Taeku Lee and J. Eric Oliver examined prevailing sentiments about weight-related issues in Public Opinions
FIGURE 11.6
Percentage of people in each weight category who want to or are trying to lose weight, November 3–5, 2003
and the Politics of America's Obesity Epidemic (Cambridge, MA: Harvard University, 2002). Lee and Oliver sought to characterize Americans' attitudes about obesity to determine how attitudes and beliefs affect support for obesity-related policy changes. They asserted that the concept of "moral failure" is at the root of public opinions that hold obesity as a personal choice and responsibility. They posited that obesity violates the valued American trait of self-reliance. Characterizing persons who are obese are as lazy, undisciplined, and lacking self-control enables the public to hold them responsible for their condition, and may be used as justification for bias and discrimination. The authors also posited that when obesity is understood as resulting from a lack of individual motivation, there will be little support for policies such as government regulations, civil protections, or taxes to prevent and decrease it.
Lee and Oliver observed that because obesity in America is a relatively recent phenomenon, public opinions about it are still forming, and most proposed policy changes such as taxes on sugary or high-fat snack foods, strengthening civil protections for persons who are obese, and increasing access to, and availability of public land for exercise are unsupported or actively opposed by a majority of Americans. In contrast, growing support exists for measures to regulate food advertising to children and provision of more nutritious school lunches. The authors
FIGURE 11.7
Public opinion poll on the fast food industry's responsibility for obesity, July 7–9, 2003
attributed lack of enthusiasm for policy changes to low levels of awareness of the severity and scope of the problem as well as deeply held negative stereotypes about persons who are overweight and obese. They assert that as Americans learn that the rapid rise in obesity during the past two decades did not result from moral failure they will be more inclined to advocate policies aimed at preventing and reducing obesity.
Research conducted by the Grocery Manufacturers Association reinforced Lee and Oliver's finding that Americans are inclined to blame obese people for their condition. The 2002 survey reported that 89 percent of Americans believe that individuals are to blame for being overweight, and just 5 percent attributed obesity to environmental or genetic factors. In an online editorial, "It's Your Fault" (http://www.obesity.org, February 7, 2002), American Obesity Association executive director Morgan Downey lamented that "The moral judgement of laziness, lack of self-control, weakness even extend to denying obesity is a disease. Thus, obesity is not so different from other diseases that are modifiable by personal behavior. But our reaction to it is. Its principal feature may be that we suspend the compassion we normally feel."
The view that overweight and obesity are matters of personal responsibility is reflected by the overwhelming public sentiment that the fast-food industry is not responsible for the obesity epidemic. A Gallup Poll conducted July 7–9, 2003, found that 41 percent of Americans believe the
TABLE 11.9
Public opinion poll on holding the fast food industry legally responsible for diet-related health problems of its customers, July 7–9, 2003
WOULD YOU FAVOR OR OPPOSE HOLDING THE FAST FOOD INDUSTRY LEGALLY RESPONSIBLE FOR THE DIET-RELATED HEALTH PROBLEMS OF PEOPLE WHO EAT FAST FOOD ON A REGULAR BASIS?
| 2003 Jul 7–9 | Favor % | Oppose % |
| National adults | 9 | 89 |
| Overweight | 10 | 89 |
| Weight about right | 7 | 90 |
| Underweight | 10 | 88 |
| SOURCE: Lydia Saad, "Would You Favor or Oppose Holding the Fast Food Industry Legally Responsible for the Diet-Related Health Problems of People Who Eat Fast Food on a Regular Basis?" in "Public Balks at Obesity Lawsuits," The Gallup Organization, Washington, DC, July 21, 2003. Copyright © 2003 by The Gallup Organization. Reproduced by permission of The Gallup Organization. [Online] http://www.gallup.com/content/default.asp?ci=8869&pg=1 [accessed February 10, 2004] | ||
fast-food industry is "not responsible at all," an additional 25 percent consider the industry "not too responsible," and 27 percent said it bore "some responsibility." Just 6 percent said the industry was "very responsible" for consumers' weight problems. (See Figure 11.7.) Further, 89 percent of Americans opposed holding the fast-food industry legally responsible for weight- and diet-related health problems of persons who eat fast food regularly. (See Table 11.9.)
Increasing Awareness of Obesity Risks
A national poll conducted by Lake Snell Perry & Associates, Inc., from May 28 to June 1, 2003, for the Harvard Forums on Health, a project of the Harvard University Interfaculty Program for Health Systems Improvement, found that most Americans (79 percent) were aware that obesity is a pressing health problem in the United States today. Further, about eight in ten Americans appreciate that obesity increases the risks of heart disease (86 percent), hypertension (86 percent), and diabetes (78 percent).
