In the first assessment of public opinion since obesity was formally classified as a disease, a new study from the Rudd Center for Food Policy & Obesity at the University of Connecticut has found that a majority of Americans support the designation.
“Given that two-thirds of Americans have overweight or obesity, the disease classification potentially affects a substantial portion of the population,” says Rebecca Puhl, the study’s co-author, professor-in-residence in the Department of Human Development and Family Studies, and Deputy Director of the Rudd Center.
“It is important to examine public perceptions of obesity in light of this classification, and this study is a starting point.” The study was published today in the journal Obesity.
The American Medical Association (AMA) classified obesity as a disease in June 2013. Rudd Center researchers surveyed a diverse, national sample of 1,118 adults in January 2014, assessing their agreement or disagreement with 33 statements supporting and opposing the classification.
Most of the survey respondents, 69 percent, were unaware that the AMA had designated obesity a disease. Overall, there was more public agreement with statements supporting the classification of obesity as a disease than opposing it. The majority of adults surveyed (51 to 61.7 percent) agreed with 11 of 17 statements in support of the classification, including views that it will lead health care providers to talk with their patients about their weight, help people with obesity gain access to treatment, and lead insurers to cover obesity treatment.
A minority of the survey participants (31 to 47.3 percent) agreed with 15 of 16 statements opposing the classification, including views that declaring obesity a disease will lead to over-reliance on medications and surgery to treat obesity, and shift the focus away from measures to encourage healthy diets and regular exercise.
The study also examined social and demographic factors related to public opinions of the classification. The survey showed that people’s attitudes were unaffected by income level, sex, educational level, or health status. Support for the classification was highest among African Americans, liberals, and those who view physiological and environmental factors as contributors to obesity. Opposition to the classification was highest among survey participants who expressed stereotypical attitudes against persons with obesity, placed more blame and responsibility on individuals for having obesity, and were aware of the AMA’s classification before the survey.
The different views among the survey participants are similar to the debate that emerged in the medical community and among advocacy groups following AMA’s designation of obesity as a disease, including whether or not the disease classification will increase or decrease society’s stigmatization of individuals with obesity. While 37 percent of survey participants believe the classification will reduce obesity-related stigma, 31 percent believe it will increase stigma.
“Classifying obesity as a disease could help challenge common stereotypes in our society that place blame and responsibility on the individual,” Puhl says. “For decades, the message to the individual has been to eat less and exercise more, and for a number of reasons that has not been effective. Obesity is a much more complex issue, and the disease classification formally acknowledges this. However, it will be important to monitor whether or not this classification can help reduce broader societal weight bias that remains so pervasive.”
Sai Liu at the Stanford University School of Medicine co-authored the study.