Obesophobia, also known as pocrescophobia, is a proposed type of anxiety disorder characterized by an excessive, unrealistic fear of gaining weight or becoming obese. While research has shown that weight bias and fat stigma are very real problems, the recognition of obesophobia as a distinct psychological disorder remains controversial.
What is obesophobia?
Obesophobia refers to having an extreme or irrational fear of gaining weight or becoming fat. People who exhibit signs of obesophobia may go to great lengths to avoid gaining even a small amount of weight, such as engaging in restrictive dieting, compulsively exercising, avoiding social situations involving food, abusing diet pills or laxatives, or undergoing cosmetic procedures like liposuction.
Some key signs that a person may suffer from obesophobia include:
- Intense anxiety about becoming fat or gaining weight
- Distorted, exaggerated fear of being obese or viewing oneself as obese even when at a healthy weight
- Avoidance of situations that may lead to weight gain
- Extreme dieting or fasting habits
- Compulsive or excessive exercising
- Eating rituals or strict rules around eating
- Preoccupation with food, calories, nutrition labels and body image
People with obesophobia often recognize that their fear of becoming fat is not rational, yet they have great difficulty controlling their anxiety. Their extreme weight preoccupation causes significant distress and impairs their ability to function in social, occupational or other areas of life.
What causes obesophobia?
There is no definitive cause known for obesophobia, but some researchers theorize that, like many other phobias and anxiety disorders, it may arise due to a combination of genetic, biological and environmental factors. Some potential contributors include:
- Genetics: Some people may have an inherited predisposition for developing anxiety disorders or obsessive thoughts.
- Brain chemistry: Imbalances in neurotransmitters like serotonin or dopamine may play a role.
- Trauma: Negative experiences related to body image, weight or eating can sometimes trigger weight-related anxiety.
- Perfectionism: People with perfectionist tendencies may be more prone to develop irrational fears about gaining weight.
- Sociocultural influences: The extreme valuation of thinness in Western culture may contribute to unrealistic standards and fears about body weight.
Obesophobia sometimes co-occurs with or stems from other psychiatric disorders like obsessive-compulsive disorder (OCD) or eating disorders like anorexia nervosa.
How is obesophobia diagnosed?
There are no widely accepted diagnostic criteria for obesophobia at this time. It is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Association and provides a standard classification of mental disorders.
Some signs that may indicate a diagnosis of obesophobia include:
- Intense, enduring fear of fatness or gaining weight.
- Avoidance of situations that may cause weight gain.
- Distorted perception of body weight (viewing self as overweight when not).
- Preoccupation with food, weight and body image for most days over the course of at least 6 months.
- Significant impairment or distress due to weight-related anxiety.
- Excessive behaviors aimed at avoiding weight gain (extreme dieting, purging, etc.).
A doctor or mental health professional would evaluate whether these signs meet the general criteria for a specific phobia according to the DSM-5. They may also assess for any other underlying disorders that could be causing or contributing to obesophobic symptoms.
How common is obesophobia?
There are no statistics available on the precise prevalence of obesophobia, as it is not formally recognized as a diagnosable condition. However, research suggests that weight-related anxiety and fear of fatness are relatively widespread, particularly among women.
Some key statistics on concerns about weight include:
|National Eating Disorders Association 2005||40-60% of US women express concerns about their weight|
|ABC News 2008||48% of women would rather be poor than be obese|
|Gallup 2013||15% of women said they would rather be hit by a truck than be obese|
These findings suggest a very high prevalence of weight-based anxiety and negative attitudes about obesity among women in particular. However, full-blown obesophobia characterized by extreme, irrational fear affecting daily functioning likely occurs in a smaller subset of the population.
How is obesophobia treated?
Treatment options for obesophobia focus on reducing irrational fear and anxiety through various modalities of psychotherapy. Some common approaches include:
- Cognitive behavioral therapy (CBT): Helps identify and change dysfunctional thought patterns contributing to obesophobic beliefs.
- Exposure therapy: Gradually exposes the person to feared situations like gaining a small amount of weight.
- Acceptance and commitment therapy (ACT): Focuses on accepting thoughts without reacting to them.
- Psychodynamic therapy: Explores root psychological issues contributing to obesophobic anxiety.
Medications like SSRIs or other anti-anxiety drugs may sometimes be used as an adjunct treatment to help manage anxiety symptoms. However, medication alone is unlikely to fully resolve the irrational fears and obsessive thoughts associated with obesophobia. Ongoing psychotherapy is usually needed to make significant, long-lasting gains in recovery.
