Dispelling Obesity Myths: Obesity is a Choice

By Stewart Lonky, MD

Obesity Myth #2: Obesity is a choice, the result of individual decision making, poor willpower, and lack of self-control. 

Here’s a little fact the diet “experts” and diet book authors never seem to grasp: The vast majority of this country’s 110 million dieters know what to eat. They’re well aware of the calories, carbohydrates, and grams of fat in their favorite foods. Most dieters have lost weight. The problem is that most dieters can’t keep it off. They know what to do, but they’re living in misery because they can’t do it. 

How is this possible? Why do so many of us fold like tents when confronted with a breadbasket or cookie? The vast majority of dieters have hitched their wagons to a horse that doesn’t ride. Tying success at weight control to willpower, as an example, is saddling your steed to one of the most fragile components of the human psyche. Fatigue, mood, lifestyle, environmental triggers, physical health, anxiety, and other forms of psychological distress easily compromise it. The average American dieter makes 4-5 weight loss attempts annually, which means the average dieter is failing 4-5 times per year. Is trying 4-5 times a year and not succeeding a lack of willpower, or a problem beyond willpower?

Self-control draws from a limited reservoir - only 5 to 10 percent of our actions rely on willpower - and is quickly depleted, like muscles that become tired after heavy exercise. One study found that consciously avoiding unhealthy food through willpower negatively impacts performance, as an example.

Yet, too many people still believe that obesity is a choice, a sign of weakness, or a personal failing. Indeed, in one recent survey, 75 percent of participants said obesity resulted from a lack of willpower. The best treatment, they said, is to take responsibility for yourself, go on a diet and exercise. Here’s a news flash: Up to 90 percent of heart disease is lifestyle-related. Yet, do we hold people responsible for their atherosclerosis, or shame someone who suffers a heart attack?

Finger-pointing is easy; finding a cogent explanation is harder. People want easy answers when it comes to obesity. But obesity is a multifactorial illness. One hundred different factors contribute to obesity. Consider these two examples. Because their fat cell signaling is compromised, obese people don’t know how full or how much fat they have stored, so their brains don’t tell them to stop refueling. Countries with low food security scores (food security is a measure of how affordable, available, and safe food is in a given location) have higher obesity and overweight rates. Poor access can mean that people don’t have enough money to pay for healthy and safe food, so they default to cheap, high-calorie, highly processed junk food. What do these two examples have to do with willpower or lack of self-control? 

Instead of attributing obesity to lack of willpower, or poor decision making, we should look to its known causes for answers. If we accept that epigenetics contribute to obesity, then we should look to epigenetic solutions to reduce obesity.

Whatever the answers, remember that obesity is a multifactorial problem resulting from broken systems in and around people, as Forbes columnist Dr. Bruce Y. Lee has noted. We shouldn’t expect easy answers for something with 100 interconnected causes. 

The sooner we accept this reality, the healthier and happier we’ll be.

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