The World Obesity Federation has defined obesity as a
chronic relapsing, progressive disease process5. Despite
this, people living with obesity often face weight bias and stigma
across all areas of society6.
WHO defines obesity stigma as “actions towards individuals
living with obesity that can cause exclusion and marginalisation, and
lead to inequities”7. This has been documented
in occupational, educational, social and healthcare settings6.
The drivers of stigma are often based around a misunderstanding of
the complex causes of obesity, with people attributing weight gain to
personal responsibility, while failing to understand the complex mix
of genetics, environment, and biological factors that drive the
disease8. Many hold the view that people living with
obesity are personally responsible for their weight and there exists a
culture of blaming people with obesity for their condition. However,
we have come to understand stigmatising obesity undermines people’s
health and can act as a significant barrier to health-seeking
behaviour, care and adherence to treatment9,10.
Current science is now guiding our understanding that obesity
is a complex chronic disease and not the fault of any one individual.
We need to work harder at delivering this message and creating
understanding, empathy and urgency to deliver multidisciplinary care
that supports people living with obesity.
Although raising awareness of the negative consequences of weight
stigma is important, awareness alone is not sufficient to eliminate
the issue. Challenging and changing widespread, deep-rooted beliefs,
longstanding preconceptions, and prevailing mindsets requires a new
public narrative of obesity that is coherent with modern scientific
knowledge. Education around the multiple factors influencing body
weight and rethinking the way we understand the causes and treatment
for obesity can only be achieved through the concerted efforts of a
broad group of stakeholders, including healthcare providers (HCPs),
researchers, the media and policy makers.
In order to gain an understanding of the current societal
narrative around obesity in Ireland and the experiences of individuals
living with the disease, surveys were developed to capture the current
ideas, attitudes and experiences of the Irish general public and
people living with obesity in September 2021. The surveys were carried
out by iReach on behalf of Novo Nordisk, with the support of the Irish
Coalition for People living with Obesity (ICPO) and gathered over
1,000 responses.
The ICPO, a patient led
organisation, advocates and provides support for people living with
obesity. As a group of people living with obesity, their aim is to
provide or direct people to education, support and raise awareness for
people living with overweight or obesity across Ireland.
Ms Susie Birney, the Executive Director for the ICPO believes that
weight stigma, in all its shapes and forms, needs to be addressed as a
matter of urgency. Particularly in the healthcare setting where the
direct reaction we see from our community is people who need vital
treatment do not return for further consultations.
Speaking on the need for the surveys, Susie says “Stigma in the
healthcare setting, or from our family even, is predominantly
unintentional. However, words matter and the outcome is the same.
Acting together we can all play our part in raising awareness of how
and why we need to change our words.”
Dr Jean O’Connell is a Consultant Endocrinologist and Chairperson of
the Association for the Study of Obesity in Ireland and provided
additional input into the survey project. Commenting on the surveys Dr
O’ Connell said, “They demonstrate the need for us to change the
obesity narrative and follow the science, which clearly shows that
obesity is a complex, chronic disease, not a lifestyle choice.”
