This paper applies symbolic interactionism to the issue of obesity prevention in healthcare, arguing that cultural symbols surrounding body weight — such as thinness as moral virtue and obesity as personal failure — shape both public attitudes and medical practice in harmful ways. Drawing on Canadian public health data, sociological research, and media examples, the paper examines how anti-obesity rhetoric reinforces stigma, blames individuals rather than systemic factors, and ultimately undermines effective health interventions. The paper concludes that meaningful reduction in obesity rates requires shifting the symbolic framing of the issue away from moral judgment and toward structural and economic reform.
Symbolic interactionism "focuses attention on the way that people interact through symbols: words, gestures, rules, and roles" (Plunkett, n.d.). The definition of health is an important component of the cultural language in which we operate. Although our definition of health sometimes seems self-evident — like something unchanging and unwavering across the eras — it is, in fact, a culturally constructed notion. This can be seen in how the definition of acceptable body weight has shifted and changed over time, as has the symbolic importance assigned to weight.
Today, being overweight is not simply considered a problem of aesthetics but also a health problem with significant social consequences. Being overweight is seen as "costing" the health system — and thus taxpayers' money — as well as placing strain on one's heart. Understanding how these symbolic meanings are constructed and reinforced is essential to evaluating whether current anti-obesity efforts are genuinely serving the goal of public health.
"Extrapolating from self-reported and measured data collected over time, it is estimated that the rate of obesity among adults in Canada in 2007 may actually be about 25%" (Public Health Agency of Canada, 2012). Obesity is on the rise, and the health system is taking increasingly aggressive steps to counteract this trend, emphasizing both the financial and the personal costs of excess weight in its public rhetoric.
"In 2005, obesity-related chronic conditions accounted for $4.3 billion in direct ($1.8 billion) and indirect ($2.5 billion) costs — a figure that may be an underestimation of the total costs of excess weight in Canada" (Public Health Agency of Canada, 2012). These statistics have been central to justifying more aggressive public health campaigns, but they also set the stage for the stigmatizing framing that follows.
The evidence indicates that emphasizing the negative consequences of obesity does not actually improve people's health behaviors. "Studies have also shown that health-care professionals hold more negative attitudes toward their patients who are obese and, as a result, often spend less time with them during office visits and tend not to counsel them about a healthy lifestyle" (Perry, 2012). Doctors are not immune to the prejudices directed at obese individuals, and because of the difficulties obese patients experience in losing weight, healthcare providers may treat them as lost causes.
One poll found that "61% of Americans believe that the main cause of the obesity epidemic is 'personal choices about eating and exercising'… Only 19% of the poll's respondents pointed to food manufacturers and the fast-food industry as the key source of the epidemic" (Perry, 2012). Obesity stigma in Western culture symbolizes a lack of self-discipline, in contrast to earlier eras when excess weight symbolized prosperity — a time when food scarcity among the poor was more common than poor food quality. Psychologist Chris Crandall of the University of Kansas found that "young adults who stigmatize obesity tend to be more ideologically conservative, favoring traditional sex roles and capital punishment" (Perry, 2012).
"Genetics, poverty, and race drive obesity rates"
"Tobacco-style warnings and their symbolic risks"
Obesity is a disease that weighs — literally and figuratively — more heavily upon the shoulders of the poor. Reducing the obesity rate is critical to improving the health of Canadians nationwide. But blaming the victim does not support weight loss efforts; in fact, it diverts attention away from the necessary social and economic changes in how food is allocated and accessed. Such structural changes are required to reduce obesity rates in a meaningful way.
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