Psychological Aspects of Adult Obesity: Perceptions of Beauty, The Stigma Experienced, and the Toll on Overall Health, a Lecture by Dr. Charlotte Markey, Ph.D., April 2, 2014

Dr. Charlotte N. Markey Associate Professor Chair, Department of Psychology Rutgers University 348 Armitage 311 North 5th Street Camden NJ 08102

Dr. Charlotte N. Markey
Associate Professor
Chair, Department of Psychology
Rutgers University
Camden NJ 08102


Dr. Charlotte Markey is a psychologist who studies social influences on eating-related behaviors (i.e., eating, dieting, body image). Some of her projects include the romantic partners’ role in eating-related behaviors, parents’ influences on their children’s eating-related behaviors and media influences on body image. Dr. Markey’s current research also involves the investigation of young adult heterosexual couples, gay, and lesbian couples and the roles that their relationships and personalities play in influencing their health.

Dr. Markey began her lecture by asking the students to comment on a series of photographs she projected on the screen. Each photograph contained a thin adult and an overweight/obese adult. The purpose of the exercise was to relate and discuss the perceptions that emanated from the images and that were picked up by the students.

Next, Dr. Markey discussed “Standards of Attractiveness” and how they have changed over time. Dr. Markey put up the painting “Olympia” by Manet, and related how, at the time (1863) it was painted, the painting was criticized because the woman depicted was thought to be extremely thin, if not suffering from under nutrition.

Olympia by Manet 1863

Dr. Markey reviewed dieting and its psychological toll on dieters. Dieting can cause more problems than initially accounted because if people who attempt a diet fail, then the repercussions from the failure can lead into a spiral of depression and self guilt. Dr. Markey discussed her insights into the psychology behind dieting and reactions to failure.

The next topic was the differences in perception experienced by obese men compared to obese women. Obese men generate an average of $1000/year more in medical costs than normal weight men, whereas obese women accumulate approximately $3000/year more in medical costs compared to women with a BMI below 30.   Another difference is that men feel bias from others towards their obesity starting at a BMI of 35, whereas women experience bias from others at a much lower relative weight, starting at a BMI of 27, which is still in the over weight category.  These differences in perception are responsible for the importance each sex places on having an acceptable body weight and image.

At this point in the lecture, Dr. Markey played a 10 min segment of the HBO documentary on Obesity; Available on You tube:

The segment of the documentary Dr. Markey played addressed the stigma experienced by people who are obese. Quite honestly, it was heart breaking to watch and hear the interviews with the obese subjects.

Next, the topic of who’s at fault if one is obese was discussed in class. Is it the obese person’s fault? Is it the environment’s fault? Does the government play a role? Is it the individual’s problem? Or is it a societal problem?

Dr. Markey explained that one reason some people feel it is acceptable to be cruel (as documented in the HBO film) to obese individuals is that these people hold the basic belief that it is the obese person’s personal responsibility for their weight gain, and therefore, that particular individual should be personally blamed for their lifestyle choices leading to obesity. But is it the case that the obese person actually has a real choice to live a lifestyle that leads to obesity? What if the obese person is truly driven by forces (such as a sustained, unrelenting appetite) that they can’t control? If this is the case, is it their personal fault for being obese?  This topic is extremely complex and there are many issues involved.   To help with the discussion, Dr. Markey concentrated on the short story she assigned:   “The Fat Girl,” by Andre Dubus

Click to access The-Fat-Girl-297rfhc.pdf

There was a lengthy class discussion concerning Dubus’ famous short story!    Please go to the website above and download the pdf of the story!

Dr. Charlotte Markey also assigned the following articles to read for the class:

Puhl RM, Heuer CA., The stigma of obesity: a review and update.   Obesity (Silver Spring). 2009 May;17(5):941-64.;jsessionid=07D3F384C87BB6DBD98A1F45F5AEC641.f02t03

Markey PM, Markey CN.,  Annual variation in Internet keyword searches: Linking dieting interest to obesity and negative health outcomes.

J Health Psychol. 2013 Jul;18(7):875-86

To learn more about Dr. Charlotte Markey’s research, please visit her website at:


  1. Fatima Cheema

    Dr Markey’s Talk was very interesting. I really enjoyed learning about the psychological aspects of obesity. People often fail to take the effects of restrictive dieting in consideration when discussing eating disorders. I believe that it is one of the main causes of binge-disorder, which may then lead to obesity.

    The Fat Girl

    The Fat Girl is a story about a girl who grows up thinking that people are fat because they chose to be. Louisa had a genetic pre-disposition to be a little overweight. Her mother started intervening and would taunt Louisa for her eating habits. Louisa however would not be satisfied and would eat more in secrecy. Later when Louisa went off to college, she continued to eat secretly in the dark. One night, her friend Carrie called her out on it and offered to help Louisa lose weight. Over the next few years, Louis went from 184 to 110. Though Louis noticed a positive reaction from society for her weight loss, she did not feel good on the inside. She married a man who loved her for her slender frame. She lived a life that often did not feel like her own. In a way Louisa felt like she had lost her identity. The story ends with Louis gaining all the weight that she had previously lost. Her husband is not happy, and she can tell that he will leave her soon
    Overall, this story made me very sad. Louisa lost her identity in the process of getting approval from society. She married a man who did not love her for who she actually was, and her mother only approved of her when she was slender. Even though this is a fictional story, I think many people go through similar struggles. People often think that media images influence young girls to form a negative body image. I however feel as though a lot of our eating habits are determined by our early interpersonal relationships. Louisa’s mother had a huge role in Louisa’s addiction. By making negative comments to Louis about her behavior, her mother made her feel ashamed for something that Louis felt like she could not control. This was most likely the reason that Louisa ate in the dark.
    I myself underwent a very similar struggle to Louisa. At the age of 12, I remember my mother making remarks about how I was gaining weight and that I should have better portion control. Being thin was always associated with having more discipline in my household. This would later cause me to go through years of restriction, and extreme dieting. I reached a point where I was no longer menstruating because I did not have enough body-fat. It was at this point that I made a personal decision to become healthy and take control over my health. I became a healthier weight for my height and age, and went on to study nutrition in college. In a way, I could see myself in Louisa. I could feel her annoyance at society for not accepting and loving her for who she was. I could feel her crankiness as she angrily starved herself. Furthermore, I could relate to the empowerment she felt at the end when she refused to give in to her husband’s expectations. She had finally realized that it was ok to be imperfect and that as long as she liked herself, everything else would be ok. I was happy for Louisa at the end.

