By Dr Stuart W. Flint, Senior Research Fellow in Public Health and Obesity, Leeds Beckett University, Leeds, UK. @DrStuartFlint
Weight stigma refers to “the social devaluation and denigration of people perceived to carry excess weight and leads to prejudice, negative stereotyping and discrimination toward those people”. People experience weight stigma and discrimination in many different settings or scenarios, including in education, workplaces, and healthcare.
People with obesity are frequently stereotyped as lazy, gluttonous, and unintelligent, and these messages are received consistently from influential sources such as the media. These stigmatising perceptions translate into discriminatory and derogatory behaviour. For instance, recently a patient told me of her employer’s first impression of her:
“I thought you better be a bloody good sales rep, looking the way you do and trying to sell a diabetes drug!”
Contrary to popular belief, and in some cases this includes the beliefs of healthcare professionals, academics and public health authorities, weight stigma does not have a beneficial effect. It does not lead to increased motivation to engage in healthy behaviours. In fact, evidence tells us that the opposite effect occurs. In response to experiences of weight stigma and discrimination, people with overweight and obesity respond maladaptively, such as avoiding healthcare settings, physical activity and exercise and may lead to disordered eating. In addition to dysfunctional behavioural responses, these experiences have a detrimental impact on physical and mental health which can include, but is not limited to, depression, anxiety and increased cardio-metabolic risk factors.
The pervasiveness of weight stigma at all levels emphasises the need for intervention, and leadership from the Government. Public health policy and campaigns must avoid problematic framing, blame and judgment, and assumptions about behaviour. Government should also take the lead in communicating in a non-stigmatising manner, influence other institutions such as media and healthcare to follow suit.
Indeed, the most motivating and least stigmatising public health campaigns relating to obesity, are those focused on supporting people to engage in healthy behaviours without mention of obesity.
In society, public health organisations and institutions (e.g. schools, workplaces) should reflect on their work relevant to public health and obesity, and where necessary make changes that will positively contribute to population health.
Finally, media portrayal of obesity, which is all too frequently stigmatising and derogatory, needs to be improved dramatically. Media portrayal presents obesity as simplistic, which is ill-aligned to the well-established evidence demonstrating the complexity of obesity. Greater beliefs of the complexity of obesity, and in particular, factors that contribute to the development of obesity that are outside of a person’s control (e.g. genetics, obesogenic environment) has led to increased support of Government policy and campaigns.
Leeds Beckett University’s Applied Obesity Research Centre: https://www.leedsbeckett.ac.uk/carnegie-school-of-sport/research/research-centres/applied-obesity-research-centre/weight-stigma-and-discrimination/
University of Connecticut’s Rudd Center: http://www.uconnruddcenter.org/weight-bias-stigma
World Health Organisation EU Region: http://www.euro.who.int/en/health-topics/noncommunicable-diseases/obesity/publications/2017/weight-bias-and-obesity-stigma-considerations-for-the-who-european-region-2017
World Obesity Day 2018: https://www.obesityday.worldobesity.org/
Free to use, non-stigmatising image banks
- World Obesity Federation: http://www.imagebank.worldobesity.org/
- Canadian Obesity Network: http://www.obesitynetwork.ca/images-bank
- University of Connecticut’s Rudd Center: http://www.uconnruddcenter.org/media-gallery
- Obesity Action Coalition: https://www.obesityaction.org/get-educated/public-resources/oac-image-gallery/
- European Association for the Study of Obesity: http://easo.org/media-portal/obesity-image-bank/
- IFB Adiposity Diseases centre: http://www.ifb-adipositas.de/en/news-press/photos