Scientific community pledges to end obesity stigma

Coinciding with World Obesity Day, over 100 medical and scientific organisations have today pledged their support for a consensus statement that recognises unscientific public narratives of obesity as a major cause of weight stigma and calls for strong policies and legislation to prevent weight-based discrimination.

In a paper published today in Nature Medicine, a team of experts, led by Professor Francesco Rubino from King's College London, outline a joint international consensus statement and a related Pledge to Eradicate Weight Stigma. The statement was developed through an international conference jointly organised by the World Obesity Federation, American Diabetes Association, American Association of Clinical Endocrinologists, American Association for Metabolic and Bariatric Surgery, Diabetes UK, European Association for the Study of Obesity, International Federation for the Surgery of Obesity and Metabolic Disorders, Obesity Action Coalition, Obesity Canada, The Obesity Society.

Previous evidence indicates that weight stigma can cause both physical and psychological harm, and that affected individuals are less likely to seek and receive adequate care. Often perceived as lazy, gluttonous, lacking will power and self-discipline, people with obesity are vulnerable to stigma and discrimination in the workplace, education, and in healthcare settings.

"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 lead author Professor Francesco Rubino, Chair of Bariatric and Metabolic Surgery at King's College London.

"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."

Main issues discussed in the statement include:

• Healthcare providers are a common source of weight stigma. The group calls on academic institutions and professional bodies to incorporate formal teaching on the causes, mechanisms, and treatments of obesity, including stigma-free skills and practices.
• Social stigma is based on the typically unproven assumption that obesity derives primarily from a lack self-discipline and personal responsibility. Such portrayal is inconsistent with current scientific evidence demonstrating that body weight regulation is not entirely under volitional control, and that biological, genetic and environmental factors critically contribute to obesity.
• The media portrayal of obesity is influential; it plays an important role in shaping public attitudes and beliefs about people with obesity. The group calls on the media to produce fair, scientifically accurate, and non-stigmatising portrayals of obesity.
• Public health practices and messages that use stigmatising approaches to promote anti-obesity campaigns are objectively harmful. The group calls for public health authorities to bring such practices to an end and increase scientific rigour in obesity-related public policy.

"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 & Obesity at University of Connecticut, USA. "It is critical that efforts to address this problem include support and action from the medical community."

"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," said Professor Rubino.

"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."

Those signed up to pledge include more than 100 organisations worldwide, including scientific societies, academic institutions, medical centres, scientific journals (including all Nature journals), 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.