  2. Christina Singh

    I enjoyed having Dr. Markey come and speak to our class about the psychological aspects of adult obesity. Discussions concerning obesity rarely ever focus on how the people who experience obesity firsthand feel. I found the documentary she presented to the class detailing experiences that obese people had to be very interesting, although it was upsetting to watch. Observing overweight people discuss how awful they were treated was a lot to handle. What made me especially upset while watching the video was how some people blamed the obese person for their excessive weight gain and their inability to lose the weight. I personally think that there are several factors that contribute to a person gaining excessive weight. I think one of the main causes contributing to obesity is the environment a person grows up in. A person raised in a low socioeconomic family is introduced to foods that have less nutritional value. Families who don’t have much money are accustomed to spending what little they have on foods that are cheap, which tend to be foods that are the worst, such as fast food. Another factor could be a person’s genetic makeup. Heavy weight can be something that is passed down from a parent to a child. Certain families are also prone to higher risk of cardiovascular disease and diabetes. In my personal opinion, I find it completely unfair for someone to blame an obese person for their weight and to criticize them without knowing the reasons for their weight gain.
    The story behind Louise’s battle between food and her weight was very disheartening in “The Fat Girl.” Since she was nine years old, Louise’s mother always kept a strong watch on the foods she ate. She told her that if she were fat, boys would not like her. In an attempt to keep her daughter’s weight down, Louise’s mother restricted her from eating certain foods and discouraged her from ever helping herself to extra food during meal times.
    I personally found this story to be very depressing. From such a young age, Louise was faced with the trauma of not being able to express who she really was. I was always taught in my nutrition classes how important it is for parents to not restrict foods that their children ate. Rather, parents should introduce and allow their children to try different things to avoid both pickiness and binge eating of foods that they were never allowed to eat. This was when Louise’s battle with food began. I enjoyed this story because it elaborated on the realities that some people face with weight gain and loss. All Louise wanted was to be happy and even though she lost weight during her last year in college, she didn’t feel like herself. It’s also sad how important of a measure society places on being thin and how this physical trait is so closely linked with being attractive. Louise never felt respected, or even loved by her mother until she came home and was able to show her mother how thin she was. The fact that she also received similar criticism from her husband, who also refused to touch her just proved how terrible her situation was. Although I would never do this, Louise’s story taught me to never give up on someone and to never criticize him or her on his or her appearance. Doing so doesn’t help the situation. Instead, helping someone with his or her weight problem by offering advice goes a long way.

    • Taylor Palm

      @ Christina Singh

      You make a really excellent point about how multifaceted obesity is. Reason for weight gain cannot be singularly summed up in one fact, it’s impossible. Simply saying a person is lazy is both ignorant and untrue. Environment, prolonged emotional distress, biology, financial realities and general lack of sound nutritional knowledge can contribute to obesity. These people pointing fingers, “they” are not doctors, nor are “they” dietitians who have the authority to make sweeping judgments on the causes of a person’s obesity. One thing we’ve heard time and time again is that fat isn’t that understood; it’s a complicated system that isn’t as easy as “don’t take a second helping at dinner.” The HBO videos showed how vulnerable and hurt these people are after years of being ridiculed by people who have no idea who they are or where they came from. The fact that random strangers feel 100% comfortable telling someone they’re fat is absolutely atrocious.

      I also agree with what you had to say about the story. Louise’s tragic battle with her weight was very raw and accurate to the society we live in. Magazines and celebrities tell us beauty is a size 2. Pretty faces, knowledge, wit; they’re not important unless your figure attracts a husband. How unfair and cruel these limitations are that they force the hand of mothers to restrict their child’s eating. While Louise’s mom was definitely a major part of the problem, her intentions were really to make her daughter happy the only way she knew how. She wanted her daughter to be happy and to be happy she had to be thin. This message is so often reinforced and creates unreachable standards for people. When Louise lost the weight, she also lost herself. Obviously we should all strive to maintain a healthy body weight but to submit yourself to extreme under restriction is potentially as harmful as being over weight.

      I think your take home message is really nice, it’s so easy to criticize and have all the right answers for someone who struggles with their weight but at the end of the day all you should do is love and support them.

      Great Post!

