"If you really wanted to, you could lose the weight." A sentence everyone has heard, usually from someone who thinks they're helping. Psychologist Alicia González says that exact sentence does more damage than it seems: "We took a biological, genetic and emotional reality and turned it into a character flaw."

Obesity is a complex disease involving biological, genetic, environmental, social and emotional factors. Yet the idea persists that losing weight is mainly about willpower: eat less, move more, "just try a bit harder". That oversimplification not only fails to explain excess weight - it creates guilt in people living with obesity.

They know, but don't see themselves

The "Reasons for Weight" survey in Spain covered 200 GPs and 1,700 people with a body mass index of 30 or above. The figures reveal a gap between knowledge and self-image: 60 percent of participants recognise obesity as a disease, 76 percent believe excess weight affects health, but only 56 percent say they themselves live with obesity.

One detail is worth noting: the survey was commissioned by the pharmaceutical company Lilly, with support from the Ipsos agency - the same company that sells some of the best-known weight-loss drugs on the market. That doesn't make the numbers wrong. But when a drugmaker funds research concluding that obesity is a disease rather than a failing, it's good to know who's behind the message.

Guilt paralyses, it doesn't motivate

González explains that guilt, shame and a sense of constant failure wreck self-esteem and put people off seeking help. When someone hears "if you really wanted to, you could" and the attempt fails again, the psychological blow is devastating. Paradoxically, guilt doesn't push towards change - it paralyses. Every failed attempt, often going back to childhood, eats away at self-esteem and breeds shame about one's own body.

The consequence is very concrete: shame makes people avoid the doctor because they expect judgement in advance. That avoidance is documented - it delays diagnoses, interrupts treatment and pushes suffering into silence.

Her proposal is to separate care from control and punishment. Treating yourself with the same kindness you would offer a struggling friend is what brings lasting change, while guilt drains motivation and destroys hope. Psychology here isn't focused on the number on the scales, but on the relationship with your own body and on dealing with emotions.

How many people put off a check-up because they already know the comment that's coming - "you've really put on weight" - from relatives at the family table, from strangers, and sometimes from the doctor themselves?