Sarah Le Broq, Director of Obesity UK, a charity supporting people living with obesity, blogs for us on the importance of language when discussing obesity and coronavirus.
Obesity is a complex health condition. The UK Government’s Foresight Report published in 2007, established that there are over 100 different factors that can contribute to weight gain and thus obesity. Many of these factors are either partially or completely outside of a person’s control, however despite this knowledge, people living with obesity face stigma on a daily basis. Public perceptions of obesity are on the whole negative and these are borne from misinformation and the overly simplistic message of ‘eat less, move more’ that society has been told for years.
Lack of guidance around coronavirus
Emerging data about the Coronavirus (COVID-19) pandemic suggests a link between obesity and more serious consequences of COVID-19, if contracted, which has been a huge worry and concern to people living with obesity. People with a BMI of 40 have been identified as being ‘high risk’ of contracting COVID-19 and advised to take ‘stringent’ social distancing measures. But what does this really mean? Should people with obesity still be allowed to work if they are a key worker? Should we be able to go to the supermarket to do our weekly shop? Or should we be self-isolating as much as we can? The guidance around this has been extremely vague and as a consequence has left people living with obesity, feeling extremely anxious, scared and confused about the uncertainty of their risk and about what actions they should be taking. This, coupled with stigmatising media portrayal of obesity, is leading to even more intense anxiety which is negatively impacting wellbeing and health.
The COVID-19 pandemic has highlighted again that we need to be mindful of the language we use when talking about people living with obesity. The COVID-19 pandemic presents challenges for everyone. People’s wellbeing, mental health, physical health, resilience and much more are being challenged and there is a real need to provide support, especially for those living with obesity. This includes avoiding the unintended consequences of inaccurate, disrespectful, and stigmatising reporting of people living with obesity (1).
Impact of inappropriate language
Evidence shows that the language (2) used to describe people living with overweight or obesity can have a profound effect on those specific individuals. People with obesity are frequently stereotyped as being lazy, uneducated, someone who does not have will power or self-discipline, may binge eat, or eat too much, and these are to name just a few. The pervasiveness and ingrained nature of weight stigma and discrimination that is evident in society means that people living with obesity internalise these messages, which can lead to physical and mental health problems, and maladaptive behaviours, such as the avoidance of health care.
In a time when we need people more than ever to prioritise their well-being and health, the presence of stigma and discrimination could be profoundly dangerous. The COVID-19 pandemic has highlighted the need to identify specific symptoms, self-isolate if appropriate and more conversely be admitted to hospital if breathing becomes an issue. The consequences of delayed presentation of severe symptoms in this pandemic could lead to unnecessary worse outcomes.
Discussing obesity in a non-stigmatising way
There are steps that can be taken to discuss COVID-19 and obesity in a non-stigmatising way and these are (2):
- Seek permission – just because obesity is a visual condition, this does not give you the invitation to discuss this without first getting permission. Use of open ended questions around weight could be useful to seek this.
- Use of person centred language/People first – An individual should not be defined by their condition. Rather than saying the expression “an obese person”, the phrase “person living with obesity” should be used.
- Avoid combative language or humour – use of combative language when referring to people’s efforts to reduce overweight or obesity, and avoiding humour or ridicule are very important.
- Do not blame the individual – Language that attributes responsibility (or blame) to a person for the development of their obesity or its consequences should be avoided.
- No assumptions – Assumptions about diet and physical activity should not be made.
The language used to discuss the condition and support people living with obesity is of paramount importance for achieving long-term benefits.
- Dr Stuart W Flint, Obesity UK, UK media coverage of obesity during COVID-19
2. The importance of language in engagement between health-care professionals and people living with obesity: a joint consensus statement. CharlotteAlburyDPhil a*W DavidStrainMDb*Sarah LeBrocqBSccJenniferLogueMDdProfCathyLloydPhDeAbdTahraniPhDfgThe Language Matters working group†