    • Pauline Suan

      I agree with what you said about how people tend to have a lot of prejudice in obese and overweight people. It’s a very harsh reality and it is sad that people have to be at society’s weight standards in order to even be taken seriously at any setting. I feel that society places too much emphasis on appearance rather than the accomplishments, personality, and uniqueness of a person. I feel that as a society we should stop and think that the stigma is everywhere and we have to think of ways that we can decrease the prejudice around our own community. We can start in schools where little children grow up and learn. We can also start at home by telling our own children to place a higher value on inner beauty than what we only see outside. After all, it all starts at home.
      Louise’s journey also touched my heart. Her story mimics the many stories that overweight and obese people have been through. Her mother raised her in restriction and unfortunately, as we all learned from our first article in our Obesity colloquium, restriction does not help the child. The ending was very depressing to me and it connects a lot to the prejudice society has over obese and overweight people. It really showed that even in the end, her husband never loved her for who she really is but how she used to look like. The most depressing aspect about this story is that people experience this everyday. Although it is a fictional story, it affects and happens to more than one third of the country’s population their whole lives.

  3. Amanda G

    It was such a great opportunity to have Dr. Markey come in for a guest lecture. I found her presentation to lead to one of the most interesting discussions we’ve had in class so far.

    “The Fat Girl” by Andre Dubus
    This short story fills the reader in on the life of Louise. Louise is a girl who has been judged for her weight all of her life. It begins initially at home, with her mother. Her mother seems to herself have eating issues and or an eating disorder. With her mother having her own insecurities about weight, Louise’s mother is quick to push her own issues onto her own daughter. Louise seems to have more than just a troubled relationship with her mother, but with her father as well. From gluing together pieces from the story it leads the reader to believe that Louie’s father has sexual molested her. (Even though no one else wrote about this, I decided to leave this observation in my review. There were a few people who actually agreed with me when we discussed the papers in class.) Louise’s home life is nothing close to being a safe environment for any child to grow up in and walk away with no mental/physical issues. Even though Louise’s mother strictly controls what her daughter can and cannot eat, Louise has found away to get what she wants without her mother finding out. Louise develops at such a young age, to hoard food in her room and to sneak it when her mother is not looking. All through high school she has a fascination with being friends with skinny girls. When Louise graduate from high school, she moves onto college. There she initially struggles with food hording as well. It’s not until she befriends a girl named Carrie, that she finally becomes open with who she is. Carrie is a supportive friend to Louise and tells her it’s okay to eat in front of her. One day when Carrie comes back to school, she decides to ask Louise if she wants her help to try and lose weight. Louise follows through with the direction Carrie gives to her and over time, Louise does lose the weight. At this time she goes home to see her family and her mother cannot believe how her daughter has transformed. She is so amazed and “proud” of her that she spends money on Louise and buys her new clothes and even has someone come to the house to take photos of her. This is the first time Louise’s mother actually seemed to show any kind of positive love towards her daughter. The story moves on to Louise finding a husband who “loves” her and they marry and have a child together. While she is pregnant Louise slips back into her eating habits of when she was young. Her husband criticizes her and tells her she is getting fat, not just gaining baby fat. Once she has the baby, her eating continues and she is almost ashamed because she is hording food and waiting for her husband to leave so that she can feel comfortable eating whatever she wants not in his presence. At the end of the story she realizes her husband is going to leave her.
    This was such an emotional short story. From things that I have learned in other classes, I know that your eating habits start when you are very young. You learn habits from your family members and their opinion on food greatly impacts your view on food. Louise’s mother was a typical authoritarian parent who felt the need to control every thing her daughter consumed. From my child and nutrition classes I have taken, I know that the more you restrict your child the more they crave the foods you restrict. Just because as a parent you restrict and don’t allow your child to have certain foods they will find a way to hoard the food and eat it when you’re not looking. When a child hoards food they over indulge beyond what they would eat if the parent would just allow the foods to be consumed sometimes. Children need to be educated on foods that they can eat all the time and foods that are sometimes okay to eat. If a parent themselves, such as Louise’s mother has their own eating struggles it’s virtually impossible for them to teach their children the right ways to eat.

    • Amanda,
      Interesting comments! I never thought that about Louise’s father…hmmm…. I liked to think there was some positive parenting going on in this fictional character’s life!
      With best wishes,
      Dr. Markey

      • JLD

        Several others in class agreed with Amanda concerning Louisa’s father although they did not mention this in their write ups. I went back and reread the beginning and did not pick it up. I thought the father was trying to compensate for the mother. Certainly great fiction can deliver different perceptions!
        Joe Dixon

    • Fatima Cheema

      Hi Amanda,
      I completely agree with your point that children should be educated on the nutritional value of food. Furthermore, parents should be required to take ‘parenting classes’ with regards to food and nutrition. Louisa’s mother’s criticism of her eating behavior made Louisa ashamed of who she was. Being overweight was perhaps a genetic component of Louisa’s physiology. It was part of who she was and being told to alter it would make her feel that she was not acceptable as she was. She had to become somebody else in order to please society. This perfectionism and people-pleasing attitude is often what causes eating disorders. Eating disorders are also linked to genetics, so it made sense that both Louis and her mother had an unhealthy relationship with food.

  4. Cassie Hsu

    I really enjoyed Dr. Charlotte Markey’s lecture as it was easy to follow and the information presented was interesting in that it really puts society’s view on overweight people into perspective. It is amazing how differently people are treated when they are seen as fat. Many treat them as almost sub-human and that is a very sad thing to witness.

