Niamh Arthurs: Pandemic has amplified language that stigmatises obesity

On World Obesity Day, registered dietitian Niamh Arthurs outlines how restrictions in the current Covid-19 pandemic have increased mental health challenges for this group
Niamh Arthurs: Pandemic has amplified language that stigmatises obesity

Some positive change is happening. One example is this image which is not the usual photo of a person with obesity without a head in a stereotypical situation. Photo via World Obesity Federation.

As we mark World Obesity Day today, researchers are calling on the Government to implement the Obesity Action Plan in light of the fact that people living with obesity have experienced heightened mental health challenges and stigmatisation in the pandemic. 

According to Dr Jean O’Connell, Chair of the Association for the Study of Obesity on the Island of Ireland, people living with obesity have an increased risk of severe illness with Covid-19, and the pandemic restrictions have heightened mental health challenges for this group. 

“These combined physical and psychological vulnerabilities have highlighted the need for a proactive approach to treatment of obesity in Ireland. We need to stop being influenced by food and diet industry vested interests, and start practicing evidence-based medicine, as we do for other chronic diseases. 

"We need to see cross governmental support and funding for full implementation of the newly launched Model of Care for Obesity Management in Ireland. This includes equal and timely access to accredited multi-disciplinary community and bariatric surgery centres, and reimbursement for medications proven to support weight loss interventions," she says. 

World Obesity Day is intended to increase awareness of the root causes of obesity and improve understanding of the actions required to address them. It is a day for encouraging advocacy in order to address the common perceptions in society that drive unfair weight bias and stigma and make it even more difficult for individuals and families affected by obesity to receive proper clinical care and access to treatment. 

This is a day that encourages collaboration across stakeholders, policy makers, healthcare professionals, individuals affected by obesity and society as a whole. By working together, knowledge and experiences can be shared to drive policy improvements and stipulate change that ultimately prioritise obesity as a health issue and enable more supportive environments and better care to be developed.

In September 2020, Irish researchers into obesity co-hosted a successful four-day event called ECOICO2020. Following that, researchers are calling for implementation of the Obesity Action Plan. Different research groups will mark World Obesity Day today by hosting an online event. 

Niamh Arthurs BSc, MSc is an ASOI Committee Member and a Registered Dietitian and Researcher in Child and Adolescent Obesity.

Niamh Arthurs BSc, MSc is an ASOI Committee Member and a Registered Dietitian and Researcher in Child and Adolescent Obesity.

With the theme 'Addressing Obesity Together' this collaboration of healthcare professionals, researchers and people living with this chronic relapsing disease, is an opportunity for everyone to join and learn about working together in Ireland towards achieving a more informed and just society which will enable happier, healthier and longer lives for everybody. 

As Bernadette Keenan of the Irish Coalition for People Living with Obesity (ICPO) says, involving healthcare professionals, multi-disciplinary weight management services, researchers, medical and other health professionals and people who live with obesity in addressing obesity together is crucial. "Sharing the patient experience is done so in the hope to reduce stigma and also educate that obesity is a disease which needs ongoing treatment and care".

The Covid-19 pandemic has amplified stigmatising and controversial thoughts on obesity which further drives the common but incorrect public narrative of “eat less and move more” as the main way to treat obesity. 

This public shaming and blaming heightened by the use of inappropriate imagery, dramatic headlines and inaccurate statements is extremely distressing and damaging to those affected by obesity and reduces the likelihood of people receiving the care and treatment needed. 

It is a vicious cycle which needs to end.

The Department of Health recently published Ireland’s national Obesity Policy and Action Plan (OPAP) Progress Report and outlined significant achievements, including:

  • The introduction of a sugar-sweetened drinks tax, which commenced on 1st May 2018; 
  • The appointment of a national clinical lead for obesity in the HSE, with work advanced on the development of a model of care for the management of overweight and obesity; 
  • The publication of new healthy eating guidelines, food pyramid and supporting resources (recently complemented by the healthy eating guidelines for 1-4 year olds); 
  • And the development of nutrition standards for schools.

Although we are making some progress in Ireland there is still a lot more to do. Almost a quarter (24%) of people in Ireland live with obesity; this is your relative, colleague or friend who is affected. 

According to the recent childhood obesity surveillance initiative (COSI) report published in October 2020, 1 in 5 primary school-aged children surveyed in Ireland are living with overweight or obesity. Although this report found that overall rates of childhood obesity in Ireland are plateauing, the prevalence is significantly greater in DEIS schools. 

This highlights the widening gradient between social classes and the necessity to look at current initiatives and supports collaborative action from healthcare professionals (HCPs), policy makers and other key stakeholders who might impact obesity prevention, treatment and care in Ireland.

Much greater understanding in society and across healthcare services is needed that obesity is not the result of ‘wrong’ behaviour and playing the ‘blame and shame’ game does not help individuals or families affected by overweight or obesity. There are complex links between biology, genetics and living environments that contribute to the current prevalence of overweight and obesity in Ireland and in the world. 

We all need to challenge our own thoughts and internal biases on body size or shape and consider the complexities of obesity as a chronic, progressive and relapsing disease. Adults are role models and if children and teenagers observe adults commenting on people’s body sizes or shapes, then that child or young person may do the same. 

Though weight bias and obesity stigma are common, some positive change is happening. One example is the accompanying image which is not the usual photo of a person with obesity without a head in a stereotypical situation. Slowly the media is treating those with a larger body with more respect. 

Photo via World Obesity Federation

Photo via World Obesity Federation

Secondly, real efforts are being made to improve the training of our health professionals in relation to supporting patients with obesity.

The ASOI are supporting people living with obesity and overweight to advocate for their right to respectful and evidence-based care and support. We are helping healthcare practitioners to learn more about their role in treating obesity with evidence-based non stigmatising, person-centered approaches. 

We are pushing for further research, heath systems monitoring, and surveillance that are needed to address this disease. World Obesity Day will include global recognition as well as regional and national campaigns and local activities and events. 

Organisations and individuals from across the world will be participating. The ASOI members represent health professionals, scientists and researchers and patient representatives working together to address the many impacts obesity has on the lives of children, teenagers and adults living in Ireland.

People can register for the ICPO and ASOI World Obesity Day online event here: https://www.surveymonkey.com/r/J9NKV5Q

Reliable sources of information and details about upcoming events and initiatives relating to overweight and obesity in Ireland:

The Association for the Study of Obesity on the Island of Ireland (ASOI)

The Sláintecare Integration Fund Project on Childhood Obesity 

The W82GO Child and Adolescent Weight Management Service at Children’s Health Ireland at Temple Street

  • Niamh Arthurs BSc, MSc is an ASOI Committee Member and a Registered Dietitian and Researcher in Child and Adolescent Obesity.

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