Social support plays a crucial role in various aspects of physical health. Generally seen as positive, social support has been extensively studied and shown to have a beneficial impact on health outcomes. This article aims to provide a brief overview of the extensive literature on the positive effects of social support on health.
Additionally, it will examine the evidence supporting the advantages of social support in weight management for individuals undergoing behavior change interventions and bariatric surgery. However, it is important to recognize that not all forms of social support are positive.
Consequently, this article will explore the ways in which social support can hinder an individual’s efforts to manage their weight effectively. Finally, a new model of negative social support will be proposed, emphasizing concepts such as sabotage, feeder behavior, and collusion. This model will be viewed within a systems approach to relationships, considering the central role of homeostasis.
Social Support
Social support has been defined in various ways by different researchers. For instance, Cohen and Wills categorized social support into esteem support (which boosts self-esteem), informational support (providing advice), companionship (engaging in shared activities), and instrumental support (offering practical assistance).
In contrast, Lett et al distinguished between structural support (network contacts) and functional support (perceived benefits from the network). Sarason et al, on the other hand, focused on both the quantity of friends available for support and the satisfaction derived from that support. In a simpler sense, Wallston et al viewed social support as encompassing perceived comfort, care, esteem, or assistance from others.
Positive Impact of Social Support
Consistent with a positive perspective, extensive research has demonstrated the favorable impact of social support on a broad spectrum of health outcomes. For instance, social support has been found to be a significant predictor of positive changes in health-related behaviors, including exercise, diet, smoking cessation, contraceptive use.
Additionally, it plays a crucial role in facilitating help-seeking behavior during the early stages of illness onset, as well as in promoting adaptation, adjustment, and overall quality of life throughout the course of an illness.
Wing and colleagues conducted a review of the National Weight Control Registry in the USA and emphasized the significance of social support in sustaining weight loss for up to 5 years. Furthermore, in a conceptual review of the literature, Elfhag and Rössner similarly identified a beneficial impact of social support on weight maintenance for a minimum of 6 months after intentional weight loss.
Negative Impact of Social Support
While social support is generally associated with positive health outcomes in various health domains, such as weight loss, weight maintenance, and improved well-being in obesity management, recent research highlights a more complex aspect of social support. It reveals that not all forms of support are advantageous. In certain cases, support can have negative implications, particularly when it comes to health-related behaviors.
For instance, support can sometimes result in coercion and exertion of pressure on individuals to engage in unhealthy behaviors.
In the realm of managing obesity, research has also revealed a potentially detrimental role played by social support. For instance, interviews conducted with individuals who have undergone bariatric surgery indicate that the level of support they receive may not always be optimal. Tolvanen et al observed instances where friends and family members can be discouraging and even stigmatizing.
Similarly, Gerac, Brunt, and Marihart highlighted how patients often receive hurtful and critical comments, while Ficaro emphasized the challenges faced by daughters when their mothers experience significant weight loss. Additionally, Whale, Gillison, and Smith outlined various ways in which negative aspects of social support can undermine efforts to manage weight, particularly when friends feel threatened by the weight loss of others.
The Act of Sabotage
The literature on social support for weight management highlights the presence of intentional sabotage, where individuals deliberately undermine the efforts of those trying to lose weight. Various studies investigating the experiences of individuals engaging in behavioral interventions demonstrate instances where friends and family members sabotage weight loss attempts, hindering progress in achieving weight management goals.
Being a Feeder
Sabotage represents a specific type of negative social support that can impede efforts to lose weight. Within this context, a significant aspect of sabotage pertains to eating behavior. Experts examined the intentional and explicit act of offering food, even when the recipient is not hungry or striving to consume fewer calories. This behavior, commonly referred to as “Being a Feeder,” contributes to undermining weight loss endeavors.
Collusion
Intentional negative social support can manifest as sabotage, actively undermining an individual’s weight loss efforts, which may include behaviors like being a feeder—offering food when the recipient does not wish to eat. However, there is a third form of negative social support that operates in a seemingly more benign manner, involving a degree of collusion.
Collusion, defined as a fundamental aspect of communication aimed at maintaining conversation and avoiding conflict, has been recognized, observed, and studied in various disciplines. It also finds relevance in the concept of “killing with kindness,” which has been explored in fields such as literature, drama, veterinary medicine, international aid, and obesity research.
Social Support as Part of a System
When individuals embark on weight loss journeys, they may encounter negative social support in the form of sabotage, collusion, or feeding behaviors from their closest relationships. This phenomenon can be analyzed within the framework of systems theory and the concept of homeostasis.
According to this perspective, relationships are viewed as dynamic systems, where the members are driven to maintain equilibrium and the existing state of affairs. As Minuchin posited in 1985, this system can be understood as an error-correcting process that controls behaviors deviating from the expected patterns of a family through corrective feedback loops.
Takeaway
Within the scope of our studies, we have examined the concepts of sabotage, being a feeder, and collusion. People undertake weight loss endeavors for diverse reasons, such as improving their overall health and bolstering their self-esteem. Friends and family members can significantly contribute to their success by offering valuable support.
However, it is important to acknowledge that in certain cases, those closest to individuals may unintentionally impede their progress. This can manifest through the provision of tempting unhealthy food options or the creation of barriers that hinder the adoption of a healthier lifestyle.
