To mark the first ever World Obesity Day, the Royal College of Physicians (RCP) has joined over 100 medical and scientific organisations across the world to sign a consensus statement on putting an end to the stigma surrounding obesity.
Published in the journal Nature Medicine, the statement highlights the unscientific, stigmatising language so often used when talking about obesity as a major cause of weight stigma, and calls for strong policies and legislation to prevent weight-based discrimination.
Over 19 million people in the UK are living with obesity, and yet despite the risk of developing type 2 diabetes, cancer, heart disease and poor mental health, many people feel too stigmatised or ashamed to discuss their weight with a doctor.
People living with obesity are also less likely to attend screening visit for cervical smears or mammograms.
In May 2018 the All Party Parliamentary Group on Obesity published the results of a survey showing that
- 89% of people with obesity have felt stigmatised, criticised or abused as a result of their obesity.
- 90% of people with obesity said more understanding around obesity would make them more comfortable seeking care.
Similarly, doctors have been known to avoid talking about weight with their patients, for fear of offending them.
Professor Rachel Batterham, the Royal College of Physicians' lead adviser on obesity, is clear about the urgent need to address the stigma surrounding the condition:
'People living with obesity are constantly shamed and blamed for their disease. This is because, many people including doctors, policy makers and others, fail to recognised that obesity is a chronic disease with far reaching consequences for both individuals and societies. They may believe that patients suffer from a simple lack of willpower, or have made a lifestyle choice, or refuse to ‘eat less and move more’. But like all chronic diseases, the root causes of obesity run much deeper; and can be genetic, psychological, sociocultural, economic and environmental.
'The consensus statement we’ve signed is part of a global effort to end weight-based stigma. We must start by providing doctors with the skills needed to discuss healthy weight routinely during every contact with patients to ensure that no more opportunities are missed to help people stay healthy.
'Anything we can do to support doctors and patients to talk openly about obesity is a step in the right direction. It could ultimately mean the difference between life and death.'
Last year the RCP called on the government to recognise obesity as a disease, a move which would help to remove the stigma and misbelief that obesity is a lifestyle choice.
As an example of good practice, the following conversation starters, developed by the STOP Obesity Alliance in Canada, were devised to help doctors address the important issue of obesity sensitively and respectfully with their patients:
- “You mentioned a number of symptoms, such as fatigue and aching knees, which may be related to excess weight. Would you like to talk about this to see if we can help you feel better?”
- “Would it be okay if we discussed your weight?”
- “Are you concerned about the effect of your weight on your health? Do you feel that affects your quality of life? For example, do you find it difficult to do everyday things like walking up a flight of stairs?”
Obesity Canada, has also created five steps to help doctors better manage their patients’ weight and related health issues:
- ASK for permission to discuss weight and explore readiness
- ASSESS obesity related risks and ‘root causes’ of obesity
- ADVISE on health risks and treatment options
- AGREE on health outcomes and behavioural goals
- ASSIST in accessing appropriate resources and providers