Does obesophobia increase eating disorder risk?
Some researchers theorize that obesophobia could be a risk factor for developing an eating disorder like anorexia nervosa or bulimia nervosa. Features of obesophobia like severe restriction of food intake, distortion of body image, fear of weight gain and obsessive calorie counting mirror some core symptoms of eating disorders.
One study that surveyed over 1,000 people with self-reported eating disorders found that 82% said they would rather be obese than return to their eating disorder. This provides some indication that eating disorders may be linked to an underlying phobia of fatness.
However, not everyone with obesophobic thoughts necessarily develops a clinical eating disorder. More research is needed to understand if obesophobia is a causal risk factor for eating disorders.
Overlap between obesophobia and eating disorder symptoms
|Obesophobia Symptoms||Similar Eating Disorder Symptoms|
|Distorted body image and fear of fatness||Distorted body image in anorexia nervosa|
|Strict dieting rules and avoidance of weight gain situations||Restriction of energy intake and food avoidance in anorexia nervosa|
|Preoccupation with calories, nutrition facts and body weight||Excessive concern over “healthy” eating in orthorexia nervosa|
Can you develop obesophobia later in life?
Obesophobia often first emerges in childhood or adolescence, but it is possible for it to develop later in adulthood as well. Major life events, psychological stressors or physical changes can potentially trigger excessive weight-related anxiety in someone with a predisposition.
Examples of factors that may contribute to new onset obesophobic symptoms include:
- Being teased or bullied about weight
- History of inconsistent dieting and weight fluctuations
- Onset of a medical condition associated with weight gain
- Pregnancy and post-partum body changes
- Menopause transition
- Entering a new relationship
- Starting a diet with an obsessive focus on calories
- Experiencing traumatic events or increased overall anxiety
The media’s glamorization of thinness along with society’s pervasive weight stigma also likely plays a role in the development of obesophobia at any age. Women in midlife may be particularly vulnerable when facing the cultural expectation to “battle aging.”
Are people born with obesophobia?
Obesophobia is generally not viewed as a condition that people are born with. Rather, it appears likely to develop through a person’s upbringing, experiences and psychological makeup. However, some children seem to show early signs of unusual anxiety regarding weight and eating that cannot be explained simply through modeling parental behavior.
Research suggests certain inherited tendencies may predispose someone to obesophobia, such as:
- Genetic susceptibility to high anxiety
- Hyperactive amygdala response to fear stimuli
- Imbalances in brain chemicals like serotonin
- Sensitivity to social rejection
- Risk of developing obsessive thoughts
So while obesophobia itself does not appear to be inborn, some children may have an innate neurobiology that makes them more vulnerable to developing fears about body weight when exposed to triggering environmental stimuli.
What are the effects of obesophobia?
The effects of obesophobia may range from mild to quite severe based on the degree of weight-related anxiety. Possible effects include:
- Poor body image and low self-esteem
- Impaired social functioning
- Isolation or avoidance of social activities involving food
- Anxiety, depression and lower quality of life
- Disordered eating patterns and weight fluctuations
- Compulsive or excessive exercise
- Abuse of laxatives, diuretics, or diet pills
- Eating disorders in more extreme cases
Obesophobia can also have serious physical health consequences when anxiety leads to sustained restrictive dieting, purging behaviors, nutritional deficiencies, or repeated cycles of weight loss and gain.
Additionally, some research indicates that experiencing weight stigma itself can actually contribute to unhealthy eating patterns, weight gain, and higher body dissatisfaction.
Is obesophobia a disability?
Obesophobia is generally not considered a disability. The Americans with Disabilities Act (ADA) defines a disability as a physical or mental impairment that substantially limits one or more major life activities.
While obesophobia can certainly impair daily functioning, it is not formally recognized as a medical condition that would qualify someone as disabled under the law. However, in severe cases where it leads to malnourishment or accompanies other mental health disorders, it may potentially contribute to a considered disability.
In summary, obesophobia refers to an intense, irrational fear of gaining weight or becoming obese. While not formally recognized as a distinct psychological disorder, research indicates that anxiety and phobic avoidance related to body weight is relatively common, especially among women.
Extreme obesophobic symptoms likely impact a smaller proportion of the population. But they can still severely impair quality of life when weight-related anxiety leads to social isolation, disordered eating patterns, poor self-image, and other detrimental effects.
More research is needed to understand obesophobia’s causes, diagnostic criteria, and relationship to eating disorders. Integrative treatment approaches can help address the underlying cognitive distortions, anxiety, and obsessive thoughts driving obesophobic behavior.