    People who are overweight have a risk of health issues than those with healthy weight, leading them to turn to healthy weight loss strategies. However, it is observed that the weight loss is temporary and after about two years, the weight is gained back. The cycle of weight loss and regaining weight is known as weight cycling, and is seen among the obese and dieters. Studies show that this cycle has a negative impact on mental health, including problems such as depression and self-esteem, and may even pose increased physical health risks such as diabetes, heart disease, and strokes. Research suggests that diets have almost no positive effects on health and those who diet commonly end up gaining more weight than they lost at the end.
    To further research on the effects of dieting, the Internet is used to help find dieting interests and the harmful effects on a national level. About 78 percent of the United States’ population has access to the internet and this gives valuable information on keyword searches about the issues and concerns. Dieting starts at various times in the year, with the most popular time being New Years. However, most people lose interest and give up, then regain the interest in the following January. One study focuses on the presence and size of dieting-related keyword surges that could help serve as a predictor for negative health risks. It is predicted that people in states with high obesity levels tend to have a higher number of dieting-related keyword searches, with the highest in January and gradually decreases throughout the year until the following year, where the cycle repeats. Results show that the greatest number of keyword searches occurs in the southern area of the United States.
    The internet is such an important factor in people’s lives today and most of us are centered around it, with all the laptops and smart phones. It is rare for someone not to be connected at any given time, and so much information is accessible literally right at our fingertips. It is amazing that one can track information based on what others search for on the Internet and it really shows that almost anything could be found if searched. I found that the results of the study were not surprising that most of the searches came from the South. Based on knowledge of diets and habits, the Southerners tend to include more fatty food in the diet which might lead to weight gain.
    Based on personal experience, there are not many people in my family who have a problem with weight gain; however I do know of a family friend who shows the dieting and weight gain cycle problem. While she does not follow the January cycle, throughout the year she practices months of dieting but even the slightest stop makes it seem like all the weight is gained back. I feel that this might happen because those who are overweight have diets that lead to it and forcing oneself to lose weight would only work for so long before they fall back into the same pattern and gain the weight back which makes it seem like nothing has changed. This may lead to a negative result because the dieter feels like they failed and may result to eating more if they feel depressed and lead to more weight gain. This was what Professor Markey mentioned in lecture and it is definitely one of the big factors on why people fail to lose weight after dieting. The psychological aspect of succeeding and failing is strong enough to tip the scales between losing and gaining weight.

    • Sunny Brower

      I really enjoyed Dr. Markey’s lecture as well Cassie, as I too found it extremely interesting and easy to follow. I think the fact that she did not get into the technicalities of the issue, but just spoke about everyday issues which we have all seen with our own eyes is what made this lecture so interesting. I have seen firsthand how those who are overweight are treated differently and not as equals to healthy weight individuals as you had mentioned. It is a terrible thing to see and even more depressing to learn how many people have these tainted views of obese individuals simply due to their appearance.

      As you explained of your personal experience with your family friend who is a victim of the dieting and weight gain cycle, it made me also think of a family friend of mine who suffers from the same issue. For all of his adult life and the five years which I have known him he has battled dieting and his weight. His relationship with food, eating and exercise is very negative, as well as, confusing. Do to his continual process of losing and gaining for the past twenty plus years and trying diet after diet, I feel he has skewed, unhealthy views towards foods. I believe to him at this point in his life, food has become his enemy which he feels he cannot conquer which has led to somewhat of binge eating behavior that makes him feel as if he is in control. It is sad to think the psychological affects which people suffer from due to their “failure” with dieting. With this knowledge and educators like Dr. Markey we as a society need to be more aware of the stigma we have created, as well as, the struggle obese individuals may go through if we ever want to end the cycle of obesity.

    • Cassie,
      The dieting cycle is easy to fall into… Polivy and Herman (two researchers; they happen to be married to each other) have written excellent papers about this. I highly recommend an article published in American Psychologist in 2002.
      Dr. Markey

  5. Chelsea

    I really enjoyed Dr. Markey’s presentation. People are always looking at obese individuals negatively, forgetting that they also have feelings. After watching the stigma video, it is shocking how cruel people can be.
    I read the article titled, “Linking dieting interest to obesity and negative health outcomes,” which was really interesting. The article explains a study done from January 2005-March 2011 to see which states had the highest and lowest “dieting-related keyword searches.” One statement in the article, “Individuals who are overweight tend to diet the most,” really sums up the whole point of the article.
    “Weight cycling,” is described in the article, and it’s something I have never heard of. It is described as losing weight during a diet, and then gaining it back within the next two years. Diets have little to no positive effects on long-term weight loss and overall health, which I completely agree with. In order to lose weight and keep it off the healthy way, you need to eat nutritiously and exercise regularly, not just search how to go on a diet through google and attempt to lose weight for a month, specifically December-January, as the article explains.
    There were three predictions made in the article, and although I didn’t agree with each one, I found Prediction 1 to be very interesting because I always noticed more people at the gym right after New Year’s Eve, but I never thought anything of it. Turns out, as predicted in Prediction 1, there is a 29% increase in dieting-related keyword searches between December-January, as people are making New Year’s resolutions.
    “Dieting-related keyword searches” refers to people searching about health-related topics, specifically related to dieting, on the internet. The study done by Dr. Markey shows that states with higher dieting-related keyword searches had higher rates of obesity, as opposed to states with lower dieting-related keyword searches. It makes sense, since individuals who diet are more likely to be overweight, states with high dieting-related keyword searches, most likely means that those states have a higher percentage of people dieting, meaning a greater amount of people will be overweight.
    The results of the study proved whether the predictions made were accurate or not. Before reading the results, I found Prediction 3 to be absurd. It explains that individuals living in states with higher dieting-related keyword searches will be more likely to die from chronic diseases related to obesity, resulting from diets and weight cycling, including diabetes, heart disease, and stroke. I thought that a simple internet search could not have that much of an effect on mortality rates, but after the study was conducted, it was proven that individuals living in states with higher dieting-related keyword searches were more likely to die from these diseases than people living in states with lower dieting-related keyword searches.
    Dieting relates to negative health effects due to weight cycling. Weight cycling is linked to dieting-related keyword searches, so states with high rates of dieting-related keyword searches have higher rates of obesity.

