Calling overweight people fat or lazy must stop because stigma is blocking the fight against the obesity epidemic, experts have said.
A statement made by 100 health professionals worldwide said prejudice against overweight people can cause both physical and mental harm.
The ‘social exclusion’ faced by people with obesity is similar to that of diseases in the past, such as the plague, HIV and cholera which were wrongly blamed on individuals, the scientists said.
Timing their release with World Obesity Day, the group are busting the myth that obesity is only caused by people’s food choices and behaviours, because it also a result of genetics and environment.
Around one in four adults and one in five children are obese in the UK.
The group of over 100 worldwide organisations are aiming to challenge ‘unscientific public narratives of obesity as a major cause of weight stigma’
In a paper published today in Nature Medicine, a team of experts, led by Professor Francesco Rubino from King’s College London, issued what they called a Pledge to Eradicate Weight Stigma.
‘Weight stigma is a public health problem, undermines human and social rights and is a major stumbling block in the fight against the epidemic of obesity,’ said Professor Rubino, chair of bariatric and metabolic surgery at King’s College.
He said that the idea that obese people are ‘lacking in self discipline and personal responsibility’ is wrong, and that biological, genetic and environmental factors critically contribute to the condition.
The group, comprising of everything from scientific societies to Weight Watchers, are aiming to ‘expose the misconceptions that contribute to weight bias’.
The opinion that obese people are often perceived as ‘lazy, gluttonous, lacking will power and self-discipline’, leaves suffers vulnerable to stigma and discrimination which can lead to mental health issues and does nothing in the fight against it, they say.
Professor Rubino likened the ‘social exclusion’ faced by obese people to that of AIDs sufferers.
He said: ‘History shows us with examples such the plague, cholera and HIV/AIDS that stigma can interfere with public heath efforts to control epidemics. Initiatives aimed at combatting stigma and social exclusion were as important then as they are now.’
The group say that obese people are even the subject of stigma in the public health sphere, the media, in the workplace and in the education system.
They are calling on academic institutions and professional bodies to incorporate formal teaching on the causes, mechanisms, and treatments of obesity.
Professor Rubino said: ‘The objective of this initiative was to gather a broad group of experts and scientific organisations and, for the first time, speak with one voice to unambiguously condemn weight stigma and expose the misconceptions that contribute to weight bias.
‘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.’
‘Weight stigma occurs in almost every aspect of our society, including the health care setting,’ said co-author Professor Rebecca Puhl, deputy director for the Rudd Center for Food Policy and Obesity at University of Connecticut.
‘It is critical that efforts to address this problem include support and action from the medical community.’
The statement comes after the Royal College of Physicians called for obesity to be reclassified as a disease last year, in line with the World Health Organisation’s classification, in order to get to grips with the problem.
Rather than laziness and overeating, people become dangerously fat because of ‘health inequalities, genetic influences and social factors’, the college said.
Responding to the comments, broadcaster Michael Buerk shocked many by stating in the bluntest of terms that obese people are ‘weak, not ill’ and would cost the NHS less if their ‘greed and bad choices’ did not lead them to keel over in their 50s.
Professor John Wilding, a consultant endocrinologist at Aintree University Hospital, in Liverpool, told the Daily Mail at the time: ‘Obesity is caused by factors largely outside our control, such as the increased availability of cheap processed food, sedentary lifestyles encouraged by the reduction in schools sports fields, and increased stress, which may lead some people to overeat.
‘Many also have a genetic tendency to pile on the pounds.’
Dr Richard Pile, a GP with a specialist interest in cardiology, disagreed. He said: ‘I can’t imagine a time when I would call obesity a disease; my fear is that if we do this it will take power and responsibility away from patients and open the floodgates to pills and procedures, with rising costs to the NHS as well.’
Obesity is a growing problem in the UK and around the world, with almost half of Britons and one in five people worldwide expected to be extremely overweight by 2045.
Obesity can lead to a number of serious and potentially life-threatening conditions including type 2 diabetes, coronary heart disease, some types of cancer – such as breast cancer and bowel cancer – and stroke.
It can also affect quality of life and lead to psychological problems, such as depression and low self-esteem, the NHS say.
For most adults a BMI of 30 to 39.9 means you’re obese while 40 or above means you’re severely obese.
However, BMI is not used to diagnose obesity because people who are very muscular can have a high BMI without much fat.
Those signed up to pledge include more than 100 organisations worldwide, including scientific societies, academic institutions, medical centres and scientific journals including Nature.
Industry, including WW (Weight Watchers) and the All-Party Parliamentary Group on Obesity, a group of cross-party members of the House of Commons and House of Lords of the British Parliament, also joined the group.
A graphic showing the average male and female weight in the UK in 1993 compared with 2017