Despite their understanding of obesity as a health risk comparable to cigarette smoking, Americans were divided about how best to address the problem. About half think that obesity is "a private issue that people need to deal with on their own," while the other half described it as "a public health issue that society needs to help solve." Although 81 percent of Americans believe the government should assume a role in combating obesity, just 35 percent thought it should play a major role, and 18 percent said the government should not be involved in addressing obesity. Three-quarters of the respondents felt that healthcare providers should take the lead in fighting obesity, two-thirds said schools should be involved, and about one-quarter thought employers should play a pivotal role.
Support for actions to reduce obesity was greatest for campaigns to inform and educate the public about healthy
TABLE 11.10
Public opinion poll on discrimination felt by overweight people, July 7–9, 2003
HOW OFTEN DO YOU FEEL DISCRIMINATED AGAINST IN PUBLIC LIFE OR EMPLOYMENT BECAUSE OF YOUR WEIGHT—[ ROTATED: EVERY DAY, EVERY WEEK, ABOUT ONCE A MONTH, A FEW TIMES A YEAR, LESS THAN ONCE A YEAR, (OR) NEVER]?
| Based on 443 adults who say they are overweight | |||||||
| Every day | Every week | About once a month | A few times a year | Less than once a year | Never | No opinion | |
| 2003 Jul 7–9 | 2% | 2 | 4 | 5 | 4 | 82 | 1 |
| SOURCE: Lydia Saad, "41. How Often Do You Feel Discriminated against in Public Life or Employment Because of Your Weight—[ ROTATED: Every Day, Every Week, about Once a Month, a Few Times a Year, Less Than Once a Year, (or) Never]?" in "Smoking Edges out Obesity as Employment Liability," The Gallup Organization, Washington, DC, August 7, 2003. Copyright © 2003 by The Gallup Organization. Reproduced by permission of The Gallup Organization. [Online] http://www.gallup.com/content/default.asp?ci=9007&pg=1 [accessed February 20, 2004] | |||||||
eating, exercise, and the health risks of obesity (77 percent) and for creation of more public recreation areas where people can exercise (81 percent). More than half of the respondents (62 percent) agreed that requiring restaurants to supply nutritional information would be helpful, while less than half (41 percent) favored taxes on junk food.
Stronger support existed for measures aimed at preventing childhood obesity. More than eight in ten Americans favored healthier school lunches and health education classes, and three-quarters believed that increasing physical education in schools and educating parents about healthy eating and exercise for children were important. More than half (59 percent) supported limiting television advertising of unhealthy foods such as soft drinks, chips, and candy aimed at children, and three-quarters of Americans said they would support actions to reduce childhood obesity with their tax dollars.
Prejudice and Discrimination
While much research has documented instances of stigmatization, bias, and discrimination against persons who are overweight or obese, a Gallup Poll survey conducted July 7–9, 2003, reported that most overweight Americans do not feel that they have been discriminated against because of their weight, and the majority of Americans deny feeling prejudice against people who are overweight. Eighty-two percent of overweight survey respondents said they had never experienced weight-based discrimination, and an additional 4 percent said it occurred less often than once a year. (See Table 11.10.) As Table 11.11 shows, just 16 percent of survey respondents said that the fact that a person is overweight would cause them to respect that person less; however, 20 percent conceded that they
TABLE 11.11
Public opinion poll on respect for overweight people, July 7–9, 2003
ALL IN ALL, DOES THE FACT THAT A PERSON IS OVERWEIGHT MAKE YOU RESPECT THEM MORE, RESPECT THEM LESS, OR DOES IT MAKE NO DIFFERENCE TO YOU?
| Respect person more | Respect person less | Makes no difference | No opinion | |
| 2003 Jul 7–9 | 1% | 16 | 83 | * |
| *Less than 0.5% | ||||
| SOURCE: Lydia Saad, "49. All in All, Does the Fact That a Person Is Overweight Make You Respect Them More, Respect Them Less, or Does It Make No Difference to You?" in "Smoking Edges Out Obesity as Employment Liability," The Gallup Organization, Washington, DC, August 7, 2003. Copyright © 2003 by The Gallup Organization. Reproduced by permission of The Gallup Organization. [Online] http://www.gallup.com/content/default.asp?ci=9007&pg=1 [accessed February 20, 2004] | ||||
TABLE 11.12
Public opinion poll on hiring overweight people, July 7–9, 2003
IF YOU WERE IN A POSITION TO HIRE SOMEONE FOR A JOB, AND YOU LEARNED THAT THE PERSON WAS OVERWEIGHT, WOULD IT MAKE YOU MORE LIKELY TO HIRE THAT PERSON, LESS LIKELY, OR WOULD IT MAKE NO DIFFERENCE?
| More likely | Less likely | No difference | No opinion | |
| 2003 Jul 7–9 | 1% | 20 | 78 | 1 |
| SOURCE: Lydia Saad, "50. If You Were in a Position to Hire Someone for a Job, and You Learned That the Person Was Overweight, Would It Make You More Likely to Hire That Person, Less Likely, or Would It Make No Difference?" in "Smoking Edges out Obesity as Employment Liability," The Gallup Organization, Washington, DC, August 7, 2003. Copyright © 2003 by The Gallup Organization. Reproduced by permission of The Gallup Organization. [Online] http://www.gallup.com/content/default.asp?ci=9007&pg=1 [accessed February 20, 2004] | ||||
would be less likely to hire an overweight candidate for a job. (See Table 11.12.)
