overweight people are mean, stupid, ugly and have few friends.”

Who is Blameworthy?

If the obese individual in question is a child, the idea of blame is ridiculous – although maybe, in a just world, a relative or two might be due for some bad-parent-shaming.

An obese adult is different. A case might be made that blame could fairly be placed on not just one lousy choice, but on a multitude of small, seemingly minor choices, made day after day. But Dr. Christopher Ochner takes a more nuanced view, suggesting that a “point of no return” arrives, after which obesity is no longer a matter of choice. Here is his argument:

I have a problem with the assumption that individuals should just be able to simply adopt a healthy lifestyle sufficient to be lean. To be on par with your never-obese lean individual, this would mean their making significant changes to metabolism, neural dopamine levels, neural responsivity to food cues, gut-peptide profile and adipocyte count.

After a certain point, the standard advice to eat less and move more just doesn’t cut it, and he sees both educators and clinicians as remiss in their loyalty to the cliché. Of course, there is no doubt that practically everybody could benefit from more exercise, and for almost everyone, the most basic form of exercise should be pushing their chair away from the table.

While an adult can perhaps be assigned responsibility for every step of the way that led to obesity, that path cannot be easily retraced without solid professional help. The factors that cause obesity and the factors that maintain it are quite different, and once obesity has moved in and grabbed the reins of power, the game changes. This applies, says Dr. Ochner, to “all but very few exceptional individuals.” He continues:

Once someone has been obese for some time, the confluence of a number of extremely potent weight-maintenance mechanisms readily override even the most legitimate of attempts to will past it.

Your responses and feedback are welcome!

Source: “Insight: America’s hatred of fat hurts obesity fight,”, 05/11/12
Source: “The doctor replies again: Once obese, it’s tough to escape,”, 08/01/14
Image by Gaulsstin


2 Responses

  1. It is time that obesity and food addiction were recognised for the illness that they are and Doctors / the Govt should look into setting up clinics like AA to help food addicts overcome this powerful addiction and regain their health

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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