Obesity and responsibility: Is it time to rethink agency?

Abstract

Despite obesity declared a disease, there still exists considerable weight stigma in both popular culture and health care, which negatively impacts policy making regarding prevention and treatment. While viewed as a choice or a failure of willpower by many, evidence exists to challenge the argument that both weight gain and failure to achieve weight loss maintenance are the individuals' fault due to personal failure or lack of responsibility. In this article, we draw upon literature from obesity treatment, neuroscience, philosophy of mind, and weight stigma to challenge the commonly held beliefs that individuals are free to choose how much they can weigh, and achievement of long-term weight loss maintenance is completely subject to conscious choice. In reality, the regulation of hunger, satiety, energy balance, and body weight takes place in subcortical regions of the brain. Thus, hunger and satiety signals are generated in regions of the brain, which are not associated with conscious experience. This points towards biological determinism of weight and challenges ideas of willpower and resultant moralization regarding body weight regulation. In this article, we will thus argue that in the context of dysregulation of hunger and

“You Are Always at War With Yourself” The Perceptions and Beliefs of People With Obesity Regarding Obesity as a Disease

“…In this context, body weight is perceived as under one's conscious control. This conflicts with contemporary understanding of the biological and environmental determinants of body weight (Grannell, Fallon, Al-Najim et al, 2021). These biological determinants lead to the generation of appetite signals within sub-cortical regions of the brain which project to the cortex where conscious percepts are generated.…”

“…While it is beyond the scope of this article to present a philosophical argument for obesity as a disease, it has been necessary to broach the topic as it holds immense relevance with regards to the aim of this study. Readers can refer to a recent discussion regarding obesity as a disease which raises important philosophical questions (Grannell, Fallon, Al-Najim et al, 2021). The research questions in this study were as follows (a) What are the perceptions and beliefs of PWO regarding what makes obesity a disease and (b) What are the perceptions and beliefs of PWO regarding obesity causality along with determinants of and barriers to weight loss maintenance.…”

P2X7 Activation Enhances Lipid Accumulation During Adipocytes Differentiation Through Suppressing the Expression of Sirtuin-3, Sirtuin-5, and Browning Genes

“…Obesity has been linked to several chronic diseases, cardiometabolic comorbidities, malignancies, and COVID-19 severity ( World-Health-Organization, 2021 ; Chiang et al, 2013 ; Chiang and Huang, 2014 ; Chen et al, 2021 ; Gammone and D'Orazio, 2021 ). The impaired inner energy regulation and the obesogenic environment lead to the risk of arriving at a pathological state of obesity ( Grannell et al, 2021 ). The majority of excess energy is sequestered as TGs in lipid droplets of WATs.…”

Nutrition Meets Social Marketing: Targeting Health Promotion Campaigns to Young Adults Using the Living and Eating for Health Segments

“…Addressing the food environment will be critical in supporting behaviour change in these Aspirational Healthy Eaters, making the healthier choice the easier choice. The medicalization and problematization of obesity [43] as a disease is likely to mitigate against this group's behaviours, in that it will support their contention that there is nothing to be done about being overweight by an individual unless there is medical assistance.…”

“…This group will require specific messaging and campaign action to prompt them into taking action towards healthier habits. They will also need assistance in understanding and accepting that they have agency in making healthier choices [43]. Motivating the Contemplating Another Day's to engage in healthful behaviour will require social marketing campaigns, as well as specific interventions designed to intercede and disrupt existing behavioural repertoires.…”