Title: Diabetes and obesity: Weight, Stigma, blame and shame

Abstract:

For many people, living with diabetes can be stigmatizing. Understanding social stigma and self-stigma and its potential to negatively impact diabetes management will be reviewed.  Included in this examination is the common misconception  that stigma might help motivate individuals with obesity to lose weight and improve their health. However, it generally has the opposite effect. The general public should be aware that blaming and shaming people with obesity is not an effective tool for promoting weight loss, and it may contribute to poor health. Negative attitudes toward obesity by healthcare professionals can also act as a barrier to successful diabetes self-management. When people feel shamed because of their weight, they are more likely to avoid exercise and consume more calories to cope with stress. Disparagement of others due to their weight and messages that perpetuate blame and shame, if internalized, can cause harm to the physical and mental health of individuals with obesity. People who report feeling stigmatized may have more feelings of psychological distress and a greater tendency to self-isolate. Stress from feeling blamed for diabetes can ultimately worsen someone’s condition, as counter hormones (i.e. cortisol and adrenaline) when produced, may increase blood glucose if a person does not have enough insulin in their system to offset the additional hormones.  The “diabetes blame game” is not appropriate and not helpful at all. Strategies to eliminate stigmatism will then be discussed. Included in the assessment of stigma is the lack of knowledge about diabetes in general. Education about diabetes is important. While lifestyle factors such as physical activity and weight may increase the risk of developing type 2 diabetes, age, race and genetics also play a large role. These additional factors involved in the onset of diabetes are not necessarily in one’s control. Also important to the understanding of type 2 diabetes is that it is a progressive disease. The development of insulin resistance and the need to inject insulin should not be seen as a failure on the part of the person with type 2 diabetes. Healthcare professionals can educate patients about the complex biological and environmental factors that contribute to obesity. Studies show that empathy from providers can break down stigma. They need to treat patients with respect, discuss weight with sensitivity and without judgment, and give support and encouragement to patients who struggle with weight management, instead of focusing on what patients did “wrong.” Getting support from other people with diabetes is another way to overcome blame and shame. Others who understand the daily experiences of life with diabetes can help make somebody else feel less alone with their condition and provide emotional support. Working with diabetes educators, people with diabetes can learn strategies for successful behavior change. People with diabetes can try to make positive changes, utilize self-compassion and feel good about themselves. Empowering patients with diabetes to manage it well is the antidote to stigma, blame and shame.

Biography:

I am a licensed Clinical Psychologist and Certified Diabetes Educator in Private Practice specializing in treating the emotional issues of patients with diabetes utilizing a cognitive-behavioural orientation. I provide individual, family, and/or group therapy sessions. I am the author/editor of MY SWEET LIFE: Successful Women with Diabetes and the editor of MY SWEET LIFE: Successful Men with Diabetes. Each chapter, written by a highly respected and successful woman/man with diabetes, shares their heart-warming stories leaving the reader to feel inspired and empowered to find balance in their personal, professional, and spiritual lives.