Recent advances in the development of weight loss drugs have brought discussions about weight to the forefront of public conversation. A new YouGov poll explores what Americans think about the causes of obesity, the link between obesity and health, weight-based prejudice, and the appropriateness of certain terms and conversations related to obesity. The poll finds that 72% of Americans believe there is an obesity epidemic in the United States and that 71% say that they personally know someone who is obese, including 19% who identify as obese. The results also show that most Americans believe that people who are obese experience discrimination in a variety of settings, including dating, the job market, and the health care system. Consistent with this, many people who are obese report experiencing prejudice in these settings, particularly in the realm of health care.
Causes of obesity: Self-control or chronic disease?
Americans are divided in their opinions on the causes of obesity. When asked which comes closer to their views on the subject, 39% attribute obesity to a lack of self-control, while 37% consider it a complex chronic disease. People who identify as obese are far less likely to view obesity as a self-control issue (23%) than as a chronic disease (59%).
When asked what role specific factors play in causing obesity, Americans are most likely to say that lifestyle choices (59%) or the food industry (49%) play a very important role, with large shares also describing the role of mental health issues (41%) and genetics (40%) as very important. Fewer say that access to health care (28%) or environmental factors (23%) are very important contributors.
Obesity and health
A vast majority of Americans (81%) believe that obesity is linked to health outcomes, with 36% saying it is very strongly linked and 45% saying it is somewhat linked.
The poll also highlights a shift in opinion over the past decade, as 55% of U.S. adult citizens now believe it is possible for someone to be "a lot" overweight and still be healthy, compared to only 23% of U.S. adults who said so in a poll conducted by the AP and NORC in 2012.
One common measure of body fat is BMI, or Body Mass Index, which is a value calculated from the weight and height of a person. Our poll finds that 61% of Americans consider BMI to be a good predictor of health outcomes, while 21% disagree.
The majority of Americans believe that people who are obese face discrimination in various settings. More than half believe people who are obese experience prejudice at least somewhat often in each of the following: dating (80%), the job market (72%), health care (65%), public transportation (64%), restaurants and stores (61%), within their families (61%), and in the education system (60%).
People who describe themselves as obese in our survey are more than likely than those who don't to say prejudice against people who are obese occurs at least somewhat often in most settings asked about.
In addition, large shares of people who describe themselves as obese say they've personally faced prejudice in these settings, particularly in the health care system (44% say this) and in dating (37%).
Two-thirds of Americans who identify as obese (68%) — as well as 33% of Americans overall — say they've been advised by a health care provider to lose weight in response to a health concern they raised that they felt was unrelated to weight.
In terms of who experiences weight-based prejudice, 50% of Americans say that women who are obese are more likely than men who are obese to be discriminated against, while 36% believe both genders are treated equally in this regard and only 8% say men who are obese are more likely than women to face discrimination.
Americans are more likely to say society should be more accepting of people who are obese than to say less accepting, with 34% advocating for more acceptance, 20% for less, and 22% believing the current level of acceptance is appropriate.
As for terminology, "overweight" is the term considered appropriate by the most Americans for referring to someone who is considered clinically obese, among six terms that were asked about (51% say it is appropriate). It is followed by "plus-sized" (41%), "obese" (36%), "heavy" (34%), and "large" (30%). Just 23% of Americans think it is appropriate to refer to someone considered clinically obese as "fat."
Conversations around weight
Conversations around weight can be delicate, though our poll does find some agreement regarding what is and is not appropriate to say in certain social situations. When discussing weight with someone they know, 68% of Americans find it appropriate to compliment weight loss, while 19% deem it inappropriate. In contrast, 67% find it inappropriate to tell someone they would be more attractive if they lost weight, and similar proportions disapprove of commenting on weight gain (64%) or offering unsolicited weight loss advice (63%). The one scenario without a majority consensus on whether it is appropriate is expressing concern about someone's health due to their weight: 46% say it is appropriate while 34% say it is inappropriate.
— Carl Bialik and Linley Sanders contributed to this article
Methodology: This poll was conducted online on March 22 - 27, 2023 among 1,000 U.S. adult citizens. Respondents were selected from YouGov’s opt-in panel using sample matching. A random sample (stratified by gender, age, race, education, geographic region, and voter registration) was selected from the 2019 American Community Survey. The sample was weighted according to gender, age, race, education, 2020 election turnout and presidential vote, baseline party identification, and current voter registration status. Demographic weighting targets come from the 2019 American Community Survey. Baseline party identification is the respondent’s most recent answer given prior to March 15, 2022, and is weighted to the estimated distribution at that time (33% Democratic, 28% Republican). The margin of error for the overall sample is approximately 3%.
Image: Adobe Stock (Antonio Rodriguez)