    I really enjoyed this article, it was very interesting!

    • Chelsea,
      Thanks for your comments! Keep in mind that our study is correlational — so we can’t prove that weight-cycling leads to more heart attacks, for example. But, it is a very likely interpretation of the data!
      Dr. Markey

  6. Ashley Aaron

    The lecture given by Dr. Markey was one of the most easily understood and relatable lectures we’ve had so far. After learning the biology behind obesity, she really tied together the emotional and mental aspects of how this problem starts. While I loved her entire presentation, I would like to share my thoughts on the short story “The Fat Girl” by Andre Dubus.
    This story depicted a troubling time in a young woman’s life as she struggled with her weight. Her name was Louise, and the story begins with her as a young child feeling pressure from her mother to restrict her eating habits. While her father was much more loving and affectionate, her mother ultimately had the most influence on how Louise behaved later in life. Constant hunger led her to begin sneaking foods and develop a sweets addiction. When Louise left for college, some habits followed but she felt more comfortable in the confines of her dorm than she did at home with her mother. Soon, her roommate Carrie confronted Louise about her eating habits and offered to help Louise lose weight. Their goal was to transform Louise from one hundred and eighty-four pounds to a thin one hundred and fifteen pounds. Through severe dieting, a moderate increase in physical activity, and the new habit of heavy smoking, Louise made it all the way down to one hundred and thirteen pounds. While those around her were thrilled at her transformation, Louise did not experience the same excitement or pride for her work. She had become her mother, and while she found herself a husband to love her, she did not love herself. After becoming pregnant, Louise had lost the discipline that Carrie taught her and she went back to her old ways. She ended up gaining most of her original weight back, and expressed no desire to attempt another diet.
    This story was just plain sad. It’s sad that she was doomed from the start and that while her friend was trying to help her, she ultimately did more damage than good. To go from one unhealthy habit of overeating to chain smoking and anorexia is senseless. The worst part is that the latter was more accepted among family and friends simply because Louise’s appearance become more acceptable. Nobody bothered to think about how her insides were doing. It’s also sad to think that had Louise had a positive, educated professional in her life, she may have been able to actually get healthy. She may never have reached a hundred and thirteen pounds, but even she debated the concept that maybe she was meant to be a hundred and thirty-six pounds. This story is the prime example of why professionals like nutritionists and personal trainers need to be accessible by everyone. The people that need help the most are rarely the ones that ask for it. By making education segments to programs like SNAP that provide services for those who may not be able to afford it otherwise can really make a difference in someone’s life. Nobody needs to be rail-thin and weight should never be the only factor used to determine someone’s health, but sneaking candy in the middle of the night is clearly not a healthy behavior and can certainly be changed in order to improve the quality of someone’s life.

    • Talia Gabbay

      I could not agree with you more! Louise’s family and friends were too consumed with the way Louise looked to notice how unhealthy her method of loosing weight was. Of course some of this unawareness probably stemmed from a lack of knowledge about to proper way to lose weight. However, I do not see this as a valid excuse. I think that it is unbelievably sad that friends and family, who should have been supportive and concerned when such drastic changes occurred, did not notice. You point out a really important part of the story when you talk about Louise replacing her unhealthy food habits with chain smoking. Neither are healthy life styles. Just as her mother and friends wanted her to lose weight when she was overweight, they should have wanted her to stop smoking because of the known risks of smoking. Overall, I think you have pointed out really important aspects of the story and I like your thorough reflection.

    • Ashley,
      I agree with your thoughts! I love the example of Louise – it reminds us that people are not just physical beings but emotional and psychological beings as well!
      Dr. Markey

  7. Luisa Martinez

    I was very moved by Dr. Markey’s lecture materials, the HBO documentary was especially rough for me to get through. My brother is obese, and I have seen his struggle to lose weight, I have seen the looks on other people’s faces when he walks into a room. The last time we visited our parents down south, we took one of those little tiny planes and I saw the look on everyone’s face when they saw my brother get on board; they were all probably thinking the plane was gonna go down because of the heavy kid on board! Seriously, that’s the look they had on their faces. My brother has not visited my parents since.

    The stigma, the name calling, the discrimination (it can’t be called anything else), is out there and it is time to put an end to it. It is that very same attitude that discourages people like my brother from even trying, and to think that they get the very same looks and treatment from those who are supposed to be helping… well that’s just devastating all on its own. The story about Louise, though fictional, paints a very clear picture of what is like to be and think like an obese person. It is a great example of the psychological struggle, as well as the physical struggle experienced by an obese individual on a daily basis.

