The Psychology of Eating: From Healthy to Disordered Behavior

Obesity Treatment 187

There was some evidence that in the longer term, daily weighing was asso-
ciated with a reduction in bingeing. This study was correlational, however,
rather than experimental. It is possible, however, that weighing is detrimental
only if the individual has not lost weight and can be beneficial if weight
loss targets are being achieved.

Should Obesity Be Treated at All?

The problems with treating obesity raise the question of whether it should
be treated at all, and this debate has been argued within both the profes-
sional and the lay press. For example, Garrow remains a strong advocate
of obesity treatment, and concluded a paper in 1994 with the statement
“I have been running a hospital obesity clinic for more than 20 years...
Obesity is often treated badly. The solution is not to pretend it does not
matter but to treat it well” (1994, p. 655). In contrast, Wooley, who is a
vocal skeptic about obesity treatment, argued in a paper with Garner in
1994, “We should stop offering ineffective treatments aimed at weight loss

... Only by admitting that our treatments do not work – and showing that
we mean it by refraining from offering them – can we begin to undo a
century of recruiting fat people for failure” (Wooley and Garner, 1994,
p. 656). They also argued that treatments should be withheld until they
can be proved to be effective, in the same way that “the drug industry has
to show both safety and efficacy” (p. 655). Brownell, although an advocate
of obesity treatment, has also questioned whether obesity should always
be treated and has questioned how much weight should be lost (e.g., Brownell,
1991). He has argued that the belief that body size and shape are change-
able can result in victim blaming: “When individuals do not meet the implied
responsibilities, they are blamed and are assumed to have negative personal
characteristics” (p. 308). In order to answer the question “Should obesity
be treated?” it is first necessary to examine the costs and benefits of treat-
ment and then to explore the treatment alternatives.

The costs of obesity treatment

With the exception of the surgical interventions now available, all obesity
treatment programs involve recommending dieting in one form or another.
Traditional treatment programs aimed to correct the obese individual’s abnor-
mal behavior, and recent packages suggest that the obese need to readjust