Obesity is a chronic condition… so why are we still treating it like a character flaw?
The waiting room was full, but she felt alone.
She had rehearsed what to say, but when the doctor asked why she was there, she hesitated. “Just a checkup,” she mumbled, though her knees ached, her sleep was broken, and her chest tightened with every flight of stairs.
What she really meant was: I need help. What she feared was: I’ll be judged.
This is not an uncommon story. For people living with obesity, the act of seeking care often starts with a silent negotiation: How much of myself can I safely share without shame?
And when shame becomes the first symptom of the care journey, it often becomes the last word, too.
Obesity Is a Disease. The System Still Treats It Like a Decision.
Obesity is now recognized as a chronic disease, yet patients and providers remain stuck in an outdated narrative—one where weight equals willpower, and treatment means “try harder.”
That stigma doesn’t just hurt feelings—it harms outcomes. People with obesity report delaying care, withholding information from doctors, and internalizing shame that directly contributes to anxiety, depression, and avoidant behavior.
In a study we carried out using our Empathy Engine, a proprietary consumer data hub with insights from over 3,500 people and caregivers across the US, representing more than 150 conditions, 43% of people with obesity said they don’t talk to their doctor about their mental health—even though nearly half reported it as a major concern.
Worse still, healthcare settings themselves are often where the stigma is most acutely felt. In social listening sourced from Waldo, an AI-powered platform that accelerates brand research and audience insights, one person described the experience bluntly: “I didn’t go to the doctor for 5 years because the last time I did, all he said was, ‘You should really do something about your weight.’”
Shame Is Predictable. That Means It’s Preventable.
When viewed through a behavioral science lens, shame is more than a social or emotional response—it’s a predictable barrier that interferes with diagnosis, treatment, and adherence.
We know, for instance, that stigma triggers stress, which can dysregulate eating and exercise behavior. Shame fuels silence and self-blame, delaying conversations that could prompt early interventions and sapping motivation to persist with treatment.
In our obesity cohort, individuals with high internalized bias were 2 times more likely to report feeling burned out by their condition—signaling a major risk factor for drop-off in treatment persistence.
These aren’t just psychological dynamics. They are marketing, communications, and care design challenges that we can solve.
Rebuilding the Clinical Conversation
Fixing this starts long before the exam room. It starts with how we talk—about weight, about worth, about what it means to treat a person with obesity with dignity.
We need to prepare HCPs not just with what to say, but how to say it:
•Language that is person-first: “a person living with obesity,” not “an obese patient”
•Frames that acknowledge complexity: “Your weight may be impacting your health, and it’s not just about willpower.”
•Tools that support trust building: From intake forms to visual aids, everything should cue partnership, not prescription.
Among people with obesity, only 44% say they’ve ever discussed their personal health goals with their provider—despite 69% wanting an active partnership in decisions.1
And marketers have a role to play, too. Every campaign, every message is either reinforcing the shame loop—or helping break it.
You Can’t Manage What You Can’t Say Out Loud Without Shame
We talk often about meeting patients where they are. But what if where they are is silent? Ashamed? Disengaged?
This isn’t just about representation or sensitivity. It’s about effectiveness. If patients don’t trust the messenger—or can’t relate to the message—they will disengage. And no therapy, no matter how clinically advanced, can work on someone who opts out of the conversation.
Empathy, here, isn’t fluff. It’s strategy.
When we treat obesity as the condition it is—not the failing it’s assumed to be—we create space for something radical: asking for help without fear.
And finally, for them to receive it.
Footnote:
1. Syneos Health Proprietary Empathy Engine Patient & Consumer Behavioral Study, 2024. This study includes behavioral data from 3,518 patients and healthcare consumers across the United States. Data were collected via an online panel between April 15, 2024 and May 27, 2024.