    The fat girl by Andre Dubus

    When I first read the small poem at the beginning of the story, The Fat Enter Heaven, I must admit I had to read it more than once. I couldn’t understand whether the poem was a metaphor for heaven or an actual description of heaven as experienced by the obese (if there is in fact a heaven). Then I decided, what’s described in this poem must be how it feels for an overweight/obese person to let their “guard” down. When you get to that point where you just don’t care anymore, people’s opinions and social pressure don’t exist. “Now their commonplace lives, the guilt about weight, the ridicule fade and disappear”- how Louise must have felt by the end of the story. She had not died and gone to heaven, it was simply heavenly to not care anymore about the social constraint and pressure of being overweight; she could shed her girdle and eat her chocolate in peace!
    Poor Louise, it is all I kept thinking while reading the story. As children often do, Louise learned about body image and self-esteem from her mother whom apparently struggled with self-image herself. Not knowing how to relate healthy eating habits with body image and self-esteem, she taught her daughter that food restriction was the best way to be and remain thin. As we have learned in this class already, food restriction in children typically leads to overeating in the long run; as Louise did by sneaking around the kitchen to make her super sandwiches or when she ate her candy late at night in the dark. To begin such a complex and destructive relationship with food at such an early age, leads to major low self-esteem issues, self-hate and other psychological issues which can then be carried to adulthood and passed on to the next generation. Throughout the story, you can see Louise loved food but she hated herself for it. The closest thing she had to a support system was her friend Carrie, who unlike her mother (and later her husband) showed empathy towards Louise. It was Carrie’s empathy that motivated Louise to actually lose weight, that feeling of someone accepts me for whom I am but want to help me become a better version of myself. She didn’t see her as her “fat” roommate, the girl who is doomed to be fat for all eternity. She saw Louise’s eating late at night as a cry for help rather than a problem to be fixed.
    This story is a reflection of how our society views obese individuals, how it beats them down instead of helping them build themselves up. It illustrates how the overweight are pushed to view themselves through the hourglass mirror of society, which clearly conflicts with the body image that stares at them in the mirror. This is clearly not constructive, but destructive and eventually so many people just like Louise end up giving up. It is not that they give up on themselves, it is more like they give up trying to be a reflection of what society wants them to be.

    • Miranda Schlitt

      Louisa, I completely agree with you. Obese individuals have to face extremely harsh discrimination and are often stigmatized in the eyes of society of being lazy and careless about heir health, which is not the case. It is so sad to hear about your brother and how he feels that he is unable to visit your parents because of his size as he is so poorly misjudged by others. You brought up the poem before the short story we read before Dr. Markey’s lecture. I did not read the poem but your description makes perfect sense and I think can be somewhat related to others who are struggling with insecurity issues or body image issues. It is sadly true that so many people go through such harsh realities that when they finally come to accept themselves for who they are they feel “free”. Louise came to that realization at the closing of the short story which ties directly to the poem. It is so sad to see that it took her that long to be able to finally accept herself and be who she wanted to be. Self acceptance is extremely hard and it takes a person a long time to be able to accept themselves at times, but the fact that Louise came to the realization at the end of the story is a wonderful ending and should be a lesson to those struggling with weight.

    • Louisa, Thank you for sharing such honest and deeply personal reflections on Dr. Markey’s lecture and “The Fat Girl” story. It must be very troubling to watch your brother struggle firsthand with the stigma of obesity. I’m sure that you want to do everything you can to help your brother be happy, healthy, and confident, and I can only imagine how to difficult it is to observe others judging him or making inappropriate gestures or comments. I am interested to hear if this is something you talk openly with your brother about, and if so, how you have approached the topic with him. I know from my own experiences that talking to loved ones about weight — and especially its psychological impact — can be very tricky. He is fortunate to have a supportive and nonjudgmental sibling at his side.

      More than anything, Dr. Markey’s lecture (and the accompanying short story and documentary) reminded me how ingrained anti-obesity stigma is in our society. People — even dietitians, behind closed doors — throw around the word “fat” so casually. And then there are all of the subtle and not so subtle signs of stigma we see (or don’t see) in everyday life. One that stood out from the video was the woman who mentioned that others peer into her cart to see what she’s eating or tell her she shouldn’t be buying or eating certain foods. It is amazing how rude and inappropriate people can be. Worst of all, many of these acts are “hidden” and people may not even realize what they are doing, let alone the effect it has on overweight individuals they are interacting with. Certainly, the stigma that surrounds weight is doing nothing to reduce the high rates of obesity in this country. We all need to be more conscious of how we respond to obesity in our own environment, not just as nutrition professionals, but as human beings who should treat others with the respect and dignity that each and every one of us deserves.

    • Luisa,
      Yes, society could do a much better job of “building people up” (as you put it). Blaming people rarely (if ever!) has done anything positive to improve their health!
      Dr. Markey

    • Christina Singh


      I really enjoyed reading your blog post because you were able to relate Louise’s struggle with her weight to your brother’s experience. I’m so sorry that your brother has had such a hard time with his weight. The society we live in today can be very judgmental. I definitely agree that people who are obese are less likely to stay motivated because the people around them are not supportive. I’ve witnessed the looks on other peoples’ faces whenever I went to the gym and observed the way people glanced at people who were overweight. It’s obvious that they are judging them.
      When reading The Fat Enter Heaven, I also thought to myself, “Poor Louise,” throughout reading. Reading about her experiences made me extremely unhappy. I can’t even begin to explain how upset I was especially when I read the part of the story describing the relationship she had with her husband. I thought to myself that she has already been through enough and just when I thought that she was finally happy with someone, he criticizes her for her weight, just like her mother did.
      You’re absolutely right when you stated that obese individuals don’t necessarily give up on themselves, rather they give up trying to be a reflection of what society wants them to be. I couldn’t agree more with this statement. Society has a terrible way of building up a person’s self esteem. Whenever I pick up a fashion magazine, I never find a picture of someone who is obese. Actually, I never find someone who has an average body size. The media focuses so much on a skinny body type, making it that much harder for an obese person to feel comfortable anywhere they go.

