Obesity – the last acceptable stigma?

When I was at medical school, now a hideously long time ago, I don’t remember a single lecture or teaching opportunity about obesity. I do however, remember some hideously awful moments where senior colleagues made disparaging comments about a patient’s size, (sometimes in front of them) and jokes about patients just not trying hard enough to lose weight.  That was 22 years ago and sometimes it doesn’t feel like things have changed much when I read or hear comments from colleagues or listen to patient experiences. 

But things have changed. Research and understanding about obesity have accelerated rapidly over the last 20 years. The physiological changes that occur in a person living with obesity are understood better. The genetic predisposition that explains why one person will gain weight and one won’t, in the same environment, is a fascinating and ever-expanding area of knowledge. The interactions between the individual and their food and living environment that lead to weight gain are better understood and the psychological effects of living with obesity are researched and acknowledged. The links between social deprivation and obesity are well known. The role of ultra-processed foods contributing to someone gaining weight is also becoming understood.  We know that the population of the world hasn’t simultaneously become lazy and gluttonous in the last 50 years, leading to the rising rates of obesity around the world, we know that it is much more complex than that. But efforts to reverse this trend in all countries have so far, come to nothing. Is this because individuals just aren’t trying hard enough? No, it isn’t that simple. 

Yet there is still a belief that an individual living with obesity hasn’t tried hard enough to lose weight, that they haven’t done the “right” diet plan or that they eat huge amounts and don’t move enough. There are judgement values made about that person that lead to weight stigma. Weight stigma harms individuals, it means they do less well in school and work, that they get less good healthcare and that they are at high risk of mental illness and social isolation.

So what can we, as health care professionals do, to make sure we don’t contribute to the stigma and ensure that we treat obesity in an evidence informed way, just as we do all other medical conditions?

I have been teaching about obesity for a few years now, and it is fascinating to teach colleagues a topic that is unknown through no fault of their own, it was never on any curriculum. The feedback from people that have then felt able to bring up the topic of weight with their patients in a way that has helped, shows that they find it massively rewarding and of huge benefit to their patient. 

The NB obesity course and associated book will help you to understand the science of obesity, assess your patient and decide which treatment approaches will work for that individual. It will also help you to discuss with your patients their predisposing factors and experiences of weight loss and regain, ensuring a holistic approach to their care and hopefully leaving their critical inner-voice a little quieter. 

Join myself and Sarah on 3^rd March for an informative, entertaining and educational morning and why not keep the obesity conversation going and share your experiences with GP peers, while earning CPD in the GP Horizon App.