Although the survey respondents said they were not prejudiced against persons who were overweight, 43 percent agreed that setting higher health insurance rates for significantly overweight individuals was justified. (See Figure 11.8.)
Another survey, Nearly One-Half Of Americans Polled Believe Obese Workers Are Discriminated Against on the Job (San Francisco, CA: Employment Law Alliance, 2003), found that 47 percent of American workers believe obese employees suffer discrimination in the workplace. Thirty-two percent think that obese workers are less likely to be respected and taken seriously at work. Thirty-one percent say overweight and obese workers deserve special government protection against weight-based discrimination. Thirty percent feel obese workers are less likely to be hired or promoted, and 11 percent who described themselves as overweight or obese said they have been victims of weight-related discrimination.
FIGURE 11.8
Public opinion poll on raising insurance rates for overweight people, August 7, 2003
In "Do Unhealthy Americans Get Too Much Respect?" (Gallup Poll Tuesday Briefing, September 16, 2003) Gallup Organization health-care editor Rick Blizzard posited that while it may be "politically correct" not to discriminate against persons who are overweight, as well as those who smoke or drink alcohol excessively, acceptance of behaviors which are to some degree controllable may be counterproductive. He fears that Americans' over-reliance on research and development to identify "medical solutions" for every health problem, including overweight, coupled with a tendency to blame others for health behaviors and health problems discourage people from assuming an active role in their own health by engaging in healthy behaviors.
Blizzard is concerned that absent peer pressure to reduce health risks by losing weight and exercising more, public sentiment relieves individuals of any personal responsibility for their health-related behaviors and tacitly reinforces the acceptability of overweight and obesity. He observed that Gallup data suggested that peer pressure to engage in healthy behaviors is low. Blizzard and many public health educators worry that the public's apparent indifference may undermine even the most aggressive attempts to combat the obesity epidemic in America.
FIGURE 11.9
Public opinion poll on whether fast food is good for you, July 7–9, 2003
Who Is to Blame for Overweight Children?
American youth are more overweight today than ever before, and, according to a May 2003 CBSNews/ New York Times poll, seven in ten Americans described childhood and adolescent obesity as a major health problem, while 29 percent considered it a minor problem. Seventy-four percent of women termed childhood overweight and obesity a major problem, compared to 62 percent of men, and more non-parents (75 percent) than parents (60 percent) considered it a major health problem.
In response to the question, "Which one of the following do you think is most to blame for children and teenagers today being overweight—children not exercising enough, children eating fast food, or parents not preparing healthy meals?" half of Americans blamed children's diets. Twenty-seven percent of survey respondents said parents were not preparing healthy meals at home, and another 21 percent blamed children's consumption of fast food. An additional 22 percent believed that children do not get enough exercise, and 17 percent held that all of these factors conspired to create the epidemic of childhood obesity. More men than women felt insufficient exercise was the main reason children were overweight, by 28 percent to 17 percent. By 31 percent to 16 percent, parents were more likely than nonparents to name lack of exercise as the primary reason American youth are overweight.
Nearly half of the parents surveyed (48 percent) said their children were consuming more fast food than they
TABLE 11.13
Public opinion poll on how often fast food is eaten, July 7–9, 2003
HOW OFTEN, IF EVER, DO YOU EAT AT FAST FOOD RESTARUANTS, INCLUDING DRIVE-THRU, TAKE-OUT, AND SITTING DOWN IN THE RESTARUANT—EVERY DAY, SEVERAL TIMES A WEEK, ABOUT ONCE A WEEK, ONCE OR TWICE A MONTH, A FEW TIMES A YEAR, OR NEVER?
| Every day | Several times a week | About once a week | Once or twice a month | A few times a year | Never | |
| 2003 Jul 7–9 | 4% | 17 | 31 | 30 | 13 | 5 |
| SOURCE: Lydia Saad, "How Often, if Ever, Do You Eat at Fast Food Restaurants, including Drive-Thru, Take-Out, and Sitting Down in the Restaurant—Every Day, Several Times a Week, about Once a Week, Once or Twice a Month, a Few Times a Year, or Never?" in "Public Balks at Obesity Lawsuits," The Gallup Organization, Washington, DC, July 21, 2003. Copyright © 2003 by The Gallup Organization. Reproduced by permission of The Gallup Organization. [Online] http://www.gallup.com/content/default.asp?ci=8869&pg=1 [accessed February 10, 2004] | ||||||
did when they were their children, but they also claimed their children exercise as much as they did when they were young. Forty-four percent said their children engaged in as much physical activity as they had as children, and an additional 21 percent said their children exercise more than they had as children.
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