    • Cassie Hsu

      Luisa, it is always hard to see someone you know personally go through the harsh treatment that people with obesity get nowadays. It is sad to physically see the discrimination towards people who are overweight, and like you mentioned with the plane experience, the looks on the people’s faces must have burned into you and your brother’s minds. I feel like it is amazing how this ‘disease’ is treated differently than others, where it may seem like even those who are supposed to help end up looking at the patient in disgust. If someone had cancer, other’s responses may be more consoling but then putting an obese individual in front of the same audience and they will probably try to avoid that person as much as possible and think they cannot do anything right. This is an attitude that needs to change, especially in doctors.
      I enjoyed your bit towards the poem in the beginning of the story! I am sure this is how a lot of overweight people feel after being judged so harshly. I feel that it is so sad in the story when Louise’s mother put so much emphasis on her weight that Louise had to sneak snacks before going to bed and how happy she was after Louise had come back after losing so much weight. She treated Louise with love only when she had shed her weight and it is devastating to see a parent with such shallow views.
      As I mentioned earlier, I believe society needs to change their attitude and behaviors towards the overweight and stop putting such a negative idea with obesity. These people are probably not proud to be this way, but it becomes much more difficult to seek help and support when all they are met with is distrust and disgust.

  8. Pauline Suan

    I loved Dr. Markey’s lecture. Despite the harsh reality of prejudice and stigma against overweight and obese populations, I feel that lectures like Dr. Markey’s have the potential of educating more people to carefully treat and help each other in such a size-diverse society. In return, proper education and lectures that teach about the reality of epidemics such as obesity would provide a significant decrease of prejudice and stigma within the nation.

    Searching for a remedy has been only a click away on the Internet in the 21st century. Obesity has become the sickness the public has been concerned about. The Markeys’ study examined the variation of internet searches on dieting. Surges on keyword searches was discovered with this study and it perfectly relates to the cycle Dr Markey had shared in lecture. Usually, people have a high amount of motivation to start dieting so they start searching the internet for solutions. Since the public doesn’t have a very good educated idea of nutrition, they easily fall for the fad diets that can be found online. As we learned in Nutrition and Health, the most effective diet is eat whatever you like (as long as it is clean and healthy) and exercise. Losing weight also comes with a great control with nutrition. Eating right can significantly help a person lose weight. Therefore, consulting a nutritionist is the best way to educate people who are trying to safely lose weight. With the proper way to lose weight, people would have more adherence because they can see that they have many options in finding the right foods to eat and they would feel healthier about themselves. I think that there should be classes on how to eat food in school and in community colleges for the public to take whenever they need lose weight and to especially monitor their health. Just like improving one’s health, it takes perseverance and time for progress. Google cannot make an instant individualized plan for the person searching for answers. Google has a countless amount of information from various sources worldwide. Therefore, not all of the information taken from the internet are valid or even scientifically proven to have actually safely worked. Google is a tool that can only help if one knows exactly what to search. Therefore, educating the public is very important in preventing and improving the case and risk for obesity.

    Obesity has become a major concern in society. With the pressure seen everywhere, people are pushed to find instant remedies and this can obviously be ineffective because fad diets do not work long-term. As a society I feel that we should advertise more education than very skinny models on the billboards. We should come together and try to understand one another instead of criticizing each other. But this is not a Utopia we live in and advertising companies still be in support for big money companies. Part of society will always judge and have a lot of stigma but we can start educating both sides of the spectrum starting in the schools. I feel that most of the criticism start in the schools when kids are more inclined to pick on the chubbier kids. I feel that educating the children will give them a better perspective as they grow up. Educating them just as Markey educated us about the harsh prejudice in society today can make a difference in how people think about others psychologically. I loved her articles as well as her lecture. It really opened my mind to a deeper understanding of something that is currently happening today.

    • Jessica Sahota

      I completely agree with your statement of “searching for a remedy is only a click away” with the rise of the internet. Many people use the internet as a source of information without realizing that many of the information that they regard as truth may be exaggerated or false. When it comes to diet searches this sentiment holds even more true. Quick weight loss diets are extremely popular in today’s day and age because of the stigma of being overweight and the need to achieve impossibly high standards of beauty. I also believe that educating people on the media’s portrayal of beauty in schools is an important step to giving children a better perspective of themselves and the media which can help them lead a healthy life style. It is also important for people to seek nutrition consultation from a dietitian so they can acquire a individualized diet plan to help them with their food-related goals. Many do not realize that dieting is not the same for each person and it can lead to disastrous results when done inappropriately. Overall, I like you reflection of Dr. Markey’s lecture and your opinion on ways to help solve this problem .

    • Pauline,
      Thanks for your thoughts. I can only hope that more RD will be available (and integrated into primary care practices) to help people manage their weight in a *healthy* way in the not-so-distance future!
      Dr. Markey

  9. Emily Ross

    I was very interested by the reading materials for Dr. Markey’s lecture and was extremely engaged by the discussion that was prompted during her time in our class. The short story, “The Fat Girl” by Andre Dubus was an impressive commentary on the lasting negative effects that poor eating habit role modeling can have on young children.

    This story examines the devastating emotional and physical effects that negative body image can have on an individual. A timeline of one girl’s life tells the story of the destruction caused by obsessive eating and harmful body image.

