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World Health Organisation Warns About The Health Consequences Of Obesity Stigma



Yesterday (World Obesity Day), the European Regional Office of the World Health Organisation released a brief on the importance of weight bias and obesity stigma on the health of individuals living with this condition.

The brief particularly emphasises the detrimental effects of obesity stigma on children:

“Research shows that 47% of girls and 34% of boys with overweight report being victimized by family members. When children and young people are bullied or victimized because of their weight by peers, family and friends, it can trigger feelings of shame and lead to depression, low self-esteem, poor body image and even suicide. Shame and depression can lead children to avoid exercising or eatng in public for fear of public humiliation. Children and young people with obesity can experience teasing, verbal threats and physical assaults (for instance, being spat on, having property stolen or damaged, or being humiliated in public). They can also experience social isolation by being excluded from school and social activities or being ignored by classmates.

Weight-biased attitudes on the part of teachers can lead them to form lower expectations of students, which can lead to lower educa onal outcomes for children and young people with obesity. This, in turn, can affect children’s life chances and opportunities, and ultimately lead to social and health inequities. It is important to be aware of our own weight-biased attitudes and cautious when talking to children and young people about their weight. Parents can also advocate for their children with teachers and principals by expressing concerns and promo ng awareness of weight bias in schools. Policies are needed to prevent weight-victimization in schools.”

The WHO Brief has important messages for anyone working in public health promotion and policy:

Take a life-course approach and empower people:

Monitor and respond to the impact of weight-based bullying among children and young people (e.g. through an -bullying programmes and training for educa on professionals).

• Assess some of the unintended consequences of current health-promo on strategies on the lives and experiences of people with obesity. For example:

  • Do programmes and services simplify obesity?
  • Do programmes and services use stigmatizing language?
  • Is there an opportunity to promote body positivity/confidence in children and young people in health promotion while also promoting healthier diets and physical activity?• Give a voice to children and young people with obesity and work with families to create family-centred school health approaches that strengthen children’s resilience and consider positive outcomes including but not limited to weight.• Create new standards for the portrayal of individuals with obesity in the media and shift from use of imagery and language that depict people living with obesity in a negative light. Consider the following:
  • avoiding photographs that place unnecessary emphasis on excess weight or that isolate an individual’s body parts (e.g. images that dispropor onately show abdomen or lower body; images that show bare midri to emphasize excess weight);
  • avoiding pictures that show individuals from the neck down (or with face blocked) for anonymity (e.g. images that show individuals with their head cut out of the image);
  • avoiding photographs that perpetuate a stereotype (e.g. ea ng junk food, engaging in sedentary behaviour) and do not share context with the accompanying wri en content.

Strengthen people-centred health systems and public health:

• Adopt people-first language in health systems and public health care services, such as a “patient or person with obesity” rather than “obese patient”.

• Engage people with obesity in the development of public health and primary health care programmes and services.

• Address weight bias in primary health care services and develop health care models that support the needs of people with obesity.

• Apply integrated chronic care frameworks to improve pa ent experience and outcomes in preventing and managing obesity. In addition:

  • recognize that many patients with obesity have tried to lose weight repeatedly;
  • consider that patients may have had negative experiences with health professionals, and approach patients with sensitivity and empathy;
  • emphasize the importance of realistic and sustainable behaviour change – focus on meaningful health gains and
  • explore all possible causes of a presenting problem, and avoid assuming it is a result of an individual’s weight status.
  • Acknowledge the dificulty of achieving sustainable and significant weight loss.

Create supportive communities and healthy environments:

  • Consider the unintended consequences of simplistic obesity narratives and address all the factors (social, environmental) that drive obesity.
  • Promote mental health resilience and body positivity among children, young people and adults with obesity.
  • sensitize health professionals, educators and policy makers to the impact of weight bias and obesity stigma on health and well-being.

Hopefully, these recommendations will find their way into the work of everyone working in health promotion and clinical practice.

The whole brief is available here.

@DrSharma
Edmonton, AB

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