March 2024
Blog | Redefining weight stigma: Let’s talk about obesity
By Emmanuele Adjekum and Anja Pätzold
Share post:Read time: approx 10 mins
Image credit: World Obesity Federation
Obesity remains one of the major public health concerns in the UK, with rates increasingly growing over the past few decades.
According to NHS data approximately more than 1 in 4 adults aged 18+ are estimated to live with being overweight or obesity. According to recent research, obesity is associated with increased risk factors for type 2 diabetes and cardiovascular disease (Dobrowolski et al. 2022; Watts, 2023).
Despite the health implications, stigma and the lack of knowledge seem to be major contributors linked to the condition.
Though the World Health Organization (WHO) recognises obesity as a disease the UK does not and many people are unaware of the complexity of obesity, associating solely diet as the primary cause.
However, biological, social, psychological and environmental factors are equally involved in the development and long-term impact of the disease. This blog post will look at the complexity of obesity and stigma in the UK, exploring the impact and need for a positive change within our society.
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Credit: World Obesity Federation
Understanding Obesity
Weight bias is when people are viewed negatively due to their weight, and weight stigma is the social stereotyping and discrimination faced by individuals due to their weight and size. A study found that patients living with obesity have experienced being talked down to, accusatory language around their health and poor non-verbal communication from healthcare providers.
Negative stereotypes associated with obesity can include laziness, lack of willpower or moral character, low levels of intelligence and unattractiveness. Weight stigma generally affects several aspects of life, including employment, education, social interactions, media representations and healthcare.
Despite efforts to reduce weight stigma, it persists even within healthcare settings, as reported by the findings from an All-Party Parliamentary report. The report revealed that only 26% of individuals living with obesity felt treated with sufficient dignity and respect by healthcare professionals. Additionally, 42% felt uncomfortable discussing weight-related concerns with their GP.
When exposed to healthcare stigmatisation, individuals living with obesity may be less likely to open-up or seek medical care, leading to delayed diagnosis and inadequate treatment. The lack of support and increased feeling of shame and guild often leads to a decline in mental health which may result in unhealthy eating behaviours such as binge eating or emotional eating.
Breaking the stigma cycle.
Breaking the weight stigma cycle requires a collective and effective effort. The way we treat and communicate can shape perceptions, attitude, and efforts to help people with obesity. The words that we use in our daily lives, as well as in healthcare settings, hold significant power and can either reinforce stigma or increase empathy and support.
This is why the British Dietetic Association (BDA) has implemented specific communication guidelines. For instance, using first-person language when discussing obesity - eg
- "person with obesity" rather than "obese person”
- avoiding stigmatising or combative language
- using appropriate imagery in the media
...can all help to change the perception around the condition (BDA, 2021). Particularly, the media representation of individuals living with obesity in positive settings, wearing professional clothes, exercising, or eating healthily can be a fantastic way to reduce harmful stereotypes and increase awareness and inclusion.
Breaking this cycle surrounding weight, health and behaviours is crucial for improving physical as well as mental health of the population group. Another step forward that may help change people's eating behaviour is to integrate a more balanced and mindful approach towards the food we eat.
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Credit: World Obesity Federation
Mindfulness and eating habits
Mindfulness is the practice of being fully present and aware of our thoughts, feelings, and sensations in one present moment. An expansion of this approach is mindful eating, which emphasises specifically on being present and involved in the act of eating, which entails giving attention to the colour, smell, texture, and taste of food, as well as the sensations of hunger and fullness in the body.
Since for many people food is not just fuel but also a tool of comforting and soothing one’s emotions, it can lead to repeated episodes of mindless eating where food is consumed without full awareness on what and how much has been eaten.
A recent review demonstrated that mindfulness-based interventions including mindfulness eating can lead to reduced calorie intake and improvements in eating behaviours. Therefore, by taking more time and enjoying every bite of a meal, mindful eating can help break the cycle and allows people to genuinely value and appreciate food.
How to become a 'mindful eater'
One way to incorporate mindful eating into daily life is to start by taking a few deep breaths before each meal or snack. By doing so the body can centre itself in the present moment, making it simpler to focus on the process of eating.
Moreover, it is important to minimise distractions such as TV, scrolling through the phone or loud music to enable a stronger connection to the food and sensations in your body while eating.
A key element is to listen to the body’s hunger and fullness cues, which can be assessed using a scale from 1-10 and eating before a high level of hunger is reached and to stop before a prominent level of fullness emerged (BDA, 2023). All this can help to prevent overeating whilst also promoting a healthier relationship with food.
