The social perception of obesity is advancing, but the prejudice remains intact

For some time, the medical community and some patient associations have insisted on the importance of perceiving obesity as a complex, chronic, and multifactorial disease. The message has gained ground in recent years. However, a study with a representative sample of the Spanish adult population suggests that this change in framework, from “it's the person's fault” to “it's a disease,” does not translate into less prejudice. That is, better understanding the causes does not, by itself, mean better treatment of those living with obesity.

The research, published in Scientific Reports, surveyed 1,000 adults in Spain about their beliefs on obesity, their stereotypes, and their willingness to discriminate in everyday situations. The main result is not very comforting. The weight bias remains almost the same among those who view obesity as a disease and those who attribute it to lack of self-control.

The work has been developed by a large group of researchers. Among them are two Andalusians: Cristóbal Morales, from the Endocrinology and Nutrition Service of Hospital Vithas in Sevilla; and María Malagón, from the Maimónides Institute for Biomedical Research in Córdoba.

The survey starts with a simple question: Does anything change in social attitudes when it is recognized that obesity does not depend solely on “eating less and moving more”? In the survey, 59.2% of participants considered obesity to be a disease, while 40.8% attributed it to a lack of self-control. In the first group (those who adopt the disease approach), there were more women and more people with a university educational level and middle-upper social class.

Thus, improving knowledge does change some opinions, but it does not deactivate the prejudice. For example, those who see obesity as a disease recognize to a greater extent that weight regulation depends on biological, genetic, and environmental factors (58.4% versus 35.2%). They also support more that anti-obesity drugs be funded with public funds (74.3% versus 56.6%). However, when asked about behaviors and attitudes of rejection, the portrait is very similar in both groups.

Approximately 30% of respondents acknowledged having felt prejudice or rejection towards a person with obesity or excess weight at some point.

Although most believe that discrimination exists, this awareness does not prevent the bias from being reproduced at the individual level. The authors suggest promoting broader strategies and involving academic institutions, professional organizations, media, public health authorities, and policies that avoid reinforcing simplistic or blaming narratives and promote approaches that focus on health and functionality, not just on weight.