Lifestyle diseases: time to stop blaming and shaming

‘Lifestyle diseases’ – a phrase that has crept into the western world’s vernacular in recent years. It’s relatively self-explanatory, referring to diseases we get that can be attributed to one or more aspects of the lives we lead. Things such as eating too much junk food or not getting enough exercise, or the old ‘favourite’ – smoking.

Lifestyles that feature these excesses and shortcomings all increase the risk of disease and it’s a big – and costly – problem worldwide. So much so that it has become a focus of the United Nations.

Acknowledging lifestyle diseases as a major problem, Professor Fatma Al-Maskari wrote on the UN’s website that even modest adjustments to lifestyle behaviours are likely to have a considerable impact at the individual and population level.

Acknowledgement is one thing, but doing something about the problem has proved a tough nut to crack. Prof. Al-Maskari identified the adjustments as achievable, and a message of self-empowerment has also been common. “All I have to do is cut back on the ciggies and go for a walk each day.” Various versions of that statement have become a common refrain.

The aims seem achievable, so when they’re not achieved, the risk of a ‘blame and shame’ mentality surfaces. An overweight person who develops heart disease might draw a comment such as, ‘Well, they have only themselves to blame.’

And while there may be some basis to that, the truth is usually far more complex. The narrative has become a topic of focus for Dr Nikki-Anne Wilson, of Neuroscience Research Australia (NeuRA).

Stigma of lifestyle diseases

One condition not often thought of as a lifestyle disease is dementia. In fact, there are a number of lifestyle factors that elevate dementia risk. That has been a focus for Dr Wilson, who has published her research in The Gerontologist.

Dr Wilson’s article is titled “Dementia prevention and individual and socioeconomic barriers: Avoiding ‘lifestyle’ stigma”. Co-written with NeuRA colleague Dr Kaarin J Anstey, the paper calls for “greater awareness of individual and socioeconomic barriers to behaviour change-oriented dementia risk-reduction”.

“We caution against inadvertently increasing health inequities through ‘lifestyle’ stigma,” they wrote. What’s needed, they say, is an approach that harnesses current dementia risk-reduction knowledge and effectively addresses barriers to change.

The paper highlights the negative ramifications of stigma in dementia, and also targets “overly simplistic media representations of dementia”. These representations paint dementia as a disease that one can ‘stave off’ through lifestyle. The same could be said of other lifestyle diseases such as diabetes and obesity.

And again, there are kernels of truth in those representations, but the reality is more nuanced.

Damage caused by stigma

Feelings of shame and guilt are not the only outcomes of lifestyle diseases being stigmatised, the authors argue. Drs Wilson and Anstey also explore potential negative implications for research funding and policy resulting from stigma.

The impact of stigmatising those who have developed lifestyle diseases is almost always negative. As easy as it is to say – or simply think – that sufferers need to get their act together and make better choices, evidence suggests such an approach rarely works.

Each sufferer of a lifestyle disease has their own story and complications. The causes of lifestyle disease are relatively easily identified. Finding and implementing solutions are far more difficult.

Do you know someone who has a lifestyle disease? Do you think they are treated fairly?  Let us know via the comments section below.

Also read: Drug may finally dispel the myths of obesity