A study published this month in PLoS One finds that victims of weight discrimination (“fat-shaming”, in case you only speak Tumblrese) are more likely to subsequently gain weight.
It’s hard for me to like a study that so obviously got exactly the result its organizers wanted it to get. And obvious confounders are obvious – level of discrimination faced was based on self-report, and the sorts of people who hang around the sorts of people who fat-shame may differ systematically (in class? education?) than who avoid that kind of abuse – but the study’s endpoint of change in weight over time rather than just weight itself goes some of the way toward addressing those concerns. And I’ve got to give them credit for studying an important issue and getting a highly significant result. So let’s let them have their soapbox:
There are both behavioral and physiological mechanisms that may contribute to the relation between discrimination and obesity. Weight discrimination is associated with behaviors that increase risk of weight gain, including excessive food intake and physical inactivity. There is robust evidence that internalizing weight-based stereotypes, teasing, and stigmatizing experiences are associated with more frequent binge eating. Overeating is a common emotion-regulation strategy, and those who feel the stress of stigmatization report that they cope with it by eating more. Individuals who endure stigmatizing experiences also perceive themselves as less competent to engage in physical activities and are thus less willing to exercise and tend to avoid it. Finally, heightened attention to body weight is associated with increased negative emotions and decreased cognitive control. Increased motivation to regulate negative emotions coupled with decreased ability to regulate behavior may further contribute to unhealthy eating and behavioral patterns among those who are discriminated against.
New study! This one published – oh, look, isn’t that interesting – this month in PLoS One, finds that survivors of the Holocaust have greater life expectancy than control Jews who did not experience the Holocaust.
Here the authors definitely got a result they were not looking for and did not want. And here, too, we have all sorts of confounders: they tried hard to construct a matched control group of Jews who emigrated from Poland to Israel just before the Holocaust, but we have no idea what sort of differences there might have be in those populations (just to make up one story, maybe poor people who had less to lose were more likely to emigrate). And here too, there is no shortage of soapboxes. From here:
One possible explanation for these findings might be the “Posttraumatic Growth” phenomenon, according to which the traumatic, life-threatening experiences Holocaust survivors had to face, which engendered high levels of psychological distress, could have also served as potential stimuli for developing personal and inter-personal skills, gaining new insights and a deeper meaning to life. All of these could have eventually contributed to the survivors’ longevity. “The results of this research give us hope and teach us quite a bit about the resilience of the human spirit when faced with brutal and traumatic events”, concluded Prof. Sagi-Schwartz.
So, let me sum up what we’ve learned here today.
Having someone call you fat is a profoundly disturbing form of stigmatization that breaks your normal cognitive coping mechanisms and subjects you to levels of stress that the human body and psyche were never designed to withstand.
But being rounded up like cattle, having your entire family killed in front of you, and then being starved nearly to death in a concentration camp for several years is useful opportunity to grow as a person, and will leave you stronger and better-adjusted.
I shouldn’t be too sarcastic. Stranger things have ended up being true. Maybe constant low-grade minor stress has a deleterious effect but a single extremely stressful event can be salutary. Maybe stress is good for you only after you’ve achieved a safe distance from the stress and can reflect on it from a position where you’re absolutely sure it will never happen again. Maybe stress makes you obese in the short term, but also makes you live longer in the long-term. Maybe the cultural differences between elderly Polish Jews and middle-aged Americans mediate the effect stress has on their bodies.
Or maybe these effects are mediated by unexpected processes. Maybe the Holocaust survivors live longer not because of personal growth, but because they got a sort of involuntary caloric restriction that permanently altered their metabolism. Maybe (as the researchers point out in their paper) only people who were exceptionally healthy survived the Holocaust, and these people continued being exceptionally healthy into their old age. Maybe obese people who aren’t shamed stick to a careful diet to avoid shaming, but once the shaming starts they figure it can’t get any worse and go wild.
Or maybe one or both of these studies is totally and fundamentally flawed and we’re wasting our time here. I give 50% probability that the fat result is legitimate, and 90% probability the Holocaust result is due to something other than personal growth, probably survivor effect or caloric restriction – but I bet others will disagree.
Yet I think what struck me most about this combination was how “stress makes you miserable and unhealthy” sounds reasonable, but “stress is a salutary process that allows you to grow” also sounds reasonable. No matter what happens to stressed people, psychology can go “Oh yeah, according to our theories, stress causes that” and I will nod my head and agree.
Or maybe another way to put it is that I’m impressed with the ease at which we switch narratives. All the time I hear “Well, a little bit of adversity will be good for him/her”. Or else “What you’re doing is going to destroy his/her self-esteem and scar him/her for life.” Most people selectively use either or, depending on whether they want to excuse something or condemn something at that particular moment, and they have the science available
Not only do we operate on cached thoughts, but we have a store of contradictory cached thoughts sufficient to support any proposition or its opposite.
This is why the Ethics Committee needs to hurry up and approve my replication experiment to commit genocide against a randomly selected sample of the population.