This World Obesity Day, it is crucial to recognise and address harmful perceptions such as weight stigma and bias as it can have detrimental effects on individuals' mental and physical well-being. By promoting mindfulness and kindness towards oneself and others, more space can be made for a supportive and inclusive environment that fosters positive health outcomes and influences healthy decision making.
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Nutritious Snack Ideas
Last week postgraduate Dietetics students here at University College Birmingham collaborated to develop a variety of delicious and nutritious snacks.
The students utilised their knowledge of nutrition and culinary skills to produce snacks that were both healthy and flavourful, such as homemade granola bars, fruit cookies and fresh houmous with different spices.
The kitchen session provided a hands-on learning experience for the students, enabling students to explore and experiment different ingredients and cooking techniques while emphasising the importance of balanced nutrition and the promotion of healthy eating habits. Students were guided through a mindful eating exercise when trying their creations.
In pictures: the snacks developed by postgraduate Dietetics students
Interested in the science of food and nutrition, and how you might be able to address many of the diet-related diseases affecting the UK population and internationally? Then why not check out our Dietetics (Pre-Registration) MSc course?
References
All Parliamentary Group on Obesity. (2020). The current landscape of obesity services: a report from the all-party parliamentary group on obesity. COP (squarespace.com)
British Dietetic Association. (2021). Eliminating Weight Stigma – guidelines for BDA communications. Eliminating weight stigma - guidelines for BDA communications
British Dietetic Association. (2023). Mindful Eating. Mindful Eating (bda.uk.com)
Dobrowolski P, Prejbisz A, Kuryłowicz A, Baska A, Burchardt P, Chlebus K, Dzida G, Jankowski P, Jaroszewicz J, Jaworski P, Kamiński K, Kapłon-Cieślicka A, Klocek M, Kukla M, Mamcarz A, Mastalerz-Migas A, Narkiewicz K, Ostrowska L, Śliż D, Tarnowski W, Wolf J, Wyleżoł M, Zdrojewski T, Banach M, Januszewicz A, Bogdański P. (2022). Metabolic syndrome - a new definition and management guidelines: A joint position paper by the Polish Society of Hypertension, Polish Society for the Treatment of Obesity, Polish Lipid Association, Polish Association for Study of Liver, Polish Society of Family Medicine, Polish Society of Lifestyle Medicine, Division of Prevention and Epidemiology Polish Cardiac Society, "Club 30" Polish Cardiac Society, and Division of Metabolic and Bariatric Surgery Society of Polish Surgeons. Arch Med Sci. 18 (5). doi: 10.5114/aoms/152921.
Government Office for Science Foresight Report. (2007). Tackling Obesity: Future Choices. Tackling obesities: future choices - GOV.UK (www.gov.uk)
Katterman, S., Kleinman, B., Hood, M., Nackers, L. and Corsica, J. (2014). Mindfulness meditation as an intervention for binge eating, emotional eating, and weight loss: a systematic review. Eating Behaviours, 15 (2). DOI: 10.1016/j.eatbeh.2014.01.005
Luli, M., Yeo, G., Farrell, E., Ogden, J., Parretti, H., Frew, E., Bevan, S., Brown, A.,Logue, J., Menon, V., Isack, N., Lean, M., McEwan, C., Gately, P., Williams, S., Astbury., N., Bryant, M., Clare, K., Dimitriadis, G., Finlayson, G., Heslehurst, N., Johnson, B., Le Brocq, S., Roberts, A., McGinley, P., Mueller, J., O'Kane, M., L. Batterham, R., Roberts, K. and Dimitri Miras, A. (2023). The implications of defining obesity as a disease: a report from the Association for the Study of Obesity 2021 annual conference. The Lancet, 58. DOI : https://doi.org/10.1016/j.eclinm.2023.101962
Obesity Health Alliance. (2018). Weight Stigma Position Statement. Weight-Stigma-Position-Statement.pdf (obesityhealthalliance.org.uk)
NHS Digital. (2022). Health Survey for England, 2021, part 1. Health Survey for England, 2021 part 1 - NHS Digital
Ryan, L., Coyne, R., Heary, C., Birney, S., Crotty, M., Dunne, R., Conlan, C. and Walsh, J. (2023). Weight stigma experienced by patients with obesity in healthcare settings: A qualitative evidence synthesis. Obesity Reviews, 24 (10). https://doi.org/10.1111/obr.13606
Watts, M. (2023). Metabolic Syndrome. Metabolic Syndrome - Risk Factors, Symptoms & Diagnosis (diabetes.co.uk)
World Health Organization. (2024). One in eight people are now living with obesity. One in eight people are now living with obesity (who.int)
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