    A major focus of this story is Louise’s relationship with her appearance-obsessed mother. This relationship is at the root of Louise’s unhealthy relationship with food. From a young age, her mother taught Louise to associate food with very negative outcomes rather than teaching her about the benefits of certain foods and their ability to nourish ones body. Instead, Louise was shamed out of eating, causing her to binge in private and form a secretive and shameful relationship with food. This lifestyle that plagued Louise throughout childhood continued to rule much of her life. Never learning the healthy way to eat and sustain a well-balanced diet, Louise faced years of yo-yo dieting that caused her to lose dangerous amount of weight and then gain it back at a moments notice. Louise is said to have struggled with diet throughout her pregnancy (a time when healthy living should be of upmost importance), facing an addiction to cigarettes and unsupportive relationships with others. Louise’s life was one of ups and downs and her weight and diet plan followed a roller coaster that stemmed from her mothers negative role modeling and food shaming.

    While reading this short story, I was reminded of a major topic that I have been covering in my ‘Nutrition of the Child in the Family’ course this semester. Much of what we discuss is the important and immense impact that parents play in the development of their child’s self esteem and relationship with food. There are several ‘do’s’ and ‘don’t’s’ when it comes to successfully modeling a healthy relationship with food for your young child. Some of the ‘do’s’ include avoiding a major focus on food in daily discussion, teaching kids about the foods that nourish and aid their body, teaching children how to exercise in fun and healthy ways, as well as teaching your child to enjoy food in moderation and realize that food can be a greatly beneficial part of life while understanding that it is not all there is to life. Similarly, some ‘don’t’s’ include not teaching calorie-restrictive dieting to young kids, not fostering a weight-obsessed outlook in children, not restricting food in high amounts as well as not allowing any food that is wanted at any given time. The important take away is to teach children moderation as well as balance when it comes to diet. As this story so accurately depicts, an obsessive mentality towards food will only create a negative relationship, making weight management and physical well being a very difficult task.

    • Emily,
      Thanks for your comments! I love that you are taking an entire class on Nutrition of the Child in the Family! That sounds excellent!
      Dr. Markey

  10. Corryne Crabtree

    I thought Dr. Markey was a wonderful speaker and was so glad we were given the opportunity to listen to her speak. I can’t wait to read her book that comes out in December.

    I read Dr. Markey’s suggested story “The Fat Girl” by Andre Dubus and enjoyed it very much. The story begins by telling the story of Louise as a young girl and her mother dictating when and what she ate, while her father begged her mother to let her eat what she desired. As a result of this restriction, Louise began sneaking down to the kitchen, well after dinner ended and making peanut butter sandwiches for herself. Louise did this for a long time and when it was time to go to college, she finally began feeling like she was free and had no shame in eating sweets when she pleased. As Louise attended her classes however, she still felt uncomfortable with her physical appearance and began dieting under the instruction of her friend Carrie. Carrie put Louise on a diet and to her delight; she began losing a lot of weight. In the beginning of Louise’s weight loss, she began feeling more comfortable in her own skin, however this quickly diminished. She then began feeling weak and as if she lost more than pounds on her diet and that some how she lost a piece of herself. Louise eventually got married to a man named Richard and became pregnant with her son. After giving birth, she feels the pressure again to lose the weight she gained during pregnancy. Her husband is unsupportive and is very cruel in his comments towards her. She feels even more alone when her husband blankly tells her he will help her diet due to the lack of love and compassion she notices in his eyes. She senses divorce is coming, however she was surprised to find him still in the house.

    I enjoyed reading this story of a woman’s battle with her weight, appearance and search for supportive friends and family, despite its depressing nature. I was also very surprised to hear Dr. Markey say this story was fiction, because as I was reading the story, Louise’s emotions and feelings felt so real and alive to me. I feel as if this story began about being overweight and dealing with appearance issues, however as it progressed I began getting the sense that there is more to this picture. I think this story is more about the lack of support this young woman has in her life. From the very beginning she was belittled by her mother when she dictated what Louise could eat during her meals, she felt pressured by her friends in high school and then again in her marriage. The only hint of support and compassion she received was from her father who always had love in his eyes for her and he best friend in college, Cassie. I firmly believe that a lack of support from family members is detrimental to mental health. The lack of mental stability will make an individual more susceptible to health risks. This is also confirmation that not only the physical environment causes obesity, but the social environment as well.

    The story, The Fat Girl, written by Andre Dubus, describes the difficult battle a young woman faced with the pressures to look a certain way and her battle with being overweight. I believe this woman’s issues were facilitated by the lack of friends and family support. Mental health is critical and corresponds with physical health. I firmly believe that when you live a happy and relaxed life, your health and wellness benefits as a whole.

    • Emily Ross

      I completely agree that healthy eating habits and an overall healthy lifestyle begin and end with the support of those who care for you. Without this fundamental network, healthy living is much more difficult. Similarly, I think that this story and real life experience prove that the role models who guide us through life play a huge part in the development of healthy habits. For Louise, her model of eating behavior was a mother who struggled with self expectance and constantly shamed Louise. In effect, Louise failed to develop a stable, healthy relationship with food. As children, what we observe around us and what we are taught are fundamental parts of forming our own identity. This truth extends into our nutritional well-being and must be treated with the utmost importance by parents and any other adult that interacts with children on a regular basis.

    • Corryne,
      Thanks for your comments! You can preorder my book (if you are really interested – I’ll never know either way!):
      So glad you enjoyed the class!
      Dr. Markey

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