Is obesity a choice? A psychological view

I recently came across a discussion happening in the online fitness community on whether or not obesity is a choice. A lot of the arguments on one side revolved around saying “There are a lot of factors that determine whether or not you’ll gain weight, some people have a higher tendency to gain fat, they don’t simply choose to be obese”, to which others responded “yes, but if you maintain a caloric deficit, you’re guaranteed to lose weight, it doesn’t matter if you have a higher tendency to gain fat, you just gotta adapt your habits to your individual characteristics”. But I didn’t see people taking a closer look at behavioral/psychological aspects, so that’s what I’m here for.

To begin with, in a theoretical sense, the answer is pretty straightforward: it is a choice. If you maintain a caloric deficit, you will lose weight, and what determines if you’ll be in a caloric deficit or a surplus are your are the behaviors you choose to have, therefore, even though obesity is not a conscious and deliberate choice, it is still a choice, or better yet, the result of a series of choices. But bear with me, because in a practical sense, things are not that simple.

Even if it is a choice, do people have the cognitive behavioral repertoire to afford whatever choice they want to make every single time? Because that’s a key aspect of this discussion.

Some of the people who defended that obesity is not a choice raised the question “What if a kid is obese, is that their responsibility?”, to which people who believed it was a choice answered: “No, but after you become an adult, it’s your fault to be obese”. I don’t believe that to be the case.

Everyone seems to agree that a child isn’t responsible for what they do, they’re simply doing the best they can, considering how their environment is modulating their behavior. If a child grew up in a family that has habits that lead to obesity, they’re learning those habits and reinforcing them every single day.

Not only that, but eating is pleasurable to most of us, and we tend to use, to different degrees, tasty food as a stress reliever. Some kids, by necessity, develop the habit of overeating as a way to cope with their daily stressors. That habit is repeated over and over again, every single day, for years straight. They’re learning a simple rule: “If I overeat, the stress goes away, but if I don’t, I stay stressed”, and if that individual didn’t have the opportunity to learn other coping strategies, a detail is added to that rule: “If I don’t eat, the stress becomes overwhelming, and I don’t have any other way of dealing with it, therefore, not overeating is unsustainable”.

And then, that kid becomes an adult; can we seriously expect this person to simply reverse years of cognitive structuring just because they’re past a certain age? When exactly does a kid break free from the shackles of their environment and, all of a sudden, become a free, independent, all-powerful adult?

Also, other factors make people tend to gain weight, like metabolism, different levels of hunger, medications, endocrine conditions, physical disabilities, pregnancy, and menopause, or simply things that make overeating more tempting, like food marketing, eating habits in the social life, financial cost and practicality, the list goes on and on.

The point I’m trying to make is that every behavior has a function in a context. Are people maintaining a caloric surplus simply because they’re “choosing to be obese” or because they simply like tasty food a lot? Or is it because overeating has a function in that person’s life, and without it, in the present conditions, they wouldn’t be able to function properly in their daily life?

Now, all of that doesn’t make losing weight impossible, the rule of being in a caloric deficit still stands, but all those factors influence the cost of each behavior you could have.

Imagine you’re in a context where it is extremely advantageous to you (at least in the short-term) to overeat, and you have to choose between overeating or developing new behavioral patterns that will lead you to lose weight. Let’s weigh the immediate behavioral cost of each choice:

The cost of overeating is walking up to the fridge, picking up something tasty, eating it, and enjoying the stress relief as you feel a nice flavor in your mouth and forget about all your problems for a while.

The cost of developing alternative behavioral patterns is letting go of your primary coping strategy and therefore dealing with negative emotions that might feel overwhelming, trying to learn new ways of dealing with those emotions, which takes effort and will also increase your stress levels even more, directing active effort to find useful information on how to go on about your weight loss, maintaining a consistent energy expenditure to not give in to cravings, possibly refusing social invitations that involve high-calorie food or that might trigger overeating, dedicating time and effort to working out and maybe readjusting your whole schedule to do so. While keep in mind, you could’ve avoided all of that by simply forgetting about it and overeating. There’s a big difference in the cost of that choice if you have the means to minimize the negative “side effects”, but not everyone has those.

Now, let’s add some personal background to that: you’ve tried dieting before, but you didn’t have access to high-quality advice on how to go about it, so you’ve failed miserably, multiple times, losing some pounds only to have a rebound effect and get even fatter. Actually, let’s add some more info to that, you feel ashamed of yourself for being fat, so you backed away from your social life, you have no support system to incentivize you, you’re deeply embarrassed to walk up to a gym, and every fitness influencer you see online does not look anything like you. Because of this background, you don’t believe diets work, and you don’t believe you’re capable of exercising. A strong belief of yours is that skinny people are simply genetically gifted and you’re destined to be obese forever. Now, how exactly are you supposed to make the second choice?

I know this last paragraph might’ve been a bit tiresome to read, but we must understand that if I were to list all the possible aspects that could increase the cost of choosing the alternative to overeating, that paragraph would be way longer.

And to this, some people will still answer: “Well, I was in similar conditions, but I decided to change, and I was successful”. Props to you, but if you’ve managed to do that, that means you were in a context in your life where you believed in yourself, the message about fitness you’ve had access to was convincing to you, you’ve had access to an alternative that could perform the function overeating had in your life, you had access to people (like friends or influencers) or content that inspired you, and so on. In other words, your environment allowed you to do it; it lowered the cost of not overeating. That doesn’t mean you shouldn’t be proud of yourself, but that does mean you shouldn’t look down on people who didn’t achieve what you did. Your environment granted you a good view of the risks of obesity and the benefits of a healthy lifestyle, a lot of people don’t manage to see things that clearly when they’re so immersed in their current patterns, especially considering the long-term; that’s because your environment/context not only affects how hard losing weight is, it also affects the way you see yourself, the world, and your future.

This means that yes, people can change and overcome obesity, and yes, their actions are what will ultimately determine if they’ll be able to do it; But to think that this is all a simple choice that people make is terribly reductionistic.

So, theoretically, it is a choice, but practically, if the cost of that choice is so high that it makes the choice unsustainable, is it really a choice? For some people to be able to make the “right” choice, some environmental aspects need to change, along with their cognitive-behavioral repertoire, so the cost of the choice goes down, and they can sustain the adaptive behaviors they’re looking for.

The main takeaway here is: people don’t simply decide to be obese, their circumstances led them to develop the behavioral patterns that make them gain weight. The rule of the caloric deficit stands, but simple “power of will” is not enough to change such a complex system, what people need is an environment that supports them, and provides reasonable and sustainable alternatives to their current behaviors.