ASSUMPTIONS IN HEALTH PSYCHOLOGY
The research into obesity and CHD highlights some of the assumptions in health
psychology:
1 The role of behaviour in illness. Throughout the twentieth century there was an
increasing emphasis on behavioural factors in health and illness. Research examined
the problem of obesity from the same perspective and evaluated the role of overeating
as a causal factor. However, perhaps not all problems are products of behaviour.
2 Treatment as beneficial. Drug and surgical interventions are stopped if they are
found to be either ineffective or to have negative consequences. However, behavioural
interventions to promote behaviour change, such as smoking cessation, exercise
and weight loss programmes, are developed and promoted even when the evidence
for their success is poor. Within health psychology, behavioural programmes are
considered neutral enough to be better than nothing. However, obesity treatment
using dieting is an example of the potential negative side effects of encouraging
individual responsibility for health and attempting to change behaviour. Perhaps
behavioural interventions can have as many negative consequences as other medical
treatments.
3 The mind–body problem. Research into obesity and CHD raises the problem of the
relationship between the mind and the body. Theories are considered either physio-
logical or psychological and treatment perspectives are divided in a similar fashion,
therefore maintaining a dualistic model of individuals.FURTHER READING
➧ Brownell, K.D. (1991) Personal responsibility and control over our health: When
expectation exceeds reality, Health Psychology, 10: 303–10.
This paper discusses the recent emphasis on patient responsibility for health
and suggests that encouraging the obese to diet may be an example of
attempting to control the uncontrollable.➧ Ogden, J. (2003) The psychology of eating. From health to disordered
behaviour. Blackwell: Oxford.
This book provides an account of the continuum of eating behaviour from
healthy eating, through dieting and body dissatisfaction, obesity and eating
disorders. In particular, it provides a detailed analysis of obesity and its
treatment.FOR DISCUSSION
In the light of the literature on obesity and CHD discuss the possible role of psycho-
logical factors throughout the course of an alternative chronic illness (e.g. diabetes,
multiple sclerosis).380 HEALTH PSYCHOLOGY