Daniel Callahan, a prominent bioethicist, says heaping more stigma on overweight people may help curb obesity rates in the U.S. Others say there's plenty of stigma already out there.
Unhappy with the slow pace of public health efforts to curb America's stubborn obesity epidemic, a prominent bioethicist is proposing a new push for what he says is an "edgier strategy" to promote weight loss: ginning up social stigma.
Daniel Callahan, a senior research scholar and president emeritus of The Hastings Center, put out a new paper this week calling for a renewed emphasis on social pressure against heavy people -- what some may call fat-shaming -- including public posters that would pose questions like this:
"If you are overweight or obese, are you pleased with the way that you look?"
Callahan outlined a strategy that applauds efforts to boost education, promote public health awareness of obesity and curb marketing of unhealthy foods to children.
But, he added, those plans could do with a dose of shame if there's any hope of repairing a nation where more than a third of adults and 17 percent of kids are obese.
"Safe and slow incrementalism that strives never to stigmatize obesity has not and cannot do the necessary work," wrote Callahan in a Hastings Center Report from the nonprofit bioethics think tank.
Weight-acceptance advocates and doctors who treat obesity reacted swiftly to the plan proposed by Callahan, a trim 82-year-old.
"For him to argue that we need more stigma, I don't know what world he's living in," said Deb Burgard, a California psychologist specializing in eating disorders and a member of the advisory board for the National Association to Advance Fat Acceptance.
"He must not have any contact with actual free-range fat people," she added.
That view is shared by Dr. Tom Inge, an expert in childhood obesity at the Cincinnati Children's Hospital Medical Center.
"No amount of teasing, probing questions about what they wish they could do, or medications seem to help," Inge said. "So if one is proposing to help them by more stigmatization, that would seem at once both antithetical and unethical."
Still, Callahan, a former smoker, argued that public shunning of those who lit up led to plunging rates of cigarette use. People were asked to smoke outside and told directly or indirectly that their "nasty" habit was socially unacceptable.
"The force of being shamed and beat upon socially was as persuasive for me to stop smoking as the threats to my health," he wrote. "The campaign to stigmatize smoking was a great success turning what had been considered simply a bad habit into reprehensible behavior."
That same pressure could be applied to overweight people, perhaps leading to increased efforts by people to eat right, exercise -- and actually succeed in losing weight, Callahan argued.
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